Alternative payment models for pharmaceuticals

Outcomes-based reimbursement for gene therapies in practice: the experience of recently launched CAR-T cell therapies in major European countries

Kymriah® and Yescarta® have relatively uniform list prices across the EU5, and are reimbursed according to their marketing authorisations. In France and the UK, reimbursement is on the condition of collecting additional data (at the cohort level) and subject to future reassessments; elsewhere, rebates (Germany) or staged payments (Italy and Spain) are linked to individual patient outcomes.

 Kymriah® and Yescarta® were two of the subject therapies used to pilot and validate the Valtermed system for roll-out in November. Kymriah® is reimbursed in the Spanish NHS through two outcomesbased, staged payments based on data collected through the Valtermed system: one at the time of treatment (reported to be 52% of the total €320,000 ), and a second payment at 18 months (reportedly the remaining 48%), provided that the patient has achieved and sustained a complete response to the treatment. Yescarta® was approved for reimbursement in July 2019, and follows a similar approach to Kymriah®, however, with payments linked to survival as collected through Valtermed: reportedly a first payment of €118,000, and a second payment of €209,000

 Adolf Mas (1907) exhibition at KBR

Free our genes (3)

 Patents on Life. Religious, Moral, and Social Justice Aspects of Biotechnology and Intellectual Property

Against patents, again (2)

 Patents, Human Rights, and Access to Medicines

Knowledge and decisions as the engine of health reform

 Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020

On Amazon (anything but a river) (2)

 Fulfillment. Winning and Losing in One-Click America

DouDNA

The Code Breaker. Jennifer Doudna, Gene Editing, and the Future of the Human Race

An absolute must read!

Data & Society

 A Primer on Powerful Numbers: Selected Readings in the Social Study of Public Data and Official Numbers

This publication is intended to be a non-exhaustive syllabus organized around a series of teachable or debatable claims concerning  the influence institutions of authority have on how data and numbers are created, as well as how that information is used by the datafied state to make fundamental decisions about democratic policy and process. 

Official numbers are the foundation upon which modern societies trust data. An official number is different from any other number because it’s given with authority and always there for the taking. Official data sets come out of bureaucratic and corporate offices and are imbued with the authority of those in power.

Six key arguments that center on the authority of data:

1. Modern societies are built to trust in official numbers (they even let official numbers make key decisions);
2. Official numbers are made, not found;
3. We forget that official numbers have to be made even when things are going well;
4. Institutions make public data and they make data public;
5. Official numbers are political; and
6. Consensus on official numbers requires work.

 

 

We are all behavioral economists right now (3)

 Social Preferences. An Introduction to Behavioural Economics and Experimental Research

AI everywhere (11)

A Human Algorithm. How Artificial Intelligence Is Redefining Who We Are 

Platforms, a business model (5)

 The Economics of Platforms. Concepts and Strategy

Insurance economics

 Insurance Economics

Moral machines

 Technology Is Not Neutral. A Short Guide to Technology Ethics

We are all behavioral economists right now (2)

 Psychology and Behavioral Economics. Applications for Public Policy

Chapter 5. Health behavior and decision-making in healthcare  

Addiction goods and innovation failure

When Innovation Goes Wrong: Technological Regress and the Opioid Epidemic 

The medical use of opioids to treat pain will always involve costs and benefits, and the optimal level of opioid prescription is unlikely to be zero. The mistake that  doctors and prescribers made in recent decades was to assume overoptimistically that a time release system would render opioids non-addictive. Thousands of years of experience with the fruits of the poppy should have taught that opioids have never been safe and probably never will be. The larger message of the opioid epidemic is that technological innovation can go badly wrong when consumers, professionals, and regulators underestimate the downsides of new innovations and firms take advantage of this error. Typically, consumers can experiment with a new product and reject the duds, but with addiction, experimentation can have permanent  consequences.

A must read, by Cutler et al.

 Robert Doisneau