When payment models lag behind pharmaceutical innovation, this comes at a real human cost to patients, particularly when life-saving interventions remain out of reach due to decision uncertainty or budget implications. 
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Lotte Steuten

Guest editor: Lotte Steuten | Deputy Chief Executive

When payment models lag behind pharmaceutical innovation, this comes at a real human cost to patients, particularly when life-saving interventions remain out of reach due to decision uncertainty or budget implications. 

 

A recent paper published by Woods and colleagues (EEPRU) analyzed the effects of alternate commercial arrangements for new pharmaceuticals in the UK’s National Health Service. They found that enhanced pricing flexibilities lead to better access and health benefits from multi-indication medicines, but – counterintuitively – poorer population health overall, owing to higher expenditure. Our latest Insight

interrogates the paper’s findings, and argues that this conclusion does not reflect reality and should therefore not be considered informative for the design of the NHS Commercial Framework. 

 

Our upcoming webinar also focuses on innovative financing models, with a panel discussion on whether differential pricing systems can address the challenge of pricing complex combination therapies in Europe – and whether that can indeed answer the urgent question of balancing innovation with access.  

 

We have previously argued that policies that overly emphasize cost-containment and expenditure control, particularly for off-patent medicines, could overlook the risks of drug shortages that those policies may cause. We will be revisiting our work on drug shortages, among other key topics, in our ‘Insights and Reflections from 2024’ webinar, which we hope you will join us for.  

 

In the spirit of evolving our research to meet the big questions of today, we also updated the figures from our report on the scale of unrelieved pain in palliative care in England, published in 2019. Our latest Insight includes  the latest available data to inform the ongoing conversation on assisted dying in England and Wales. Our estimates – which were covered in the Guardian last week -- showed that 20 people a day die in unrelieved pain across the UK at the end of their lives.  

 

As we’re starting to wrap up 2024 and look ahead to 2025, we are reminded of the profound impact that thoughtful health economic research can have in shaping policies that improve lives. At OHE, we remain committed to addressing the critical challenges facing healthcare systems, from ensuring timely access to innovative treatments to balancing sustainability with equity in healthcare delivery. 

New Insights

Latest estimates show that 20 people a day die in unrelieved pain across the UK at the end of their lives

Latest estimates show that 20 people a day die in unrelieved pain across the UK at the end of their lives

 

To inform the ongoing debate on assisted dying, OHE updated its 2019 findings on palliative care, revealing that 20 people a day die in unrelieved pain across the UK, even with the highest standards of care.

This marks a 15% increase since 2019, with the number of people requiring palliative care rising to over 436,000 in 2023.

Commissioned by Dignity in Dying, this research emphasises the need to address gaps in end-of-life care.

Read more
What is the impact of Uniform Pricing, Indication-Based Pricing (IBP) and alternative commercial arrangements for new pharmaceuticals in the UK NHS?

What is the impact of Uniform Pricing, Indication-Based Pricing (IBP) and alternative commercial arrangements for new pharmaceuticals in the UK NHS?

 

The EEPRU paper looks at the impact of pricing policies for multi-indication medicines on population health and access in the NHS. It finds that indication-based pricing (IBP) and commercial flexibilities (CF) improve access and health benefits but may reduce overall population health due to higher costs, assuming NICE uses an overly generous cost-effectiveness threshold. These findings are contested, with critiques pointing to flawed assumptions, suggesting IBP and CF can still support access and innovation.

Read more

Must-read Publication

Unrelieved Pain in Palliative Care in England

Unrelieved Pain in Palliative Care in England

 

Research published in 2019 estimates that approximately 125,971 end-of-life patients suffer from unrelieved pain, with 16,130 experiencing no relief at all in their final months. In England, 378,427 people receive palliative care annually, and while the quality of care is widely regarded as excellent, many patients still die in pain. Even under the best circumstances, over 50,000 patients would still face pain at the end of life, highlighting the need for improvements in care delivery.

Read more

Webinar: The Price of Success

The Price of Success
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Insights and Reflections from 2024

Insights and Reflections from 2024
Register now

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