Join Us at ISPOR!

Join IVI friends and colleagues for a networking social happy hour event!

Tuesday, May 9th from 4:30 – 6:30 PM EDT

Row 34 Boston, 383 Congress Street, Fort Point, MA 02210

RSVP HERE

Issue Panel

Date: Monday, May 8, 2023
Time: 4:45 PM – 5:45 PM EDT

Moderator: Lotte Steuten, Office of Health Economics, London, UK

Panelists:

Ravi Mehrotra, PhD, 5point0, New York, NY, USA
Michael Ward, MS, Alliance for Aging Research, Washington, DC, USA
Jason Spangler, MD, MPH, FACPM, Innovation and Value Initiative, Alexandria, VA, USA

ISSUE: The US Pharmaceutical market is the largest in the world, resulting in high biopharmaceutical investment in research and development (R&D). As an attractive market with prices determined by private market negotiations, the US benefits from early-launches, ensuring patients currently obtain the fastest and widest access to therapies in the world. The new Inflation Reduction Act (IRA) contains measures to curb Federal spending on medicines. The impact of these measures is uncertain, but this session provides some early perspectives on their possible impact on incentives for developers, launch timings for new medicines and indications, and patient access.

OVERVIEW: We present and debate the potential implications of the IRA on drug development incentives and patient access, drawing on examples from relevant disease areas and lessons from Europe, where price negotiations have been standard for many years. Steuten will moderate, setting the scene by briefly introducing the IRA and specifically its price negotiation provisions, and outlining transferable evidence from Europe, providing early evidence on the link between price/expenditure limits and access delays. Mehrotra will provide an investor’s perspective, outlining the potential impact on incentives for drug development and concomitantly the impact on innovation across therapeutic areas. Ward will provide a patient’s perspective on access to emerging therapeutics for Alzheimer’s disease and other treatments focused on older adult populations. Spangler will outline the challenges and benefits of using value assessment elements in price negotiations, balancing equitable patient access and financial sustainability. Each speaker will talk for 8 minutes, before the panel together look forward and discuss (13 minutes): How can we work together to optimize the negotiation process and the implementation of the IRA? What lessons can be leveraged from elsewhere? Steuten will encourage an open debate, seeking additional questions and perspectives from the audience (15 minutes).

Workshops

Date: Tuesday, May 9, 2023
Time: 10:15 AM – 11:15 AM EDT

Discussion Leader: Michael Willis, PhD, The Swedish Institute for Health Economics, Lund, Sweden

Discussants:

  • Tara Lavelle, PhD, Tufts Medical Center, Boston, MA, USA
  • Richard Chapman, PhD, MS, Innovation and Value Initiative, Alexandria, VA, USA
  • Kimberly Westrich, MA, Xcenda, Carrollton, TX, USA

PURPOSE: Despite evidence that treatment value often varies across patient subgroups, coverage decisions in the US are usually based on evidence aggregated at the population level. Thus, patients diverging from the average risk “being denied for being different,” as cautioned by the National Pharmaceutical Council, with suboptimal patient and economic outcomes. The purpose of this workshop is to promote cross-stakeholder awareness of the implications of unaddressed heterogeneity in comparative economic analysis and discuss how best to promote evidence generation capable of supporting patient-centered decision-making.

DESCRIPTION: The workshop will begin with an overview of heterogeneity in comparative economic analyses, including a discussion on the important sources relevant to the decentralized US setting (e.g., socioeconomic, geographic, insurance, and provider variability). Methods to address heterogeneity and implementation challenges will be outlined (Willis, 10 minutes). Next, the consideration of heterogeneity in the US cost-effectiveness literature will be discussed, leveraging results from two Tufts Cost-Effectiveness Analysis (CEA) Registry samples. Good practices and opportunities for improvement will be illustrated via examples from the literature (Lavelle & Willis, 10 minutes). The next discussant will highlight under-appreciated and under-studied sources of heterogeneity that may be particularly important in the decentralized US setting (Chapman, 10 minutes). The last discussant will present the payer perspective, including issues with implementation in health benefit design, such as resource constraints, institutional barriers, and equity concerns (Westrich, 10 minutes). An interactive case study that includes various sources of heterogeneity will be used to facilitate audience participation. This hands-on learning exercise will highlight the importance of considering all relevant sources of heterogeneity when tailoring analyses to decision problems. Different stakeholder viewpoints, evidence requirements, and barriers to  implementation will be discussed (All, 20 minutes). This workshop will be valuable to researchers, payers, patient representatives, and manufacturers interested in ensuring that comparative economic analysis supports patient-centered decision-making.

Date: Tuesday, May 9, 2023
Time: 4:45 PM – 5:45 PM EDT

Discussion Leader: Richard Xie, PhD, Innovation and Value Initiative, Newton, MA, USA

Discussants:

  • Jon Campbell, PhD, Institute for Clinical and Economic Review, Hingham, MA, USA
  • Joshua Krieger, PhD, Entrepreneurial Management Unit, Harvard Business School, Newton, MA, USA
  • Maia Z. Laing, MBA, Optum, Washington, DC, USA

PURPOSE: The purpose of this workshop will be to (1) discuss the strengths and weaknesses in accounting for innovations in existing approaches to health technology assessments (HTA), (2) identify prioritized areas for methods and data research to better define and measure innovations, and (3) outline practical steps that different stakeholders can take to advance the methods and practice to better account for innovations in HTA.

DESCRIPTION: Over the past decades, innovations in health technologies have been a major contributor to improved life expectancy and quality of life. However, as biomedical and digital innovations accelerate, the methods and practice to define and measure innovations in HTA are not keeping pace. The Innovation and Value Initiative (IVI) convened a multi-stakeholder expert roundtable to identify prioritized areas that need further research in methods and data to better define and measure innovations. This workshop brings together cross-stakeholder participants to highlight these prioritized areas, and outline action steps that stakeholders can take to better account for innovations in HTA. In this workshop, Dr. Xie will first discuss the importance of considering innovations in HTA and briefly introduce the Expert Roundtable held by IVI to identify prioritized areas for research (8 minutes). Ms. Laing will provide an overview of how innovative properties of health technologies are being considered in current approaches to HTA, and discuss their strengths and limitations (8 minutes). Based on the results from the roundtable held by IVI and live-polling with the audience, Dr. Campbell will discuss prioritized areas for additional research, and how novel methods and data can be better integrated into existing HTA frameworks (8 minutes). Dr. Krieger will discuss the steps that stakeholders can take to better account for innovations in HTA, and the likely impacts on patients’ well-being and long-term dynamic efficiency (8 minutes). The workshop will end with a facilitated dialogue and live Q&A with the audience.

Podium Presentation

Date: Tuesday, May 9, 2023
Time: 1:45 PM – 2:45 PM EDT

Presenting Author: Alejandro Amill-Rosario, PhD, MPH, University of Maryland, School of Pharmacy, Baltimore, MD, USA

Summary:

  • A discrete choice experiment was developed based on patient-informed priorities in major depressive disorder (MDD) and administered to a representative sample of 300 patients. Based on the survey data, this study aimed to quantify the preferences for treatment attributes and the relative attribute importance, overall and by severity subgroups.
  • In evaluating treatment options for MDD, relationships and hopefulness were preferred over productivity and treatment effects by people with MDD. These findings were similar by depression severity subgroups.
  • These findings revealed patient priorities in treatment selection and can be used to inform patient-centric elements for economic evaluation for health technology assessment.

Posters

Poster Session: 1
Poster Code: HTA17

Date: Monday, May 8, 2023
Time: 9:45 AM – 1: 15 PM EDT

Presenting Author: Richard Chapman, PhD, Innovation and Value Initiative

Summary:

  • This study aimed to identify best practices to ensure health equity is integrated into health technology assessment (HTA).
  • Following key informant interviews, literature review, and guidance from a Steering Committee, two expert roundtables were convened including discussants representing lived experience, patient advocacy organizations, researchers, payers, clinicians, and industry.
  • Roundtable participants identified best practices, grouped into near-term actions; actions requiring further exploration, testing, or development; and up- and down-stream actions requiring leadership and resources that existing outside of HTA.
  • Near-term actions focus more on process, power, and accountability measures, as well as testing existing methods and approaches.

Poster Session: 2
Poster Code: EE133

Date: Monday, May 8, 2023
Time: 3:15 PM – 6:45 PM EDT

Presenting Author: Michelle Cheng, MHS, Innovation and Value Initiative

Summary:

  • This study aimed to document the process and impact of stakeholder engagement in finalizing the design of a web-based user interface (UI) for an open-source health economic model in major depressive disorder (MDD).
  • The feedback from stakeholders indicated that UI design should be tailored to specific needs, prioritize simplicity, and incorporate clear instructions, explanations, references, and limitations.
  • These findings suggest that stakeholder engagement can result in UI design that may more effectively address the decision needs of different stakeholders.

Poster Session: 2
Poster Code: HTA32

Date: Monday, May 8, 2023
Time: 3:15 PM – 6:45 PM EDT

Presenting Author: Jennifer Bright, MPA, Innovation and Value Initiative

Summary:

  • This qualitative study aimed to identify and refine the elements of a consensus-based framework to center health equity in HTA practice and methods.
  • Key informant interviews revealed that HTA must fundamentally improve how health equity is centered in four domains including (1) people, power and processes; (2) data, inputs, and infrastructure; (3) methods; and (4) communications and use.
  • Future action must focus on refining and sharing best practices, testing equity-focused methods, and transparent convenings, learning-focused discussions, and defining metrics that will measure improvements in HTA to center health equity.

Poster Session: 3
Poster Code: PCR113

Date: Tuesday, May 9, 2023
Time: 9:45 AM – 1:15 PM EDT

Presenting Author: Alejandro Amill-Rosario, PhD, MPH, University of Maryland School of Pharmacy

Summary:

  • Productivity is often considered in economic evaluation, but its importance to adults living with major depressive disorder (MDD) is unclear. The objective of the study is to quantify and compare preferences for MDD treatment among adults with different levels of reduced productivity due to their MDD.
  • Study findings revealed that there was heterogeneity in preference for treatments among individuals of different levels of reduced productivity due to MDD.
  • Such heterogeneity should be considered in treatment selection and economic evaluations for MDD.

Poster Session: 3
Poster Code: EE248

Date: Tuesday, May 9, 2023
Time: 9:45 AM – 1:15 PM EDT

Presenting Author: Julia F. Slejko, PhD, University of Maryland School of Pharmacy

Summary:

  • This study aimed to identify whether previous cost-effectiveness analyses in major depressive disorder (MDD) addressed patient-informed attributes, whether patients were engaged in the model process, and whether patient preferences were incorporated into economic models.
  • The findings indicate that while productivity and out-of-pocket costs are often included in models in MDD from the societal perspective, very few addressed other attributes important to patients, used patient-derived inputs, or included patients in the evaluation process.
  • Methods to incorporate patients and their valued elements as part of a value assessment are needed.

Poster Session: 4
Poster Code: PCR195

Date: Tuesday, May 9, 2023
Time: 3:15 PM – 6:45 PM EDT

Presenting Author: Erica de Fur Malik, MTS, Innovation and Value Initiative

Summary:

  • This project aimed to develop a framework that offers guidance on how to incorporate full range of economic impacts on patients and caregivers in patient-centered research to inform decision-making.
  • A series of multi-stakeholder engagement activities, including a steering committee, key informant interviews, a roundtable discussion, and consensus session, helped inform the development of a framework for researchers to capture economic impacts on patients and caregivers.
  • This framework orients researchers and decision-makers to partner with patients and caregivers throughout any initiative and to use a mixed-methods approach to capturing the full complexity of people’s economic impacts.

Poster Session: 4
Poster Code: HTA75

Date: Tuesday, May 9, 2023
Time: 3:15 PM – 6:45 PM EDT

Presenting Author: Richard Xie, PhD, Innovation and Value Initiative

Summary:

  • This study aimed to identify prioritized areas for future research to better define, measure, and reward innovation in health technology assessment (HTA).
  • A multi-stakeholder Expert Roundtable identified scientific spillover, real-option value, and broader impacts on society as prioritized attributes for research in methods and data.
  • Advancing research through a Call for Papers initiative will help identify innovative solutions to sustain the long-term sustainability of the R&D ecosystem and improve social welfare.

Poster Session: 5
Poster Code: HTA93

Date: Wednesday, May 10, 2023
Time: 8:30 AM – 11:30 AM EDT

Presenting Author: Michelle Cheng, MHS, Innovation and Value Initiative

Summary:

  • This systematic review aims to explore the incorporation of social determinants of health (SDOH) into health technology assessment (HTA) for health equity consideration, using predefined SDOH domains and variables and screening articles from 2012 to 2022 through PubMed.
  • This study reviewed 13 full-text articles on SDOH in HTA and found that only 8 of them explicitly incorporated SDOH variables, indicating the need for further research to develop the use of SDOH variables in practice to promote health equity.

Poster Session: 5
Poster Code: HSD99

Date: Wednesday, May 10, 2023
Time: 8:30 AM – 11:30 AM EDT

Presenting Author: Shihan Jin, MPH, University of Southern California, Los Angeles, CA

Summary:

  • The objective of this retrospective claims analysis was to examine the role of telemedicine in providing access to outpatient psychotherapy for children and young adults with incident major depressive disorder (MDD).
  • The results indicated that telemedicine helped offset the significant decrease in the use of outpatient care and led to an increase in total psychotherapy visits for patients with incident MDD due tot he COVID-19 pandemic.
  • Increases in psychotherapy visits were observed across all races and ethnicities, but racial and ethnic disparities persisted.
  • These findings suggest that access to telemedicine can be an important tool to increase access to mental health services in general, but other initiatives may be needed to close access gaps across racial and ethnic subgroups.