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PAYER PERSPECTIVES ON FUTURE ACCEPTABILITY OF COMPARATIVE EFFECTIVENESS AND RELATIVE EFFECTIVENESS RESEARCH
Rachael Moloney1, Penny Mohr2, Emma Hawe3
1Center for Medical Technology Policyrachael.moloney@cmtpnet.org.
Payers expect comparative effectiveness research (CER) and relative effectiveness (RE) to influence drug access decisions. They will increasingly use policy tools and their own data to manage new drug approvals.
Area of Science:
- Health economics
- Pharmaceutical policy
- Evidence-based medicine
Background:
- Comparative Effectiveness Research (CER) in the US and Relative Effectiveness (RE) research in Europe are evolving frameworks.
- Payers' evidentiary standards significantly influence new drug access and market entry.
Purpose of the Study:
- To understand payer perspectives on the impact of CER and RE on drug access decisions by 2020.
- To explore how evidentiary standards for new drugs may change due to CER/RE.
Main Methods:
- Semi-structured interviews with 14 senior payer officials in the US and Europe.
- Online survey assessing current and future use of CER/RE evidence.
- Analysis of hypothetical cases to gauge acceptance of different study designs and methods.
Main Results:
- Randomization remains crucial for assessing comparative/relative effectiveness.
- Increased use of policy levers like conditional reimbursement and prior authorization is anticipated.
- Observational data may be accepted for CER/RE when drug differences are minor (e.g., convenience).
Conclusions:
- Industry perceptions align with findings: CER/RE will likely alter evidentiary requirements.
- Payers' growing data investments and policy tool reliance will shape future evidence demands for new drugs.
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