Moderator: Adrian Towse, MA, MPhil, Director Emeritus and Senior Research Fellow, Office of Health Economics, London, UK
Panelists: Meng Li, PhD, ScM, Staff Member, Leonard D Schaeffer Center, Univeristy of Southern California, Los Angeles, CA, USA; Jens Grueger, PhD, Professor of Economics, Centre for Health Economics and Department of Economics, University of York, Heslington, York, UK
ISSUE: The ISPOR US Task Force report recommended exploring additional elements of value for inclusion in value assessment of new drugs. One of these was Real Option Value. This panel will debate whether and how it could be done, and if this is a good idea.
OVERVIEW: If a patient had to choose between two treatments offering the same expected QALY gain, they might prefer the one that offers greater life expectancy because it provides the greater chance to benefit from future scientific and clinical advances. There is a real option of moving on to a new treatment. It may not come about, but the possibility of it happening maybe worth paying for. But can it be measured and should it be rewarded? Meng Li will set out her PhD results for real option value for ipilimumab for metastatic melanoma and also report on work by others looking at option value for treatments for CML and for breast cancer. Ranges from 5% to 25% have been estimated. She will explain the intuitive rationale and the analytical techniques and data required, arguing that option value is real and can be calculated. Jens Grueger will set out with examples how industry considers new investment opportunities and the importance of market signals from payers in driving decision making about which products are taken forwards. He will argue that if patients (and society on their behalf) have preferences – for example for life extending over quality of life improving treatments - then these need to be reflected in HTA reimbursement decisions. Adrian Towse will set out likely payer concerns about incorporating real option value into decision making. Issues he will discuss include: the potential for double counting, whether the uncertainty around estimation is being handled correctly, evidence on patient preferences; and whether prices already exceed value.