HS2 - Medication Adherence as a Value Message: A Rarity In Evaluation Assessments Submitted to Major Hta Bodies

Abstract

Poor or non-adherence causes medical and psychosocial complications for patients and represents a considerable financial burden for health care systems worldwide. Medication adherence problems have not been routinely highly valued by health technology assessment (HTA) bodies in their evaluation assessments. In this study we assess the extent to which leading HTA bodies consider the value of medication adherence in their reimbursement decision making. Evaluation of published assessments made from 2010 to 2013 in five leading HTA bodies (Canadian Agency for Drugs and Technologies in Health (CADTH), the French National Authority for Health (HAS), England’s National Institute of Health and Care Excellence (NICE), the Australian Pharmaceutical Benefits Advisory Committee (PBAC) and the Scottish Medicines Consortium (SMC)) were reviewed for asthma, hypertension, diabetes, multiple sclerosis, psychological disorders and alcohol dependence. The primary outcome measure was to identify the number of assessments in which HTA bodies have considered adherence as a value message. A total of 405 evaluation assessments were submitted to HTA bodies for the above stated indications and timeframe. Out of these assessments, adherence was discussed in 65 (16.1%) of the assessments. However, adherence was not considered valuable for reimbursement decision making by HTA bodies in 19 of these 65 assessments. In the remaining 46 assessments, adherence was considered as a value message while making reimbursement decisions by the HTA bodies but it did not impact the final reimbursement decision in 79% of the instances. Leading HTA bodies have not considered medication adherence as a key metric in their reimbursement decision making.