Cost-effectiveness and financial risks associated with immune checkpoint inhibitor therapy

Kim, H; Liew, D; Goodall, S

Cost-effectiveness and financial risks associated with immune checkpoint inhibitor therapy

Kim, H Liew, D Goodall, S

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: British Journal of Clinical Pharmacology, 2020, 86, (9), pp. 1703-1710
Issue Date:: 2020-05

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Field	Value	Language
dc.contributor.author	Kim, H
dc.contributor.author	Liew, D
dc.contributor.author	Goodall, S https://orcid.org/0000-0001-6611-6565
dc.date.accessioned	2020-10-01T22:49:16Z
dc.date.available	2020-04-26
dc.date.available	2020-10-01T22:49:16Z
dc.date.issued	2020-05
dc.identifier.citation	British Journal of Clinical Pharmacology, 2020, 86, (9), pp. 1703-1710
dc.identifier.issn	0306-5251
dc.identifier.issn	1365-2125
dc.identifier.uri	http://hdl.handle.net/10453/142983
dc.description.abstract	The reimbursement of immune checkpoint inhibitor is challenging. Funding these technologies involves the careful balance between awarding innovation and ensuring affordability as increases in drug spending compete directly with other health care and social expenditure. This narrative review examined the recommendations of two HTA agencies: Australian Pharmaceutical Benefits Advisory Committee (PBAC) and the British National Institute of Clinical Excellence (NICE) to determine the factors that contribute to the approval and rejection of ICIs as well as the use of manage entry schemes and risk management strategies to control expenditure. Reimbursement decisions from 6 ICI drugs (ipilimumab, pembrolizumab, nivolumab, durvalumab, atezolizumab, avelumab) covering 10 different cancers were examined. The extrapolation of survival beyond the clinical trial and lack of head-to-head evidence are some of the main issues relating to cost effectiveness. Payers managed financial risks using different mechanisms such as risk share agreements and financial caps. This review of the reimbursement decisions and subsequent financial impact in Australia and the UK suggests budgets for immune checkpoint inhibitor therapy have been well managed so far. Through risk agreements and managed entry programs, the example of immune checkpoint inhibitor therapies illustrates that industry and payers can effectively collaborate to ensure that innovative, but expensive, drugs can be made readily available to patients.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	British Journal of Clinical Pharmacology
dc.relation.isbasedon	10.1111/bcp.14337
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1115 Pharmacology and Pharmaceutical Sciences
dc.subject.classification	Pharmacology & Pharmacy
dc.title	Cost-effectiveness and financial risks associated with immune checkpoint inhibitor therapy
dc.type	Journal Article
utslib.citation.volume	86
utslib.location.activity	England
utslib.for	160508 Health Policy
utslib.for	1115 Pharmacology and Pharmaceutical Sciences
utslib.for	1115 Pharmacology and Pharmaceutical Sciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2020-10-01T22:49:00Z
pubs.issue	9
pubs.publication-status	Published
pubs.volume	86
utslib.citation.issue	9

Abstract:

The reimbursement of immune checkpoint inhibitor is challenging. Funding these technologies involves the careful balance between awarding innovation and ensuring affordability as increases in drug spending compete directly with other health care and social expenditure. This narrative review examined the recommendations of two HTA agencies: Australian Pharmaceutical Benefits Advisory Committee (PBAC) and the British National Institute of Clinical Excellence (NICE) to determine the factors that contribute to the approval and rejection of ICIs as well as the use of manage entry schemes and risk management strategies to control expenditure. Reimbursement decisions from 6 ICI drugs (ipilimumab, pembrolizumab, nivolumab, durvalumab, atezolizumab, avelumab) covering 10 different cancers were examined. The extrapolation of survival beyond the clinical trial and lack of head-to-head evidence are some of the main issues relating to cost effectiveness. Payers managed financial risks using different mechanisms such as risk share agreements and financial caps. This review of the reimbursement decisions and subsequent financial impact in Australia and the UK suggests budgets for immune checkpoint inhibitor therapy have been well managed so far. Through risk agreements and managed entry programs, the example of immune checkpoint inhibitor therapies illustrates that industry and payers can effectively collaborate to ensure that innovative, but expensive, drugs can be made readily available to patients.

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http://hdl.handle.net/10453/142983