International Healthcare Payers & HTA Summit, Next Level Pharma

hict will be attending the International Healthcare Payers & HTA Summit organised by Next Level Pharma on March 16th & 17th 2011 in Berlin.

The theme is 'How can decision making be improved to minimise risks in drug spending but at the same time, reduce waste, enhance health outcomes and reimburse high-cost, innovative new drugs?'

 “Payers” (health plans, sick funds & insurers, payers, health technology assessors, hospital financial management & health department officials) in almost all circumstances, in both developed and developing countries are under extreme budgetary pressure. Many health systems in the developed world, face ageing populations, economic crisis and rapidly increasing healthcare costs in general, including the sustained cost increases of innovative and novel drugs. This is forcing payers to make difficult choices regarding what medical procedures to fund and what expensive medications to reimburse. No longer are “me too” drugs that have achieved regulatory approval simply approved for reimbursement at high prices. Payers need to make tough decisions based on what they define as “value”, unfortunately sometimes at the expense of funding treatments in some “lower priority” disease indications or individual patients. Despite intense political pressure from patients and stakeholders who believe healthcare is an inalienable “right” and should be “free for all,” the reality is that payers have an finite and limited budget, and face a high-degree of risk in decision making. They operate within an environment where a multitude of products are on offer, each making various therapeutic claims of efficacy and safety, often with insufficient data to validate supposed health outcome improvements over existing treatment options. How can payers make the right decision in a high-risk, high uncertainty environment? Various options and decision-making tools exist, some old, some novel. Traditional decision making based on, for example, price referencing, DRGs budgets or generic substitution are still significant. However, recent advances in the sophistication of HTA analysis and modelling, flexible pay for performance models, risk-sharing and value-based pricing schemes have become increasingly important to mitigate payer risk and allocate financial resources to the areas of pressing need. Savings and outcome improvements can also be found through finding efficiency gains at the healthcare delivery level, providing the right incentives for prescribers and improving patient adherence.

The agenda includes:

1. Approaches to prioritising drug spending with limited data & budget; 
2. Experiences with risk-sharing & outcome-based schemes to overcome uncertainty; 
3. Achieving savings through efficiency gains at healthcare delivery & prescribing; 
4. Patient adherence to achieve real outcomes and minimizing drug wastage; 
5. Readjusting industry/payer communication to improve patient access & outcomes for long-term sustainability; 
6. Improving evidence generation for both regulators & payers; 
7. Utilising advanced HTA methodologies to improve decision making & achieve cost effective outcomes.