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ISPOR US 2023: Plenary Session 1 – Global Focus on Affordability and Inward Investment – What does it mean for HEOR?

09/05/2023

Introduction

The opening plenary session was led by Dr. Sam Roberts (Chief Executive of NICE), who moderated a discussion on global affordability, inward investment and the consequences for HEOR. Dr. Roberts began the discussion by acknowledging growing health disparities and rising healthcare costs globally. Unsurprisingly, the Inflation Reduction Act (IRA) was a major talking point amongst the panellists.

Key discussion points

  • Dr. Meena Seshamani, a representative from CMS, outlined the various provisions in IRA to address affordability issues, and the additional considerations:
    • Personal affordability was described as a major obstacle to access to treatment in the US. The importance of value and innovation is limited if people cannot afford the medication.
    • The focus on drug affordability is a wider part of change in the CMS program, driven by the desire to spend healthcare dollars in a smarter way
  • However John O’Brien, a Senior Director at the National Pharmaceutical Council, argued the impact of IRA to manufacturers may be underestimated
    • O’Brien described the changes as a ‘watershed moment’ in the US
    • Proposals around indication expansion and orphan designations were of particular concern to manufacturers, as well as a perceived lack of transparency in the process and the inability to engage with the relevant government departments
  • Dr. Seshamani believed the HEOR industry will be of critical importance in the changing US market
    • Two major areas of research Dr. Seshamani highlighted that were the need for improved assessments of RWE, and research understanding the impact of changes to the US’ dynamic drug market from the perspectives of all stakeholders.
    • Other members of the panel agreed that the utilisation of RWE has ‘barely scratched the surface’.

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