Payer Perspectives on Health Technology Assessment

Watkins, John B.

doi:10.18553/jmcp.2012.18.3.265

JMCP

2012

DOI: 10.18553/jmcp.2012.18.3.265

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Payer Perspectives on Health Technology Assessment

John B. Watkins¹

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Cited by 3 publications

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“…We refer to CER and RE as defined by the Institute of Medicine ( 14 ) and High Level Pharmaceutical Forum ( 15 ), respectively, but use these terms interchangeably as CER/RE throughout this study. We also consider the role of patient-centered outcomes research (PCOR), tradeoffs between different CER/RE designs, and the reliability of existing methods for adjusting for bias in observational research, which remains a major challenge to its acceptability by payers ( 5 ; 16 – 18 ).…”

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confidence: 99%

Payer Perspectives on Future Acceptability of Comparative Effectiveness and Relative Effectiveness Research

Moloney¹,

Mohr

Hawe

et al. 2015

Int J Technol Assess Health Care

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Objectives: Our objective was to gather perspectives from payers on how comparative effectiveness research (CER) in the United States and relative effectiveness (RE) research in Europe will impact evidentiary standards for access decisions of new drugs by 2020.Methods: We conducted semi-structured interviews with fourteen senior officials representing public and private payers, health technology assessment groups, and pricing and reimbursement bodies in the United States and Europe. An online survey assessed current use of CER/RE evidence and potential trends that might influence its use for decision making by 2020. A semi-structured interview elicited payers' definitions of CER/RE and was structured around four hypothetical cases resembling drugs expected to be more common or poised to create policy challenges by 2020. Topics included acceptance of study designs and analytic methods associated with CER/RE. A systematic content review was done to extract relevant information.Results: According to key informants, randomization will remain an essential component for assessing comparative or relative effectiveness. They anticipate greater use of policy levers such as conditional reimbursement or prior authorization to manage diffusion of new drugs. Case studies provided important insights into situations when certain types of CER evidence may be acceptable (e.g., observational data when differences between drugs are largely convenience).Conclusions: Industry perceptions that CER/RE will change payers' evidentiary requirements in the future are consistent with our findings. Growing investment in payers' own data and increased reliance on policy tools to control diffusion of new drugs may also influence the type of evidence industry will be required to produce by 2020.

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confidence: 99%

Payer Perspectives on Future Acceptability of Comparative Effectiveness and Relative Effectiveness Research

Moloney¹,

Mohr

Hawe

et al. 2015

Int J Technol Assess Health Care

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Consideration for Employer-Based and Geographic Attributes Included in Value Assessment Methods of Next-Generation Sequencing Tests

Hart

Spencer

2019

JMCP

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Frequency of Continuous Glucose Monitoring use and Change in Hemoglobin A1C for Adults With Type 1 Diabetes in a Clinical Practice Setting

et al. 2014

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Payer Perspectives on Health Technology Assessment

Cited by 3 publications

References 10 publications

Payer Perspectives on Future Acceptability of Comparative Effectiveness and Relative Effectiveness Research

Payer Perspectives on Future Acceptability of Comparative Effectiveness and Relative Effectiveness Research

Consideration for Employer-Based and Geographic Attributes Included in Value Assessment Methods of Next-Generation Sequencing Tests

Frequency of Continuous Glucose Monitoring use and Change in Hemoglobin A1C for Adults With Type 1 Diabetes in a Clinical Practice Setting

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