PHP286 - RESPONSES OF ISPOR MEMBERS TO THE RECOMMENDATIONS OF THE SPECIAL TASK FORCE ON US VALUE ASSESSMENT FRAMEWORKS

Abstract

The concept of value based healthcare as a metaphor for assessing new therapeutic interventions has yet to identify additional metrics besides cost-effectiveness to inform public and private decision making. An ISPOR Special Task Force on Value Assessment Frameworks has recently been investigating the drivers in reimbursement decisions. Delegates at the ISPOR Europe 2017 Conference were invited to complete a questionnaire that specifically addressed current opinion on value assessment. This random survey attracted over 80 delegates from 24 countries, nearly 60% of whom considered cost-utility analysis to be a necessary component of a Value Assessment Framework. There was little agreement on whether a single transparent threshold for cost-effectiveness was appropriate, with many respondents suggesting a threshold that is much higher than the current cost/QALY. Over half (55%) of respondents considered surrogate endpoints to be acceptable for reimbursement decisions, whilst two thirds (64%) felt that MCDA might be a replacement for the QALY. Over half (53%) also felt that patients should play a more active role in health technology assessments, and risk sharing was considered to be an acceptable method of cost containment by over 70%. Finally, the majority of respondents (74%) felt it appropriate for manufacturers to command high prices for orphan drugs. In a country analysis, albeit limited by small numbers, there was general congruence between Europe and the US, apart from the need for cost-effectiveness analysis (60 vs 36% in favour, respectively). The Special Task Force has now recommended a refinement of the QALY to reflect societal values, and consider MCDA to be a viable alternative, whilst value assessment should incorporate both patient and population perspectives. The findings of this survey of ISPOR delegates were consistent with these recommendations, which illustrates the interest in the need for a Value Assessment Framework to aid reimbursement decisions.