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Defining and assessing value for next-generation therapies

By Pamela Divack

Today’s value assessments are largely designed to inform population health decisions, not individual patient decisions. But the impending influx of high-cost, personalized, and potentially curative therapies means stakeholders must rethink how they assess medical value—and how that differs between traditional vs next-generation therapies. Next-gen therapies create new challenges not only for value assessment, but also for what data and endpoints capture value, and who should be responsible for achieving and monitoring outcomes.

At Advisory Board’s 2021 Cross-Industry Value Summit, leaders from different parts of the health care industry shared how they define, measure, and drive medical value in the context of next-generation therapies, and what implications this has for individual- vs population-level understandings of value.

The featured panelists included:

  • Natasha Mayfield, PMP, Chief Product & Engagement Officer, Optum Frontier Therapies
  • Sarah K. Emond, MPP, Executive Vice President and Chief Operating Officer, ICER
  • Joe Maki, Pharm.D., M.S., Vice President, Pharmacy, Novant Health
  • Moderated by: Allison Cuff Shimooka, VP of Product and Strategy, Optum Life Sciences

Check out the takeaways below:

  • 01: Health care leaders must expand their definition of next-gen therapies to include treatments that change how the health care system operates
  • 02: Meaningfully assessing the value of next-gen therapies requires broadening our value frameworks in two ways: expanding the set of value drivers considered, and extending time horizon under which value is measured
  • 03: Evidence generators (e.g. life sciences, providers) must broaden the data sources and endpoints used to establish the value of next-gen therapies, but whether regulators and decision-makers accept this data remains in flux
  • 04: Patient-defined value drivers (e.g. quality of life, experience) will be critical to measuring the value of next-gen therapies, but there’s still a long way to go in capturing outcomes that matter to patients
  • 05: Data collection infrastructure must evolve to enable long-term evidence generation, and providers must be actively incentivized to record this data
  • 06: To advance the use of next-gen therapies, payers, providers, and value assessment organizations must address the tension between population health and patient centricity—and recognize that definitions and assessments of value will evolve

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