Opportunities and Challenges for HTA in Asia-Pacific (Part 2)

1
Opportunities and Challenges for HTA in Asia-Pacific
Part 2 of 2 (If you missed part 1, you can also find it on SlideShare.)
A roundtable interview.
AUDIO INTERVIEW!
Turn on your speakers.

Opportunities and Challenges for HTA in Asia-Pacific
IMS Experts:
Mandy Chui, Practice Leader, Pricing and Market Access, APJ
Jonathan Tierce, GM, Health Economics & Outcomes Research
Guest Speakers:
Dr. Annie Chicoye, Associate Professor, ESSEC Santé Business
School France - Singapore
Dr. Abdulkadir Keskinaslan, Market Pricing Director, APAC,
Novartis Pharma AG Basel, Switzerland
Length: ~9 minutes
To download an MP3 of this interview, click here.
To download the PDF transcript, click here.
Questions? Comments? Fill out the form at the end of this presentation.

3
So what can Asia-Pac learn from Europe in terms of HTA?
AC: I think the key takeaway from the experience in Europe
is that the role of HTA in the decision process may vary from
one country to another, but it has to be clear to all
stakeholders and it has to be based on appropriate data and
expertise. I can see there is clearly an opportunity in Asia-
Pacific’s emerging markets to avoid the painful process we
have been through in Europe, where it took a long decade
before HTA was really introduced and became one, but not
the only one, of the major components of the health
expenditure regulation process.

4
Thanks, Annie. And now, I think Abdulkadir can
enlighten us on some other innovative solutions that
may come out from some of the emerging countries and
in some time to come, European countries might learn
from what is going on in Asia.
AK: Thank you Jon. Yes, we having been using some
innovative partnering or contracting approaches, which we
sometimes call “pricing schemes,” to create value in Asia’s
emerging markets. In a nutshell, health care strategy is all
about how you spend your money, not how much money you
spend. What we have seen is that some countries are more
efficient than others at spending their money.
Know more on IMS Health, click here

5
What do you mean by that?
AK: Well for example, the UK has proven to be five times
more productive than he US at managing Type II Diabetes.
Also I should add that we should not forget that the ultimate
goal of these contracting arrangements, these “deals,” made
by manufacturers of drugs and payer-decision maker should
be improving the value of the drug.

6
So what kinds of arrangements are there?
AK: I group them into innovative “pricing schemes” and
“market access schemes”. But we can also further group
innovative pricing schemes into “financial outcomes-based”
and “risk-based” models. The financial models are very easy
to interpret. For each patient segment, you define a price or a
reimbursement such that you progressively discount your
product as its use expands.
For outcomes-based models there are a few examples, still
tough to find in Asia, but from experiences in the UK and the
US, where reimbursement is based on the outcomes delivered
and if it isn’t delivered, the manufacturer provides a rebate.

7
And the risk-based pricing models? How do they work?
AK: Risk-based pricing models are extensively done in
Australia where you put your patient segments or indications
into different risk segments, and for each patient segment the
products are based on the relative cost-effectiveness ratio. If
it justifies the price then your ultimate price is the weighted
average price in terms of population across the different
indications.

8
These are all categorised under the Innovative Pricing
Scheme idea, but does that work in markets where the
consumers are the decision makers?
AK: That’s a good question. In these types of markets we
typically see “willingness to pay” pricing models and
“affordability based” pricing models.
How do these work?
AK: Basically on the willingness-to-pay concept, you provide
incremental discounts based on patients’ compliance. To
enhance the value of the program, you can give an upfront
discount or you can provide additional services, free
diagnostic tests if necessary, depending on the disease.

9
I see. And the Affordability model?
AK: Here you try to address the patients’ ability to pay and
you try to charge accordingly. When there is no ability to
pay, you try to provide access to patients. In the end
companies try to match their investment with growing
insurance schemes as well as some commitments from
governments.

10
Can you give us some examples of countries where this
is working?
AK: In China, we know that high price products are identified
for face-to-face negotiations. That is a different way to
negotiate prices as we looked into how things were happening
in the past. Korea, Taiwan and partially Thailand are working
on developing guidelines on how to assess this. And then in
the Philippines and Indonesia, there are a lot of differential
pricing projects also in line with the development of insurance
schemes. They are covering partially the lowest income level
of the population or some of the insurance schemes are for
governmental workers.

11
What are some of the measures that Novartis is taking?
AK: Well, in the Philippines there are a lot of examples of
patient access schemes. Novartis also has a programme, we
call it KAAGAPAY, where we try to bring disease management
programs and other benefits to the patients who enrol into
this programme. And then the Glivec® International Patient
Assistance Program, or GIPAP, is a well-known example of an
affordability based model in Asia-Pacific (and most countries
are aware of this) where a third-party assesses patients’
ability to pay and there support is provided to the patient.

12
So, do different schemes work better in certain
countries?
AK: Absolutely. For example, we have a pilot in India. Here,
for an expensive per-unit product we have provided different
options to the patient together with the physician to decide
what would be best for them. So, this could be either an
incremental discount, assigned on bonuses, but after all if the
patient needs more therapy, more vials, one option could be
a fixed discounted price, the other option could be after the
initial first three injections we have identified a fixed price
that if patient pays that then patient can claim up to nine
vials, or as many as are needed as time progresses.

13
These schemes seem highly flexible.
AK: Yes that is the idea. We are also piloting for the first time
capping a price for a self-pay, because we usually have these
kinds of agreements in the UK. We are testing whether we
can just charge a patient a certain amount and then for the
next two years the patient is free to claim as much as is
needed aligning with their physician. So based on the disease
type and the progression, physicians may choose from these
options.
Thanks Abdulkadir. It certainly seems that there are
numerous opportunities for innovative partnering and
program offerings in emerging markets. I’m sure we
will hear of more as this region develops.

14
Mandy and Annie, do you have anything to add to the
points Abdulkadir has raised? Mandy?
MC: Thank you Jon. This has been an interesting discussion, and I
would end by repeating your point earlier that we have people who
are very interested to bring HTA into Asian markets. I think Asia will
be in a good position now to learn from our European colleagues.
Hopefully, here in the Asia-Pac region, we have the potential to leap-
frog over some of the developmental history of Europe and adopt
“best practices” in HTA. Also, I am fascinated and encouraged by
these innovative, multi-stakeholder, risk-sharing arrangements. By
sharing responsibility for developing health care arrangements in the
region, we can all benefit.

15
Thank you Mandy. Annie, your final thoughts?
AC: Yes I agree with Mandy. It is time to adopt HTA here in
the Asia-Pacific region, but as I mentioned earlier, HTA would
be one component, albeit a major one, of the health
expenditure regulation process. However, we should also be
looking at some of the innovative pricing models that
Abdulkadir has been describing.

16
Thank you too Annie. Abdulkadir, your final thoughts?
AK: Yes Jon. I would say that this is an exciting time in the
region where we can learn from Europe and adapt models to
suit the rapidly developing Asia-Pacific environment.
OK, well my thanks go to our three panellists today:
Mandy Chui, Annie Chicoye and Abdulkadir Keskinasian.
And thank you, audience, for your attention.

17
Thank you for listening!
If you missed part 1, it is also available on SlideShare!
• To download an MP3 of this interview, click here.
• To download the PDF transcript, click here.
• Questions? Comments?
− Fill out the form at the bottom of this slide, or
− Visit www.imshealth.com or email info.sg@sg.imshealth.com.

Opportunities and Challenges for HTA in Asia-Pacific (Part 2)

Empfohlen

Empfohlen

Weitere ähnliche Inhalte

Mehr von QuintilesIMS Asia Pacific

Mehr von QuintilesIMS Asia Pacific (20)

Kürzlich hochgeladen

Kürzlich hochgeladen (20)

Opportunities and Challenges for HTA in Asia-Pacific (Part 2)