Do Patient Reported Outcomes Impact Payer Decisions? A Qualitative Study
Author(s)
Steenrod A
Roche Pharmaceuticals, Zurich, ZH, Switzerland
Presentation Documents
OBJECTIVES: Patient Reported Outcome (PRO) data are collected widely across oncology clinical trials however, these data are seldom utilized for drug reimbursement decisions. We sought to identify priorities in payers’ decision-making, determine the preferred patient-reported data type and understand opportunities to utilize PRO data in decisions.
METHODS:
This was a qualitative interview study with national payers from three healthcare systems (US, Germany, Canada). A screener was used to identify eligible participants for the interviews. Six semi-structured interviews were conducted, each 60-minutes long. Interviews were transcribed and thematically analyzed for insights.RESULTS:
Six payers (US, n=2 National health plan; German, n=2 drug reimbursement and statutory health insurance; Canadian, n=2 CADTH) were interviewed. The impact of PRO data on access and reimbursement decisions differed across countries, whereby impact was higher for Germany than for Canada, and lowest in the US. All payers agreed that PRO evidence should come from Clinical Trials versus more subjective evidence such as real-world data. Payers in the US and Canada supported the development of new oncology PRO measures however, German payers are satisfied with current measures. US and German payers did not state that PRO impact would change in future decision making while the Canadian payers believed PRO data may become a deciding factor if no improvements in overall survival are demonstrated.CONCLUSIONS:
Germany provided clear examples where PROs were able to impact reimbursement decisions which was less evident in the US and Canada. Subjectivity of PRO data was the main issue with accepting data across markets. Increased standardization and robustness in data collection will help to improve the value of PRO data and increase data reliability. Further research and policies are needed to be established to facilitate the optimal collection, analysis, and utility of PRO data to benefit patients in the future.Conference/Value in Health Info
2024-11, ISPOR Europe 2024, Barcelona, Spain
Value in Health, Volume 27, Issue 12, S2 (December 2024)
Code
PCR6
Topic
Health Technology Assessment, Patient-Centered Research, Study Approaches
Topic Subcategory
Decision & Deliberative Processes, Patient-reported Outcomes & Quality of Life Outcomes, Prospective Observational Studies, Systems & Structure
Disease
Oncology