MM7 Issues in Developing Economic Models for Managed Care: The Case of Osteoporosis Prevention

Abstract

Although efficacy and safety data remain the mainstay of formulary decisions, the need for economic evaluation of new pharmaceutical products has become increasingly important within the managed care environment. For many new products, insufficient information is generated from clinical trials to conduct a comprehensive economic evaluation. Therefore, economic modeling is often the only feasible option for delivering timely information to decision makers about a new product's value. Unfortunately, economic models presented to managed care plans often have limited usefulness because they lack relevance or applicability to the plan's members or the overall goals of the organization. Of considerable importance is whether the model takes a budgetary perspective, enabling the plan to evaluate the financial impact of the product's benefits and costs over the short term. Also important is the extent to which the model reflects the plan's population and the anticipated clinical benefits of the product in a “real-world” setting. This workshop will discuss issues related to developing an economic model for the prevention of osteoporosis that is targeted to the managed care audience. Topics will include: (1) clinical and economic consequences of osteoporosis that are relevant to managed care in the short term; (2) characteristics of osteoporosis prevention that present unique challenges to modeling; (3) issues in using surrogate measures (e.g., bone mineral density) in an osteoporosis model; and (4) the potential impact of compliance on the cost-effectiveness of preventive therapies for osteoporosis. The goal of this workshop is to heighten the participant's awareness of the pharmacoeconomic needs of managed care and to provide guidance on developing useful economic models for this audience.