The impact of drug quality ratings from health technology assessments on the adoption of new drugs by physicians in Germany.

Katharina Elisabeth Blankart,Tom Stargardt

doi:10.1002/hec.4108

Katharina Elisabeth Blankart, Tom Stargardt

Open Access

https://doi.org/10.1002/hec.4108

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Abstract

Payers are increasingly calling for the value of new drugs to be measured explicitly. We analyze how the availability of drug quality ratings by health technology assessment (HTA) agencies affects the adoption of new drugs by physicians in Germany. We combine data from drug quality ratings, promotional spending, and a physician panel. In a latent utility model, time to adoption is specified as a function of quality rating, promotional spending by manufacturers, and physician-specific variables. As expected, drugs with a positive rating were adopted faster (p<0.001) than those without. However, our results suggest that it was the publication of the quality rating itself that affected adoption. Indeed, before a quality rating was published, drugs that went on to receive a positive quality rating were not adopted significantly faster than drugs that went on to receive a negative quality rating. In contrast, after the publication of the HTA quality rating, drugs with a positive rating were adopted significantly faster than those without (p<0.05). The per physician value of a positive quality rating was EUR 393.50. Our results suggest that there are returns from HTAs beyond their use in price negotiations.

Highlights

In most industrialized countries in 2020, health expenditure continues to rise and public budgets remain tight
When we distinguished between positive quality ratings in terms of the added health benefit a drug was assigned by the health technology assessment (HTA) agency (Model IIIc), a rating of ‘considerable added health benefit’ or ‘minor added health benefit’ appears to be equivalent to an increase in promotional spending per physician of EUR 2,228 and EUR 1,623, respectively, compared with a drug with a published negative quality rating
When comparing adoption rates of the drugs launched in the 2 years before the HTA agency appraisal process was introduced in Germany with drugs that underwent the process (Figure 2), we found that drugs with a published positive quality rating were adopted significantly faster compared with drugs that had not undergone the appraisal process (OR: 0.429, p < 0.001, see Table S3)

Summary

| INTRODUCTION

In most industrialized countries in 2020, health expenditure continues to rise and public budgets remain tight. Awareness is growing that rational approaches to resource allocation are preferable to ones that rely purely on market forces It is no surprise, that public and private payers of health care are increasingly calling for the value of new drugs to be measured in an explicit manner (Neumann & Cohen, 2015). This, in turn, has a variety of implications for measuring health gains for society, health care costs, and the resources available to manufacturers to fund research and development (Sorescu, Chandy, & Prabhu, 2003) Both comparative effectiveness research and HTAs have generated a large body of literature over the past decade, research on the information signals provided by HTAs and how these affect the adoption of new drugs at the micro level has been scant. Our study contributes to the literature by offering a novel approach to quantifying the impact of quality ratings on the speed of drug adoption and the economic value of these information signals

| BACKGROUND

| RESULTS

Findings

| DISCUSSION

| CONCLUSION