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Communicating value

The global recession has changed the way the industry needs to market its medicines
Communicating value

Austerity measures across Europe have driven cuts in health budgets, sharp price cuts, a rapid acceleration in HTA, restricted formularies and a shift in the balance of power from prescriber to payer. In this new environment companies are searching to associate their medicines with that most desirable of qualities: value.

But what is value? And how can industry best demonstrate and communicate it?

We should start with better patient outcomes, but better outcomes are not always enough. A clinical trial is not a value proposition and clinical effectiveness is only one half of HTA evaluation. In cost constrained health systems we have seen health systems retreat into using older and less effective, but cheaper, medicines.

Industry has always sought to understand the prescriber mind-set, and in future it must grant the payer and provider equal status

HTA is the preferred tool to determine value, but true value goes beyond the algorithms, QALYs, and ICERs, which seek to justify price. The failure to create the much-heralded value-based pricing system in the UK shows the limitations of HTA systems. The complexities of health and social care systems cannot yet be crunched adequately into health economic models. HTA is a necessary hurdle, but it only gets us so far. And we know that achieving cost effectiveness does not guarantee uptake.

Medicines can make significant positive impacts on healthcare systems in terms of efficiency and productivity, reshaping patient pathways to enable system reform. This value must still be realised in practice by healthcare professionals and managers.

In England the NHS-driven Medicines Optimisation programme will this year engage local payers and providers on the ability of good medicines usage to improve patient adherence and outcomes and reduce costly complications and hospital admissions.

But marketers need to find differentiators for their medicines beyond these class based initiatives. Value must be found more specifically for individual medicines. To do so industry must put itself in the mind of the payers and provider. What are they trying to achieve? What incentives or mechanism exist within or between the payer or provider organisations to drive behaviour and performance? How can some of the clinical differentiators of your medicines align with a health system's goals to provide additional unique value?

Industry has always sought to understand the prescriber mind-set, and in future it must grant the payer and provider equal status. This is how to develop a new and richer value proposition which blends both the clinical and patient benefit with the financial and operational system benefit.

The customer continues to integrate, through the rebalancing of power from prescriber to payer and provider management. Industry needs to continue the integration of its market access and prescriber communication activities, and the communication agencies it employs should break down their silos too.

The messages that emerge from this process create a 'value-led communications' approach which can resonate more effectively with commercial and clinical audiences alike.

This agenda is growing. With European economies growing slowly if at all, health budgets will continue to be challenged. Measures such as the radical expansion of co-payments for prescription medicines in Spain, or severe price cuts elsewhere for pharmaceuticals, are now accepted. We are seeing instances, eg in HCV, where simple affordability, rather than cost effectiveness, is a major factor in spending decisions. And the fact that industry has few friends who will defend it when accused (rightly or wrongly) of high prices and profits makes it an easy target.

Governments and payers are also growing in confidence about tough measures. They know that voters and patient advocacy groups are more cognisant of the need for difficult choices in austere times. In the UK the English NHS has taken 25 cancer treatments off its formularies in the Cancer Drugs Fund (CDF), denying them to future patients only months before a general election. Contrast this with the 2010 election when the CDF was created as a vote-winning ploy to ensure that all cancer medicines were available.

Making product differentiating claims with clinical and wider value benefits can sometimes be dismissed by HTA and payers due to weakness of data, perhaps because trials were not established to study these specific areas. In the future, real world evidence will be needed and employed more and more, either pre- or post-licence, to engage prescribers, payers, and HTA in the value of a medicine. The value debate is really only just beginning.

Article by
Andrew Harrison

Director of Global Healthcare at Hanover.
Contact him via email
 or call +44 (0)20 7400 4480

20th February 2015

From: Sales



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