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Quantifying Impact of Alternative Payment Agreements on Research and Reimbursement Decisions for Gene Therapies

Renske ten Ham

Thursday 30 May 2024, 11.15AM to 12:15pm

Speaker(s): Renske ten Ham, Utrecht University

Abstract:

Gene Therapies (GTs) provide new treatment options for disease with high unmet medical need. To address economic challenges for GTs, an increasing body of literature discusses payment in instalments with or without conditions, as opposed to traditional on-off upfront payment. Uptake of such alternative payment agreements models are explored by healthcare systems and payers across the globe. To move from theory to practice systematic assessment of these schemes, their design and impact on population health and costs is needed. 

Traditionally, reimbursement decisions are binary: Approve or Reject. However, newer policies like "Only in Research" (OIR) and "Approval with Research" (AWR) offer earlier access while allowing for the collection of evidence to reduce uncertainty. OIR allows access within a defined research population, while AWR gathers more evidence with wider access. Claxton, Palmer et al. were the first to develop a transparent framework making the key principles, assessments, and decisions explicit. In this framework, under traditional one-off upfront payment models GTs are expected to be mostly guided towards an OIR policy decision. This hampers widespread access to these new technologies. Combining the systematic assessment population health and value of additional information of the OIR/AWR-framework with alternative payment agreements is a novel approach which could move application and design of alternative payment agreements forward and increase patient access.

Therefore, the aim of this research is to assess impact of applying alternative payment agreements between manufacturer and payers on Approve, AWR, OIR or Reject policy choices. This is done via a case study of recently authorized gene therapy indicated for severe Hemophilia A.

Location: Presented in-person in A/019/020 with Zoom available (not recorded)

Who to contact

For more information on these seminars, contact:
Alfredo Palacios
alfredo.palacios@york.ac.uk
Shainur Premji
shainur.premji@york.ac.uk

If you are not a member of University of York staff and are interested in attending a seminar, please contact
alfredo.palacios@york.ac.uk 
or
shainur.premji@york.ac.uk 
so that we can ensure we have sufficient space

Economic evaluation seminar dates

  • Thursday 30 May 2024
  • Thursday 18 July 2024
  • Thursday 19 September 2024
  • Thursday 17 October 2024