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Improving Access to High-Cost Technologies in the Asia Region

Published online by Cambridge University Press:  24 May 2019

Linda Mundy*
Affiliation:
School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide Health and Medical Sciences Building, Adelaide, South Australia
Rebecca Trowman
Affiliation:
Scientific and Health Policy Initiatives, Edmonton, Alberta, Canada
Brendon Kearney
Affiliation:
HTAi Asia Policy Forum, Department of Haematology, Royal Adelaide Hospital, South Australia
*Corresponding
Author for correspondence: Linda Mundy, E-mail: linda.mundy@adelaide.edu.au

Abstract

Objectives

Discussions at the Health Technology Assessment International (HTAi) Asia Policy Forum (HAPF) aimed to understand the meaning of “high-cost technologies,” and to explore mechanisms to increase access to these technologies in publicly funded health systems in the Asia region.

Methods

Discussions and presentations at the 2018 HAPF, informed by a literature review and a premeeting survey of HTA agencies and industry, form the basis of this paper.

Results

Challenges payers in the public health system face when investing in high-cost technologies include a lack of data, especially real-world data, affordability, and the budgetary impact of high-cost technologies. Managed entry schemes (MES) are one means to enable earlier access to high-cost technologies, or at reduced cost to the system. Most countries surveyed had used an MES to introduce a new health technology and most industry representatives had experience with financial-based MES, such as discounts or rebates, with most put in place to increase access to pharmaceuticals. Little experience of outcome-based or evidence-generation MES was reported.

Conclusions

Although it is early days in the implementation of MES in Asia, they have the potential to play an important role enabling access to new, mainly pharmaceutical, health technologies. The development of a “road map” of MES in the region should outline the intent and need for a MES, articulating the “rules of engagement” for all stakeholders—patients, providers, payers, and industry—which will assist countries to clearly identify the problem trying to be solved, and how an MES can be part of the solution.

Type
Policy
Copyright
Copyright © Cambridge University Press 2019 

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Footnotes

The authors thank the members of the HTAi Asia Policy Forum and, in particular, the members of the Policy Forum Organizing Committee and invited speakers who attended the 2018 meeting. This article is based on discussions at the HTAi 2018 Asia Policy Forum held October 29 to 30 in Jakarta, Indonesia.

References

1.Mundy, L, Kearney, BJ, Trowman, R (2018) Overcoming the barriers to achieving universal health care in the Asian region. Int J Technol Assess Health Care 34, 18.CrossRefGoogle ScholarPubMed
2.Lu, CY, Lupton, C, Rakowsky, S, Babar, ZU, Ross-Degnan, D, Wagner, AK (2015) Patient access schemes in Asia-pacific markets: current experience and future potential. J Pharm Policy Pract 8, 6.CrossRefGoogle ScholarPubMed
3.Ferrario, A, Araja, D, Bochenek, T, et al. (2017) The implementation of managed entry agreements in central and eastern Europe: findings and implications. PharmacoEconomics 35, 12711285.CrossRefGoogle ScholarPubMed
4.OECD and WHO (2018) Health at a glance: Asia/Pacific 2018: measuring progress towards universal health coverage. http://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-asia-pacific_23054964.CrossRefGoogle Scholar
5.Teerawattananon, Y, Tantivess, S, Yothasamut, J, Kingkaew, P, Chaisiri, K (2009) Historical development of health technology assessment in Thailand. Int J Technol Assess Health Care 25(Suppl 1), 241252.CrossRefGoogle ScholarPubMed
6.McCabe, C, Edlin, R, Hall, P (2013) Navigating time and uncertainty in health technology appraisal: would a map help? PharmacoEconomics 31, 731737.CrossRefGoogle ScholarPubMed
7.Edlin, R, Hall, P, Wallner, K, McCabe, C (2014) Sharing risk between payer and provider by leasing health technologies: an affordable and effective reimbursement strategy for innovative technologies? Value Health 17, 438444.CrossRefGoogle ScholarPubMed
8.McCabe, CJ, Stafinski, T, Edlin, R, Menon, D (2010) Access with evidence development schemes: a framework for description and evaluation. PharmacoEconomics 28, 143152.CrossRefGoogle ScholarPubMed
9.Tuffaha, HW, Scuffham, PA (2018) The Australian managed entry scheme: are we getting it right? PharmacoEconomics 36, 555565.CrossRefGoogle ScholarPubMed
10.Carlson, JJ (2018) Outcome-based risk-sharing agreements. https://www.hca.wa.gov/assets/program/josh-carlson-summit-presentation.pdf.Google Scholar
11.No Authors (2007) Medicare's coverage with evidence development: a policy-making tool in evolution. J Oncol Pract 3, 296301.CrossRefGoogle Scholar
12.Mohr, PE and Tunis, SR (2010) Access with evidence development: the US experience. PharmacoEconomics 28, 153162.CrossRefGoogle ScholarPubMed
13.Mundy, L (2018) Improving access to high-cost technologies in the Asia region. Asia Policy Forum.CrossRefGoogle Scholar
14.Carlson, JJ, Chen, S, Garrison, LP Jr (2017) Performance-based risk-sharing arrangements: an updated international review. PharmacoEconomics 35, 10631072.CrossRefGoogle ScholarPubMed
15.Chatham House (2017) Chatham House Rule. https://www.chathamhouse.org/about/chatham-house-rule.Google Scholar
16.Morel, T, Arickx, F, Befrits, G, et al. (2013) Reconciling uncertainty of costs and outcomes with the need for access to orphan medicinal products: a comparative study of managed entry agreements across seven European countries. Orphanet J Rare Dis 8, 198.CrossRefGoogle ScholarPubMed
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