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Determination of Multiple Sclerosis Indicators for Value-Based Contracting Using the Delphi Method.

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Summary
This summary is machine-generated.

Value-based contracts for multiple sclerosis (MS) medications should prioritize patient-reported outcomes like worsening physical disability and functional impairment. These indicators are meaningful to stakeholders and can improve contract value.

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Area of Science:

  • Health economics
  • Pharmacoeconomics
  • Clinical outcomes research

Background:

  • Value-based contracts (VBCs) link medication costs to performance, aiming to improve patient outcomes.
  • Previous VBCs for multiple sclerosis (MS) used limited, easily collected data, overlooking other important clinical indicators.
  • Stakeholder consensus on meaningful indicators for MS VBCs remains unclear.

Purpose of the Study:

  • To identify meaningful multiple sclerosis (MS) indicators for key stakeholders.
  • To inform the development of value-based contracts for MS medications.

Main Methods:

  • A modified Delphi method surveyed 26 diverse stakeholders (patients, providers, payers, PBMs, pharma reps).
  • Stakeholders rated 12 MS indicators on meaningfulness and value using Likert scales and forced selection.
  • Feasibility of indicator collection was assessed among non-patient stakeholders.

Main Results:

  • "Worsening physical disability" and "functional impairment" were identified as highly meaningful indicators.
  • "Worsening physical disability" was selected as most meaningful by 100% of participants.
  • "MS flares requiring emergency department visit" and "inpatient admission" were most feasible to collect.

Conclusions:

  • Disability and functional impairment are key indicators for MS VBCs, supported by diverse stakeholder consensus.
  • Incorporating patient-reported outcomes like disability and functional status enhances MS VBCs.
  • This research provides a foundation for developing more effective and patient-centered MS medication VBCs.