J 2023

Novel approach to decision making for orphan drugs

DECKER, Barbora, Tomáš MLČOCH, Anastasie PUSTOVALOVA a Tomáš DOLEŽAL

Základní údaje

Originální název

Novel approach to decision making for orphan drugs

Autoři

DECKER, Barbora (203 Česká republika, garant, domácí), Tomáš MLČOCH (203 Česká republika), Anastasie PUSTOVALOVA (203 Česká republika) a Tomáš DOLEŽAL (203 Česká republika, domácí)

Vydání

International Journal of Technology Assessment in Health Care, NEW YORK, CAMBRIDGE UNIV PRESS, 2023, 0266-4623

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30104 Pharmacology and pharmacy

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 3.200 v roce 2022

Kód RIV

RIV/00216224:14110/23:00130319

Organizační jednotka

Lékařská fakulta

UT WoS

000924890900001

Klíčová slova anglicky

orphan drugs; rare diseases; reimbursement; health policy; health technology assessment

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 27. 4. 2023 09:46, Mgr. Tereza Miškechová

Anotace

V originále

Background Out of 185 orphan medicinal products (OMPs) registered in 2015–2021, a mere 110 (59 percent) were available to Czech patients, and only 54 (29 percent) were officially reimbursed. Moreover, this proportion has steadily decreased over time. After years of public debate induced by this unsatisfactory OMP patient access, the national viewpoint shifted toward creating a special pathway for the reimbursement of OMP. Thus, a rigorous pricing and reimbursement procedure with strict timelines and elaborated methodology has been recently adopted in Czechia. Methodology The innovative legislation follows the recommendations for value assessment and funding processes for rare diseases and incorporates additional elements of value, such as the societal perspective. First, the application with clinical evidence, cost-effectiveness, and budget impact analyses is submitted to the governmental health technology assessment (HTA) agency by the Marketing Authorization Holder or a Health Insurance Fund. Moreover, professional associations and patients’ organizations are rightful participants in the proceeding, providing evidence and comments. Then, the HTA agency performs the assessment/appraisal of the evidence. It subsequently publishes the assessment report summarizing available information. The report is then forwarded to the Ministry of Health and its advisory body consisting of patients, clinical experts, health insurance funds, and the State. They critically evaluate the documents and issue a binding opinion following prespecified decision-making criteria. Based on this binding opinion, the decision is issued by the HTA agency. Thus, the role of the advisory body in this process is crucial. Conclusion We believe that this novel approach may offer satisfactory patient access to orphan drugs. Moreover, it serves as a real-world example of “value-based” decision making. Background Out of 185 orphan medicinal products (OMPs) registered in 2015–2021, a mere 110 (59 percent) were available to Czech patients, and only 54 (29 percent) were officially reimbursed. Moreover, this proportion has steadily decreased over time. After years of public debate induced by this unsatisfactory OMP patient access, the national viewpoint shifted toward creating a special pathway for the reimbursement of OMP. Thus, a rigorous pricing and reimbursement procedure with strict timelines and elaborated methodology has been recently adopted in Czechia. Methodology The innovative legislation follows the recommendations for value assessment and funding processes for rare diseases and incorporates additional elements of value, such as the societal perspective. First, the application with clinical evidence, cost-effectiveness, and budget impact analyses is submitted to the governmental health technology assessment (HTA) agency by the Marketing Authorization Holder or a Health Insurance Fund. Moreover, professional associations and patients’ organizations are rightful participants in the proceeding, providing evidence and comments. Then, the HTA agency performs the assessment/appraisal of the evidence. It subsequently publishes the assessment report summarizing available information. The report is then forwarded to the Ministry of Health and its advisory body consisting of patients, clinical experts, health insurance funds, and the State. They critically evaluate the documents and issue a binding opinion following prespecified decision-making criteria. Based on this binding opinion, the decision is issued by the HTA agency. Thus, the role of the advisory body in this process is crucial. Conclusion We believe that this novel approach may offer satisfactory patient access to orphan drugs. Moreover, it serves as a real-world example of “value-based” decision making.

Návaznosti

MUNI/A/1342/2022, interní kód MU
Název: Preklinický a klinický výzkum v oblasti farmakokinetiky, neuropsychofarmakologie a personalizované farmakoterapie v onkologii
Investor: Masarykova univerzita, Preklinický a klinický výzkum v oblasti farmakokinetiky, neuropsychofarmakologie a personalizované farmakoterapie v onkologii