Payers Not Impressed with HEOR Measures

Apr 05, 2017
By Pharmaceutical Executive Editors

In an effort for the health care industry to honor its promise of patient-centricity, advocacy groups and regulators are focusing on early involvement of the patient in clinical trials, including patient-reported outcome (PRO) measures. PRO tracks the individual patients’ perspectives and experiences. Despite this, inVentiv Health released research data—collected from November 2016 through January 2017, by US executives responsible for reimbursement and formulary health plan decisions—found that 92 percent of private payers are not interested in seeing a larger use of PROs in clinical trials. In fact, many payers are skeptical about health economics and outcomes research (HEOR) that is paid solely by drug manufacturers, and almost 70 percent of interviewed payers are only confident in HEOR produced when it is supported by a neutral organization or institution.

The report is a follow-up to an earlier report, “An Advocacy Rx for Progress in Mental Health,” which focuses on generating a better understanding of the obstacles faced for advancements in the mental health arena. The first report details outcomes from advocacy and mental health experts in the US, and across Europe, aiming at a need to develop advanced screening for early detection and diagnosis of mental health conditions by pharmaceutical partners.

Advocacy groups and payers may not be on the same page regarding patient involvement when developing drugs; however, all are concerned about the potential result of reducing Medicaid programs from patients in need, due to changes made to the Affordable Care Act. Additionally, both groups agree that extra opportunities to have open discussions is crucial for patient advocates, pharmaceutical executives, physicians, and policymakers (both state and federal).

For more information, “Mental Health: An Insurance Industry Perspective” and “An Advocacy Rx for Progress in Mental Health” are available as free downloads at inventivhealth-pr.com/advocacy.  

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