Value effectiveness analyses (CEA) intention to look at how a brand new well being applied sciences impression well being outcomes and prices over a affected person’s lifetime. Whereas extrapolating long-run well being advantages and measuring potential value offsets are essential, one other essential merchandise to estimate is how the price of the brand new well being know-how is prone to evolve over instances. That is notably related for prescription drugs.
Whittington et al. (2024) write:
A drug’s internet worth typically will increase following launch and should later fall as rivals enter the market. Costs often fall extra noticeably after the drug loses exclusivity and generic substitutes grow to be out there. Nevertheless, CEAs prior to now have hardly ever accounted for these potentialities and as a substitute assume {that a} drug’s worth stays fixed over time.
Why is it essential to include dynamic pricing? FDA estimated that generic medication permitted in 2022 yielded $18.9 billion in whole financial savings through the 12 months after their approvals.
…a CEA evaluating a brand new drug to a reasonable different can overstate the brand new drug’s added value over its life cycle if it assumes that the drug’s introductory worth will persist indefinitely. By neglecting to regulate for the “downstream” drop in worth, the CEA could incorrectly recommend the brand new drug represents unfavorable worth. Importantly, assumptions about drug worth dynamics also needs to apply to comparator therapies in an evaluation. Assuming no change in comparator drug costs can overstate the worth of the brand new drug if the comparator remedy is nearing its lack of market exclusivity. A static drug pricing assumption fails to account for anticipated financial savings from the genericization of the choice remedy…
Nonetheless, 95 % of revealed CEAs, together with these carried out by ICER, assume that drug costs stay fixed of their base case.
The necessity for dynamic pricing is especially essential when evaluating pharmaceutical to non-pharmaceutical well being applied sciences.
…omitting anticipated worth declines could make a drug look no extra engaging than an equally efficient non-drug intervention (for instance, surgical procedure) with the identical preliminary worth, though worth declines following lack of exclusivity imply that the drug (in contrast to the surgical procedure) can be inexpensive over the long term.
The commentary continues by including that IRA has make the trajectory of drug pricing extra predictable as a result of (i) worth will increase are restricted to inflation and (ii) IRA permits CMS to barter chosen medication earlier than lack of exclusivity.
To learn the authors suggestions for incorporating dynamic pricing into CEA, you may learn the complete article right here.
