Role of Economic Evaluations in Value Assessments for Pharmaceutical Interventions in the United States

With rising healthcare costs and the availability of innovative treatments that require greater investment in research and development, United States (US) payers and policymakers have been discussing broader use of economic evaluations for pricing and reimbursement decision-making. Gain knowledge of how economic evaluation, value assessment, and health technology assessments evolved historically in the US and how American payers are currently using such assessments. Learn about the implications of new policy proposals such as allowing for value-based pricing and reimbursement negotiations among public payers. Gain an understanding of the process and evaluation methods used by the Institute for Clinical and Economic Review (ICER), an independent organization that specializes in assessing health technologies in the US. Review differences in economic evaluation methods used by ICER compared with those used by other US value assessment frameworks and evidence typically submitted to US payers. The structure and process of deliberation employed by ICER’s independent panels and US payers’ pharmacy and therapeutic (P&T) committees will be compared.

Study case studies on how interactions between stakeholders (e.g., patient advocacy groups, payers, and manufacturers) and the value assessment group may have impacted the recommendations or decisions. Learn about effective stakeholder communications strategy for assessments of hypothetical new treatments under a variety of review scenarios.

After the completion of this course, participants will be able to:

• Understand how the use of economic evaluations for pricing and reimbursement decisions for new pharmaceutical innovations has evolved in the US.
• Identify which organizations include economic evaluations in their health technology assessments and contrast differences in methodologies.
• Discuss implications of potential policy changes toward broader use of economic evaluations by public payers in the US.
• Understand what to expect during each technology assessment by organizations such as ICER.
• Develop strategies for how to collaborate with the assessment group to ensure the value assessments are conducted using the best available evidence.

The access period once enrolled into the course is 60 days from the date of purchase. After this duration, you will need to re-enroll if you wish to re-enter the course.

Time to complete – approximately 4-6 hours