Value-Based Healthcare in practice: IDEATE, a collaboration to design and test an outcomes-based agreement for a medicine in Wales

Author:

J Burton1ORCID,K Halsby1,G Sáinz de la Fuente1,J Pearson-Stuttard2ORCID,R Sloan2,T Porter2,G John3,A Warburton3,J Selby3,G Povey4,M Chowdhury1,C Bale5ORCID,M Davies4ORCID,E Clifton-Brown1,H Laing6ORCID

Affiliation:

1. Pfizer Ltd

2. Lane Clark and Peacock LLP

3. Digital Health and Care Wales

4. Swansea Bay University Health Board Wales

5. Betsi Cadwaladr University Health Board Wales

6. VBHC Academy, Swansea university

Abstract

Abstract

Objective: To develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges. Methods: Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical model for an OBA in a trusted research environment. A cross-disciplinary collaboration between NHS Wales, industry, and academia was developed. Data were collected from Welsh national datasets and used to inform a novel linked-dataset. OBA scenarios, with different contract parameters, were analysed to assess impact on the proportion of contract payment due and the volatility of payments. Results: An approved, in market, locally advanced and metastatic breast cancer treatment was selected as the test case. The total number of patients in the treatment cohort (2017–2020) was n = 99, and 286 in the control cohort (2014–2016). The final outcome variables selected were: 1) 1-year survival, 2) intolerance to treatment (deferral), and 3) the total days disrupted by care. The primary scenario included all three outcomes measured at the population level and used a linear payment model. Volatility analyses demonstrated contract parameters can dramatically alter the contract output with greatest risk from a single, binary outcome contract design. Conclusions: The design of an OBA is a complex process that requires a multidisciplinary approach. By better pinpointing which medicines are a good fit for an OBA, assessing solutions to data, outcomes, and contracting challenges, IDEATE provides a strong foundation for future success of OBAs in the UK.

Funder

Pfizer UK

Publisher

Research Square Platform LLC

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4. 525. 12 Apr. 2023, www.kingsfund.org.uk/publications/rise-and-decline-nhs-in-england-2000-20.

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