PURPOSE: Information about the economic value of a new health care intervention is requested by jurisdictions globally. Value-based pricing, using country-specific cost-effectiveness thresholds, has also been proposed as a method for determining an acceptable price. Value-based pricing defines the maximum acceptable price as the price that results in a cost-effectiveness ratio equal to a country-specific threshold value. Recent analyses have shown that estimates of maximum acceptable price using this definition result in counterintuitive estimates wherein the maximum acceptable price for a pharmaceutical product for high income countries with high investment in health care is lower than that estimated for low income countries with a low investment in health care. The purpose of this workshop will be to explore the reasons for this paradox as well as present alternative approaches for the assessment of economic value that could be applied to all countries despite different levels of income and investment in health care.
DESCRIPTION: We assume an assessment of the economic value of a new intervention is needed by all jurisdictions globally. We will illustrate the paradox of the maximum acceptable value-based price using the cost-effectiveness of rotavirus vaccination as an example. Possible explanations for this paradox will be presented including inappropriate threshold values or the assumption that acquisition costs are equal to opportunity costs in all jurisdictions. We will suggest two alternative approaches for the assessment of economic value and/or a determination of the maximum acceptable price that might be applicable globally: optimization of alternative intervention strategies subject to budget constraints; or analysis of return on investment for the new intervention. We will then invite the workshop participants to join us in a discussion of the proposed alternative approaches as well as of the suggestion that the same approach should be used for all jurisdictions to determine a value-based price.
