Drivers of Social Value Exceed Length and Quality of Life: Evidence from Switzerland

Abstract

S115Even in ideal cases for PBMs, the switch to a biosimilar may lead to 25% lower rebate dollars unless an increase in utilization can compensate for the lower rebate amount. ConCluSionS: In the US, biosimilars need to navigate a complex marketplace of payers including insurance companies, pharmacy benefit managers and government payers as well as providers, prescribers and patients. One key success driver will be to overcome the financial hurdles put up by well-established originator products. Given the revenue dollars at stake, an originator is unlikely to eliminate rebates, but rather to increase rebates to attempt to maintain market share vs. a biosimilar entrant.

Valuation of Treatments for Rare Diseases: A Systematic Literature Review of Societal Preference Studies

“…This was expected because in the first few questions the large and small populations were both in severe states of health (2) As the large number of patients was moved to less severe conditions, however, the presumption of priority to the larger population weakened. Participants expressed a willingness to some extent to sacrifice numbers for the sake of prioritizing the worst off (3) Lack of alternative treatments or options to manage symptoms, particularly pain, took priority over large numbers (4) The findings of the study indicate that respondents would support giving priority to a smaller but more severely ill patient population over a larger patient population when prioritizing the needs of the few is lifesaving, extends life enough to give hope of future improvement, and relieves otherwise intractable symptoms, especially pain Song et al (2018) [ 51 ] Korea Society Personal Contingent valuation NR (+) NR (+) (2) The WTP/QALY based on double-bounded dichotomous choice method was about two times greater for scenarios with severe illness compared with scenarios with moderate illness, except when the treatment was curative (in which situation, WTP appeared to reach a plateau) (4) The WTP for prolonged treatment effects lasting 5 and 10 years and cure scenarios were 1.4, 1.8, and 2.3 times greater, respectively, than in the non-cure scenario (where the treatment effect instantly stopped when treatment was discontinued) Schlander et al (2018) [ 37 ] Switzerland Society Not specified DCE (+) NR NR NR (1) The study provides support for the importance of health state before and after intervention, age, disease prevalence (rarity) and availability of social health insurance as driver of societal preference Richardson et al (2017) [ 20 ] Australia Society Personal + health care DM Rating + TO NR (+) NR (−) (2) The study supports the “severity hypothesis” that implies that a health service increasing a patient’s utility by a fixed amount will be valued greater when the initial health state is more severe (i.e., a social preference for additional priority for services for severe health states). Weights vary significantly from almost 3.0, in which there is maxim...…”

“…Decision-makers and payers have accepted greater costs for orphan drugs, and this acceptance was mostly driven by disease rarity [56]. However, across DCEs, rarity was not valued per se from a societal perspective [21,24,33,[37][38][39]. Members of the general public preferred that health care funds be used to treat common diseases and benefit more patients overall.…”

“…Most of these studies (n = 15) favored allocating funds to more prevalent diseases, even in scenarios in which numbers of patients eligible to be treated were the same for rare and common diseases [21][22][23][24][25][26][27][28][29][30][31][32][33][34]. However, some studies (n = 3) suggested that treatments for less prevalent diseases should be prioritized [35][36][37]. For example, 57% of respondents in a budget allocation survey conducted in the Australian population agreed that it was ''OK to reduce services to the majority by a little to cover the cost of very expensive services needed by the few people with rare illnesses.''…”