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Identifying Outcome Measures for Migraine Value-Based Contracting Using the Delphi Method.

Elizabeth C S Swart1, Chester B Good1,2, Rochelle Henderson3

  • 1UPMC Centers for High-Value Health Care and Value-Based Pharmacy Initiatives, UPMC Health Plan, Pittsburgh, PA, USA.

Headache
|September 30, 2020
PubMed
Summary
This summary is machine-generated.

Key stakeholders identified decreased migraine frequency and severity as top priorities for value-based contracts. These findings help align incentives for migraine medication payments and value demonstration.

Keywords:
Delphi methoddrug costsmigraineoutcome measurespharmaceuticalsvalue-based contracting

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Area of Science:

  • Neurology
  • Health Economics
  • Pharmaceutical Outcomes

Background:

  • Value-based contracts are emerging for migraine medications to align incentives between manufacturers and payers.
  • New, expensive migraine pharmaceuticals necessitate clear performance metrics for contract development.
  • Identifying meaningful outcomes for all stakeholders is crucial for successful value-based contracting.

Purpose of the Study:

  • To determine the most meaningful migraine outcome measures from the perspective of diverse stakeholders.
  • To inform the development of value-based contracts for migraine treatments.

Main Methods:

  • A Delphi survey involving 82 stakeholders (patients, providers, payers, employers, pharmaceutical representatives) was conducted.
  • Stakeholders rated the value and feasibility of 15 pre-identified migraine outcomes.
  • Consensus was defined as ≥75% agreement on outcome importance and feasibility.

Main Results:

  • "Decrease in migraine frequency" (100%) and "increased ability to resume normal activities" (96%) were highly valued outcomes.
  • "Decrease in migraine frequency" (88%) and "decrease in migraine severity" (80%) were selected as the top 3 most meaningful outcomes.
  • Significant differences in outcome prioritization were observed between patient and non-patient stakeholder groups.

Conclusions:

  • "Decrease in migraine frequency" and "decrease in migraine severity" are the priority outcome measures for migraine value-based contracts.
  • These findings provide a consensus on meaningful metrics for evaluating migraine treatment value.
  • The study highlights the importance of stakeholder input in defining contract performance indicators.