Things to highlight: This year’s report is a follow-up to last year’s report on the topic of value. It seemed logical and important that any conversation about value in healthcare be followed up with one on the concept of risk.Feel free to mention something current as an example of the attention being paid to risk/benefit.
We really wanted to explore and illustrate that notion that there is no holistic, universal approach to risk/benefit.Further, we felt that much could be learned by comparing sentiment of stakeholders from different healthcare systems.Finally, the UK’s experience with NICE provides an opportunity to emulate efforts that worked and jettison those that didn’t as other countries move toward value-based healthcare.
Emphasize the difference in perception.Strongly emphasize that the industry really needs better, more robust data as well as more sensitive measures to assess risk and benefit.Also, there are things pharma can do now (risk-sharing agreements), in the mid term (collaboration with payers throughout development) and in the long-term (pre-competitive alliances) to better mitigate risk.
There’s a slight trend toward being more optimistic among biopharma and payers, but patients seem less optimistic than they were a year ago. In addition, 60 percent of the U.K. patients are pessimistic about tomorrow’s quality of healthcare. This may be an indictment as to the overall direction of the NHS.
Emphasize that biopharma *STILL* sees the FDA as the bottleneck.But note that nearly a third cite more requests for data and payer reluctance as the BIGGEST challenge.(Remember, this was a pick-one only question.)
This is tough slide to walk through, but we gave patients twelve scenarios (each patient received four, randomly) to assess their interest in a drug that came with a clear benefit (for cancer, 10 years of extended life), (for chronic pain, making pain manageable or eliminating it altogether); as well as the probability of a side effect. Two probabilities of nausea and two probabilities of heart attack.While almost all data showed a trend indicating that patients were willing to accept more risk for more benefit, patients in the UK were far more likely to accept the risks. The takeaway: patients are simply not able to determine risk and benefit on the basis of probability. Biopharma must find ways to better communicate with them.
This is a hard slide to read at this size, but the thing to point out is that the darker portions of each line indicate the percentage of respondents who rated each tool as “excellent.” Obviously, none of these appear to be that great.We also asked what tools are you currently using, and for the most part, the tools that are being used to assess risk are not that highly rated either. Again, emphasize the need for better data and more sensitive measures.
The bullets above say most of it. But in essence, even after 10+ years of use in the UK, HTA is not perceived as adding much value. Which should be a warning sign for biopharma to get involved with the early discussions on how to better incorporate CER into this country. Focus on methodology, etc.
This is great data.All groups are supportive of risk-sharing agreements between biopharma and payers.Pre-competitive alliances are seen as having a positive effect on both speed and qualityPerception among all groups that risk-sharing agreements will increase patient access to medications.Nearly three quarters of biopharma execs and payers from both countries feel that pre-competitive alliances will produce more innovative and effective therapies.Payers would like more involvement in drug development than at the present; particularly in the later phases.
WHAT IS THE NHR?
• The New Health Report is an annual survey of stakeholders who are involved in or impacted by
drug development. Data received from this year’s The New Health Report was obtained from
responses received from biopharmaceutical executives, managed care/payer executives, investors
and patients being treated for a chronic illness. Those surveyed for this year’s report were from the
U.S. and the U.K.
WHY DID QUINTILES UNDERTAKE THIS ANNUAL SURVEY?
• As a global service provider to the biopharmaceutical industry, Quintiles launched The New Health
Report in 2010 to offer perspective and insight into several key topics that are relevant to our
customers. Quintiles continues to commission this stakeholder survey in an effort to better
understand the dramatic changes that occur within the drug development landscape.
HOW MANY PEOPLE PARTICIPATED IN THE SURVEY?
• The New Health Report 2012 is a survey of more than 1,350 U.S. and U.K.-based
biopharmaceutical executives, managed care executives, investors and patients being treated for a
chronic illness. The survey included 102 biopharmaceutical; 75 managed care executives in the
U.S.; 72 NHS executives; 509 U.S. adults and 500 U.K. adults ages 18+ who were diagnosed with
and receiving treatment for a chronic illness; and 100 investment professionals focused on the
Frequently Asked Questions
John Doyle, Dr.P.H., MPH
• Dr. Doyle has authored over 50 original research articles
in a variety of therapeutic areas. As a health economist
and epidemiologist, he has lectured on
research methodologies for academic and commercial
audiences in the U.S., Canada, Asia, Europe and
Latin America. He has consulted global pharmaceutical
and biotech firms on strategic concerns
regarding product development, pricing, reimbursement,
market valuation and other commercialization issues.
• Adjunct faculty member of the Mailman School of Public
Health at Columbia University
SELECTED AREAS OF EXPERTISE
• Comparative Effectiveness Research (CER)
• Rising cost of healthcare
• Drugs for orphan indications
• Healthcare reform and policy
Senior Vice President and Practice Leader,
Commercial and Market Access Strategy, Consulting at Quintiles
Dean Summerfield, D.Phil., M.A.
• Summerfield has worked with a wide range of
pharmaceutical and medical device companies in
engagements from long-term strategy to day-to-day
operations that spanned the clinical and
commercialisation spectrum across clinical, marketing,
market access, medical and sales functions.
• For over 16 years, he has been focused on delivering
management consulting solutions to life sciences clients
with a proven track record of enabling companies to
achieve greater commercial successes and profitable
business growth by creating fact-based strategies and
enabling their implementation.
SELECTED AREAS OF EXPERTISE
• Health Technology Assessments
• Market Access
• Risk-sharing alliances
• Pre-competitive alliances
Vice President and Managing Director - Clinical & Product Development Strategy;
Commercial Strategy; Commercial Effectiveness; Market Access; Consulting at Quintiles
Focus of the 2012 Report
The New Health Report 2011 looked to provide further understanding of stakeholder
perceptions toward value in healthcare and medicine, and called upon open dialog and
ongoing collaboration to foster an environment conducive to pharmacologic innovation.
This report aims to build upon that call for collaboration by exploring the element of
value at risk as it relates to biopharmaceutical development and delivery.
Given the global macro-economic environment and many governments’ focus on
balancing unfeasible budgets through austerity programs, the pressure for
biopharmaceutical companies to demonstrate the value of their products for driving
optimal improvement in public health has never been greater. As such, resulting
policies—i.e., reimbursement and coverage decisions—will in large part be dictated by
a framework that includes a formulaic process for determining a biopharmaceutical
product’s value relative to its risks. Yet, while centralized paying bodies are a critical
component for the ultimate commercial success of a new treatment, all other
stakeholders within the healthcare ecosystem— biopharmaceutical companies,
providers, patients and financial investors—also have to determine the tradeoffs of
how much of value is worth being put at risk, without the benefit of having either a
standardized or centralized formula for doing so.
Rethinking the Risk Equation in Biopharmaceutical Medicine
WHY US & UK?
• An equal number of patients and payers were surveyed from both countries to
enhance the report’s global appeal and relevance to the global economic crisis. The
UK is not only an accurate, progressive representative of Western European countries,
but it also possesses a long track record of using quantitative measures to make
reimbursement decisions for new biopharmaceutical products.
• For the biopharmaceutical industry, data from The New Health Report illustrate that
there is no universal approach to risk/benefit. As such, an opportunity exists for the
industry to engage stakeholders in dialogue to better design and communicate the
various tradeoffs involved in healthcare decision-making.
Payer and Patient Respondents from both the U.S. and the U.K.
• STAKEHOLDERS EACH POSSESS A UNIQUE PERCEPTION AND TOLERANCE LEVEL
OF RISK/BENEFIT WITH REGARDS TO HEALTHCARE AND MEDICINE.
> Biopharma respondents themselves have no clear consensus as to whether their company
should accept more risk in clinical development and commercialization. This could partly be
explained to the current financial state of the company, as companies with looming patent
expirations or thin pipelines will have a different risk-tolerance appetite than companies who are
• BETTER TOOLS ARE NEEDED TO ACCURATELY ASSESS RISK.
> Current metrics used by biopharma and payers are insufficient and fail to account for the varying
degrees of weight different stakeholders assign to clinical, quality-of-life outcomes and value.
• BIOPHARMA AND PAYERS NEED BETTER ACCESS TO ROBUST SOURCES OF DATA.
> Biopharma continue perceives Phase III as the most risky, but also as the phase in which they
feel less confident about available data.
• DESPITE THE PERCEIVED OBSTACLES, OPPORTUNITIES EXIST TO MITIGATE RISK.
> Pre-competitive alliances and risk-sharing agreements are supported by both biopharma and
payers, and are perceived as increasing patient access to new therapies.
For the Biopharmaceutical Industry
Outlook on the Future of Healthcare
• In terms of the quality of healthcare a decade from now, more than two-thirds of
biopharma executives, U.S. payers and U.K. payers plus nearly three-quarters of the
investors express optimism, but less than half of the U.K. and U.S. patients agree.
• Biopharma still perceives the FDA as the biggest challenges for the industry.
Access to capital and payer reluctance to cover new medications are also
Patient Perceptions of Risk
• Patients feel adequately informed about benefit, but feel less informed about
potential risks and side effects.
• Patients are willing, however, to accept greater risks for a greater benefit. This
sentiment is particularly among UK patients.
• Currently used measures
are not perceived as
excellent and do not
adequately assess risk in
• This is likely due to an
underlying lack of
confidence in the data that
feed the model.
• Better tools that are more
reflective of how
stakeholders – particularly
patients – weigh
risk/benefit tradeoffs are
Comparative Effectiveness Research / Health Technology Assessments
• The UK payers’ lack of
confidence in HTA may be a
learning opportunity for
stakeholders in the US as they
rush to embrace CER and value-
• Stakeholders in the US should
focus their CER efforts toward
proper methodology and data.
• As both countries move toward a
more value-based healthcare
system, the UK experience in
weighing risk/benefit must be
Mari Mansfield, Corporate Communications
O: +1 919 998 2639
M: +1 919 259 3298
Laura Wilson, Corporate Communications - Europe
O: +44 118 450 8392
M: +44 7854 173 106
For additional information about The New Health Report