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An Attribution of Value Framework for Combination Treatments
Andrew H Briggs1, Alexis Doyle-Connolly2, John Schneider2
1London School of Hygiene and Tropical Medicine, London, UK; Avalon Health Economics, Morristown, NJ, USA.
A new value attribution framework helps allocate value between component treatments in combination therapies. This ensures fair pricing and funding decisions for clinically beneficial combination treatments.
Area of Science:
- Health Economics
- Health Technology Assessment
- Pharmaceutical Policy
Background:
- Cost-effectiveness analysis (CEA) is crucial for policy decisions.
- Evaluating combination therapies presents challenges when backbone treatments are near willingness-to-pay thresholds.
- Lack of value attribution mechanisms risks undervaluing beneficial combination treatments.
Purpose of the Study:
- To develop a value attribution methodology for allocating value between components of combination treatments.
- To address challenges in pricing and reimbursement for novel therapies used with established treatments.
Main Methods:
- Grounded in standard CEA decision rules.
- Incorporates perfect/imperfect information on monotherapy effects.
- Accounts for balanced/unbalanced market power among manufacturers.
Main Results:
- Incremental value share depends on information availability and market power.
- Scenarios necessitate negotiation of incremental value shares within a defined range.
- The framework provides a structured approach to value allocation.
Conclusions:
- A price-independent framework for value attribution is feasible.
- Focuses on benefits quantified by quality-adjusted life-year (QALY) gains.
- Supports health technology assessment agencies in evaluating novel combination treatments.
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