Access to High-Cost Medications: A Balancing Act

UKBlogImageSmallAs continuing innovation moves us further toward personalized healthcare and the development of targeted treatments, how can patients across Europe ensure they have fair access to high-cost medications?

Securing reimbursement remains one of the biggest challenges to delivering market access for new treatments. The debate around balancing tight health budgets with fair access for patients is shaping the way governments and payers respond to these advancements. Cancer treatments are a specific concern, especially those designed to target rare and aggressive cancers, and as such have a particularly high development cost per patient.

So what’s the way forward?

This was the question posed by the Ogilvy Healthworld UK Market Access team earlier this summer when we brought together a panel of leading experts in front of an audience of industry figures, academics and patient representatives.

The panelists discussed the issue from the viewpoint of each of the 4P’s of healthcare—payers, prescribers, policymakers and patients—to chart out the future course of reimbursement.

What was the outcome?

After a far-ranging debate, five key ideas stood out as important for taking the conversation on the introduction of high-cost medicine ahead:

1. While schemes like the UK Cancer Drugs Fund have been a success, they may prove unsustainable in the long term. New systems to assess and support the uptake of new treatments must be a national priority.

2. Three key areas that will affect the cost of medication over the next decade are:

– Technological development; as new innovations make treatments more expensive, not cheaper

– How care is delivered; and potential cost-savings that can be made in reforming healthcare systems

– Whether health systems can reform the way that healthcare is funded to support uptake of new technology

3. New treatments will not necessarily lead to cost-efficiencies, but rather higher costs for payers. This means that demand and pricing must be controlled to maintain a healthy balance between supporting innovation and ensuring access to new medicines for patients.

4. Current value assessments are too narrow and need to be reformed to better reflect their full value. As newer medicines that raise costs are developed, a more complex assessment model will be necessary to ensure that their total cost/ benefit to the healthcare system can be successfully mapped.

5. If payers are to be able to afford new high-cost medicines, cost-efficiencies must be found in the delivery of services. Although healthcare systems should remain a center of healthcare delivery across Europe, it was agreed that the way they operate must fundamentally change to provide care in the most effective way possible. This should be focused on reducing hospital visits and supporting “community-based care” systems.

 

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