Product Value: Are you thinking about it enough?

The pharmaceutical industry is flooded with talk of value; value dossiers, the value story, value messages, value demonstration and value-based pricing. Value is now even more pertinent with the new NHS value-based pricing system launching early next year. This follows the expiration of the current Pharmaceutical Price Regulation Scheme in January 2014. The new scheme aims to have a greater focus on the value medicines offer to NHS patients and the wider community.

The Government’s response to the latest report from the Health Select Committee states that suggested changes to the pricing system appear modest and there are yet to be any final decisions as to how the new system will be used in practice. The Government report advises any such uncertainties should be resolved by the end of this month (March 2013).

What is value?

As value is strongly linked to the price of a new treatment it is important to fully understand what value means in this setting. When assessing the overall value of a medicine, clinical, economic and patient factors must be considered.

Clinical value is defined by the product’s efficacy data from clinical trials and how these compare to existing and future competitors. The safety profile, method of administration and effect when used alongside other treatments are also important.

Economic value can be demonstrated using cost-effectiveness analyses, such as a budget impact model. Indirect costs or out-of-pocket expenses for the patient may also be evaluated.

Value to the patient and carers includes the impact on quality of life, adverse events and ability to perform daily activities. Patient reported outcome tools, such as the EQ-5D, can be used to measure these end-points.

Real world value is a new concept, where the product is evaluated in practice – Do doctors prescribe it? Do pharmacists recommend it? Do patients prefer it? Data from real world studies will help payers re-assess the value of products that are already available.

What does this mean for pharma?

Pharmaceutical companies have an enormous challenge ahead – products will have to demonstrate value in early clinical trials to prevent high research and development costs which may not be able to be recovered. It is also no longer enough for a new medicine to display similar properties to existing products – innovation and an increase in efficacy, reduction in cost, or improved quality-of-life evidence is required.

References

1. NICE. NICE “central” to value-based pricing of medicines. 22 March 2013. Accessed 24 March 2013. Available at: http://www.nice.org.uk/newsroom/news/NICECentralToValueBasedPricingOfMedicines.jsp

2. HM Government. The Government’s Response to the Health Select Committee’s Eighth Report of Session 2012-13 on the National Institute for Health and Clinical Excellence. March 2013 Available at: http://www.officialdocuments.gov.uk/document/cm85/8568/8568.pdf ISBN: 9780101856829

ARE DOCTORS GETTING SMARTER?

Statistics show that in the UK there are a staggering 83 million mobile subscribers, which represents a market penetration of 130%.  Of these, 43%, or 36 million, are smartphones and this percentage is expected to increase to 75% by 2016.[1] Doctors are already ahead of the curve; 80% own a smartphone, 31% own a tablet and many regularly purchase apps to enhance their working lives.[2]

Opinion is divided over whether proactively increasing and encouraging the use of ‘smart’ tools in a medical setting is a good thing or not. Some of the potential pitfalls include the potential for risk of infection, the lack of regulation around their use and the creation of a barrier (leading to reduced credibility) between doctor and patient.  The level of accuracy is also a cause for concern, although apps being used for diagnostic purposes, such as a dosage calculator, may be considered a medical device. These tools must be registered with the Medical and Healthcare products Regulatory Agency (MHRA) to ensure that all the relevant checks have been undertaken.

Putting these concerns to one side, it’s easy to see the potential for apps as an information resource for doctors and patients alike, particularly as mobile technology becomes more sophisticated.  App-enabled accessories new to the market, such as the Nike+ Fuel Band and the iBaby Monitor (controlled from your iPod touch, iPhone, iPad or Mac mouse), have proven to be incredibly popular and an estimated 40% of all new apps are being developed in the health and wellbeing space.

To-date, there has been a lack of national guidance on the use of mobile technology by the medical profession, with decisions taken at a local level. However, the government’s campaign to encourage doctors to ‘prescribe’ smartphone apps, to help patients manage conditions ranging from diabetes to depression, will help to fuel a shift in this area.  The aim of the campaign is encourage patients to take more responsibility for their own health, reducing visits to doctors and thereby ‘putting them in the driving seat.’ For example, the Diabetes UK app reminds patients to check their blood sugar levels and to take their medication, with information sent electronically to the patient’s surgery or clinic.

This initiative will no doubt drive the debate about the use of smartphones in a medical setting up the healthcare agenda, but ultimately the technology will only benefit patients if the content is accurate, responsible and engaging.

Tracey Carey
Director

1. Smartphone Futures 2012-2016, 2012, Portio Research.
2. Doctors.net.uk and T. Ringrose Mobile technology: pharma companies struggle to engage with doctors on the go. 2012.