Josh feldstein hopr (presentation)


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Josh feldstein hopr (presentation)

  1. 1. Comparative Cost Effectiveness Modeling: Demonstrating a Product’s Value Proposition 3 rd Annual Health Outcomes and Pharmacoeconomics Research Josh Feldstein President and CEO © Copyright 2012 Center for Applied Value Analysis, Inc (CAVA). All rights reserved.
  2. 2. Comparative Cost Effectiveness (CCE) <ul><li>CCE opens vast new pathways for industry, providers, and payers to improve clinical outcomes and reduce overall costs </li></ul><ul><li>CCE changes the way health care thinks about health care </li></ul><ul><li>CCE quantifies the comparative value of pharmaceuticals, med-surg devices and technologies… many for the first time </li></ul>02/29/12
  3. 3. Value Analytics and CCE: A Brief Overview… 02/29/12
  4. 4. Profound Challenge Facing US Health Care, 1 <ul><li>How to manage the almost limitless flow of product innovation from industry? (Innovation does not always mean improvement) </li></ul><ul><li>Pharmaceutical and Medical-Surgical industry, Hospitals, IDNs, ACOs, Payers, and healthcare providers have little or no data on complete course-of-therapy (“episode of care”) economics </li></ul><ul><li>Scarcity of objective comparative drug / device cost effectiveness data makes true value-based (head-to-head) purchase / utilization decisions very difficult </li></ul>02/29/12 Burns LR, Wharton School Colleagues. The Health Care Value Chain. San Francisco, CA: Jossey-Bass; 2002:269.
  5. 5. Profound Challenge Facing US Health Care, 2 <ul><li>Most hospitals seeking to cut costs by 30% over next 3 years </li></ul><ul><li>Government, AHRQ, Medicare focusing on CE, but COST is off the table due to political sensitivities </li></ul><ul><li>The “dollarized” total episode-of-care cost (i.e., total value) of a medication or medical-surgical device in the real-world clinical setting is often unknown </li></ul><ul><ul><li>Increasing scrutiny of industry-provided quantification of a product’s relative value proposition </li></ul></ul><ul><ul><li>This is a huge data gap, leading to incalculably large inefficiency in healthcare delivery and fiscal waste </li></ul></ul>02/29/12 Burns LR, Wharton School Colleagues. The Health Care Value Chain. San Francisco, CA: Jossey-Bass; 2002:269.
  6. 6. So…Overall Product Value and CCE Modeling is Becoming the New Gold Standard 02/29/12 <ul><ul><li>Definition and Process: </li></ul></ul><ul><ul><li>A new awareness of broader, deeper data collection + </li></ul></ul><ul><ul><li>The total comparative dollar assessment of an </li></ul></ul><ul><ul><li>entire episode of patient care + </li></ul></ul><ul><ul><li>Use of CCE data synthesis methods and technologies + </li></ul></ul><ul><ul><li>Aligned HCP/Administration / Payer incentives = </li></ul></ul><ul><ul><li>Comparative Cost Effectiveness Modeling and Programs </li></ul></ul>
  7. 7. CCE’s Impact at Hospitals and Among Payers… 02/29/12
  8. 8. And With Industry… 02/29/12
  9. 9. Key Definitions
  10. 10. Comparative Effectiveness <ul><li>Comparing the clinical impact / effect of one treatment vs. another treatment over an appropriate episode of care </li></ul><ul><li>CE usually excludes costs </li></ul><ul><ul><li>May include measurement in “natural” units such as # of pills or # of office visits, QALYs, etc.   </li></ul></ul>02/29/12 © Copyright 2012 CAVA
  11. 11. Comparative Cost Effectiveness (CCE) <ul><li>Adds the comparative dimension of total cost over a clearly defined episode of patient care </li></ul><ul><li>Looks at comparative outcomes inclusive of the economic impact of AEs, total healthcare resource consumption (time, HR, supplies, etc.), and not JUST product acquisition cost </li></ul><ul><ul><li>All comparative AEs: incidence, severity, duration, and populations identified via in-depth data collection, analysis, synthesis, modeling </li></ul></ul><ul><li>Collects and presents cost (or at least resource use data) alongside the comparative effectiveness data </li></ul><ul><li>Provides all decision makers with very practical and important comparative product data </li></ul>02/29/12
  12. 12. Key CCE Value Analytics Challenges 02/29/12
  13. 13. CCE Modeling Needs Today
  14. 14. CCE Modeling Impacts Brand Team Thinking, Strategies, Programs, and Results <ul><li>To quantify objectively the value proposition of your product to purchasers and HCP stakeholders </li></ul><ul><li>To address the rapidly emerging New Normal: CCE </li></ul><ul><li>Hospitals, IDNs, HCPs, and Payers are increasingly demanding CCE from industry suppliers </li></ul><ul><li>Hospitals, IDNs, HCPs, and Payers are becoming increasingly dissatisfied with industry-sponsored, delivered modeling </li></ul><ul><li>Industry has a huge opportunity ahead </li></ul><ul><li>Some are resistant, some are watching and waiting, some are opportunistic… where are you? </li></ul>02/29/12
  15. 15. Value Analytic CCE Models
  16. 16. Value Analytic Modeling <ul><li>Rigorous yet easy-to-use management decision making tools (spectrum of weighted evidence) </li></ul><ul><li>Combine best available clinical and economic evidence to assess the true, comparative value of one treatment vs. another </li></ul><ul><li>Enable users to obtain relevant estimates of clinical and economic consequences associated with pharmaceutical or med-surg device selections </li></ul><ul><li>Peer-reviewed for validation </li></ul>02/29/12
  17. 17. What’s inside a Value Analytic Model? <ul><li>Interface and integration of medical statistics and health economics, which includes: </li></ul><ul><ul><li>Methods for statistical modeling of cost data </li></ul></ul><ul><ul><li>Integration of clinical evidence within a decision-modeling context </li></ul></ul><ul><ul><li>Includes missing data in economic evaluations conducted alongside clinical trials </li></ul></ul><ul><ul><li>Publishable statistical (econometric) methodologies to perform the evidence synthesis analyses </li></ul></ul>02/29/12
  18. 18. Example of an Online CCE Model Drug Input Dashboard 02/29/12
  19. 19. Sample Online Adverse Event Dashboard 02/29/12
  20. 20. Example of an Online CCE Model Device Output Dashboard 02/29/12
  21. 21. Sample Online CCE Model Pharmaceutical Output Example 02/29/12
  22. 22. Good Practice Standards for CCE Value Analytic Model Design <ul><li>Statement of perspective (e.g. healthcare facility, societal etc.) </li></ul><ul><li>Description of strategies / comparators </li></ul><ul><li>Influence diagram of model / disease pathways </li></ul><ul><li>Development of model structure and assumptions discussed </li></ul><ul><li>Table of model input parameters presented </li></ul><ul><li>Source of parameters clearly stated </li></ul><ul><li>Model parameters expressed as distributions </li></ul><ul><li>Discussion of model assumptions </li></ul><ul><li>Sensitivity analysis performed </li></ul><ul><li>Key drivers / influential parameters identified </li></ul><ul><li>Evaluation of internal consistency undertaken </li></ul>02/29/12 Adapted from Philips Z, Ginnelly L, Sculpher M et al . Review of guidelines for good practice in decision-analytic modeling in health technology assessment. Health Technology Assessment. 2004; 8(36). © Copyright 2012 CAVA
  23. 23. Value Analytics Program Design 02/29/12 Model Structure Design CCE Data Collection and Integration Model Launch Ongoing Enhancements Model 2.0+ Planning and Due Diligence Ongoing CCE ManagementEducation
  24. 24. CCE Modeling: Summary <ul><li>CCE modeling for industry communicates your products total value </li></ul><ul><li>For hospitals / systems / payers, CCE modeling result in: </li></ul><ul><ul><li>Improved clinical outcomes </li></ul></ul><ul><ul><li>Health resource use offsets and reduced total costs </li></ul></ul><ul><li>CCE Models deliver help identify strategies for promoting improved therapeutic purchasing choices and improved outcomes while conserving scarce health care resources </li></ul><ul><li>Prudently applied CCE modeling is a win-win for the entire healthcare industry, supply and HCP delivery chain </li></ul><ul><li>The need to evolve CCE resources and capabilities is NOW </li></ul>02/29/12
  25. 25. Comparative Cost Effectiveness Modeling: How to Demonstrate a Product’s Value Proposition 3 rd Annual Health Outcomes and Pharmacoeconomics Research Josh Feldstein President and CEO