opportunities and challenges for hta in asia-pacific (part 2)

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Opportunities and Challenges for HTA in Asia-PacificPart 2 of 2 (If you missed part 1, you can also find it on SlideShare.)

A roundtable interview.

AUDIO INTERVIEW!

Turn on your speakers.

Opportunities and Challenges for HTA in Asia-Pacific

IMS Experts: Mandy Chui, Practice Leader, Pricing and Market Access, APJ

Jonathan Tierce, GM, Health Economics & Outcomes Research

Guest Speakers:Dr. Annie Chicoye, Associate Professor, ESSEC Santé Business School France - Singapore

Dr. Abdulkadir Keskinaslan, Market Pricing Director, APAC, Novartis Pharma AG Basel, Switzerland

Length: ~9 minutes

To download an MP3 of this interview, click here.

To download the PDF transcript, click here.

Questions? Comments? Fill out the form at the end of this presentation.

http://goo.gl/19dbS

http://www.imshealth.com/deployedfiles/imshealth/Global/Asia%20Pacific/Content/Static%20Files/Opportunities%20&%20Challenges%20for%20HTA%20in%20Asia-Pacific%20Transcript.pdf

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So what can Asia-Pac learn from Europe in terms of HTA?

AC: I think the key takeaway from the experience in Europe is that the role of HTA in the decision process may vary from one country to another, but it has to be clear to all stakeholders and it has to be based on appropriate data and expertise. I can see there is clearly an opportunity in Asia-Pacific’s emerging markets to avoid the painful process we have been through in Europe, where it took a long decade before HTA was really introduced and became one, but not the only one, of the major components of the health expenditure regulation process.


To download the PDF transcript, click here.

Questions? Comments? Fill out the form at the end of this presentation.

http://goo.gl/19dbS


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Thanks, Annie. And now, I think Abdulkadir can enlighten us on some other innovative solutions that may come out from some of the emerging countries and in some time to come, European countries might learn from what is going on in Asia.

AK: Thank you Jon. Yes, we having been using some innovative partnering or contracting approaches, which we sometimes call “pricing schemes,” to create value in Asia’s emerging markets. In a nutshell, health care strategy is all about how you spend your money, not how much money you spend. What we have seen is that some countries are more efficient than others at spending their money.


To download the PDF transcript, click here.Questions? Comments? Fill out the form at the end of this presentation.Know more on IMS Health, click here

http://goo.gl/19dbS


http://ims-possibilities.com/?utm_source=slideshare&utm_medium=slides&utm_content=opps+and+challenges-2&utm_campaign=smpassive


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What do you mean by that?

AK: Well for example, the UK has proven to be five times more productive than he US at managing Type II Diabetes.

Also I should add that we should not forget that the ultimate goal of these contracting arrangements, these “deals,” made by manufacturers of drugs and payer-decision maker should be improving the value of the drug.



http://goo.gl/19dbS




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So what kinds of arrangements are there?

AK: I group them into innovative “pricing schemes” and “market access schemes”. But we can also further group innovative pricing schemes into “financial outcomes-based” and “risk-based” models. The financial models are very easy to interpret. For each patient segment, you define a price or a reimbursement such that you progressively discount your product as its use expands.

For outcomes-based models there are a few examples, still tough to find in Asia, but from experiences in the UK and the US, where reimbursement is based on the outcomes delivered and if it isn’t delivered, the manufacturer provides a rebate.



http://goo.gl/19dbS




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And the risk-based pricing models? How do they work?

AK: Risk-based pricing models are extensively done in Australia where you put your patient segments or indications into different risk segments, and for each patient segment the products are based on the relative cost-effectiveness ratio. If it justifies the price then your ultimate price is the weighted average price in terms of population across the different indications.



http://goo.gl/19dbS




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These are all categorised under the Innovative Pricing Scheme idea, but does that work in markets where the consumers are the decision makers?

AK: That’s a good question. In these types of markets we typically see “willingness to pay” pricing models and “affordability based” pricing models.

How do these work?

AK: Basically on the willingness-to-pay concept, you provide incremental discounts based on patients’ compliance. To enhance the value of the program, you can give an upfront discount or you can provide additional services, free diagnostic tests if necessary, depending on the disease.



http://goo.gl/19dbS




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I see. And the Affordability model?

AK: Here you try to address the patients’ ability to pay and you try to charge accordingly. When there is no ability to pay, you try to provide access to patients. In the end companies try to match their investment with growing insurance schemes as well as some commitments from governments.



http://goo.gl/19dbS




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Can you give us some examples of countries where this is working?

AK: In China, we know that high price products are identified for face-to-face negotiations. That is a different way to negotiate prices as we looked into how things were happening in the past. Korea, Taiwan and partially Thailand are working on developing guidelines on how to assess this. And then in the Philippines and Indonesia, there are a lot of differential pricing projects also in line with the development of insurance schemes. They are covering partially the lowest income level of the population or some of the insurance schemes are for governmental workers.



http://goo.gl/19dbS




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What are some of the measures that Novartis is taking?

AK: Well, in the Philippines there are a lot of examples of patient access schemes. Novartis also has a programme, we call it KAAGAPAY, where we try to bring disease management programs and other benefits to the patients who enrol into this programme. And then the Glivec® International Patient Assistance Program, or GIPAP, is a well-known example of an affordability based model in Asia-Pacific (and most countries are aware of this) where a third-party assesses patients’ ability to pay and there support is provided to the patient.



http://goo.gl/19dbS




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So, do different schemes work better in certain countries?

AK: Absolutely. For example, we have a pilot in India. Here, for an expensive per-unit product we have provided different options to the patient together with the physician to decide what would be best for them. So, this could be either an incremental discount, assigned on bonuses, but after all if the patient needs more therapy, more vials, one option could be a fixed discounted price, the other option could be after the initial first three injections we have identified a fixed price that if patient pays that then patient can claim up to nine vials, or as many as are needed as time progresses.



http://goo.gl/19dbS




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These schemes seem highly flexible.

AK: Yes that is the idea. We are also piloting for the first time capping a price for a self-pay, because we usually have these kinds of agreements in the UK. We are testing whether we can just charge a patient a certain amount and then for the next two years the patient is free to claim as much as is needed aligning with their physician. So based on the disease type and the progression, physicians may choose from these options.

Thanks Abdulkadir. It certainly seems that there are numerous opportunities for innovative partnering and program offerings in emerging markets. I’m sure we will hear of more as this region develops.



http://goo.gl/19dbS




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Mandy and Annie, do you have anything to add to the points Abdulkadir has raised? Mandy?

MC: Thank you Jon. This has been an interesting discussion, and I would end by repeating your point earlier that we have people who are very interested to bring HTA into Asian markets. I think Asia will be in a good position now to learn from our European colleagues.

Hopefully, here in the Asia-Pac region, we have the potential to leap-frog over some of the developmental history of Europe and adopt “best practices” in HTA. Also, I am fascinated and encouraged by these innovative, multi-stakeholder, risk-sharing arrangements. By sharing responsibility for developing health care arrangements in the region, we can all benefit.



http://goo.gl/19dbS




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Thank you Mandy. Annie, your final thoughts?

AC: Yes I agree with Mandy. It is time to adopt HTA here in the Asia-Pacific region, but as I mentioned earlier, HTA would be one component, albeit a major one, of the health expenditure regulation process. However, we should also be looking at some of the innovative pricing models that Abdulkadir has been describing.



http://goo.gl/19dbS


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Thank you too Annie. Abdulkadir, your final thoughts?

AK: Yes Jon. I would say that this is an exciting time in the region where we can learn from Europe and adapt models to suit the rapidly developing Asia-Pacific environment.

OK, well my thanks go to our three panellists today: Mandy Chui, Annie Chicoye and Abdulkadir Keskinasian. And thank you, audience, for your attention.



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Thank you for listening! If you missed part 1, it is also available on SlideShare!

• To download an MP3 of this interview, click here.

• To download the PDF transcript, click here.

• Questions? Comments?

− Fill out the form at the bottom of this slide, or

− Visit www.imshealth.com or email [email protected].

opportunities and challenges for hta in asia-pacific (part 2)

Health & Medicine

ims health

pdf transcript

roundtable interview

audio interview

market pricing director

market access schemes

role of hta

terms of hta