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BEACON: A Summary Framework to Overcome Potential Reimbursement Hurdles

Author

Listed:
  • William C. N. Dunlop

    (Mundipharma International Limited)

  • C. Daniel Mullins

    (University of Maryland School of Pharmacy)

  • Olaf Pirk

    (Olaf Pirk Consult)

  • Ron Goeree

    (Goeree Consulting)

  • Maarten J. Postma

    (University of Groningen
    University of Groningen
    University of Groningen)

  • Ashley Enstone

    (Adelphi Values Limited)

  • Louise Heron

    (Adelphi Values Limited)

Abstract

Objective To provide a framework for addressing payers’ criteria during the development of pharmaceuticals. Methods A conceptual framework was presented to an international health economic expert panel for discussion. A structured literature search (from 2010 to May 2015), using the following databases in Ovid: Medline® and Medline® In-Process (PubMed), Embase (Ovid), EconLit (EBSCOhost) and the National Health Service Economic Evaluation Database (NHS EED), and a ‘grey literature’ search, were conducted to identify existing criteria from the payer perspective. The criteria assessed by existing frameworks and guidelines were collated; the most commonly reported criteria were considered for inclusion in the framework. A mnemonic was conceived as a memory aide to summarise these criteria. Results Overall, 41 publications were identified as potentially relevant to the objective. Following further screening, 26 were excluded upon full-text review on the basis of no framework presented (n = 13), redundancy (n = 11) or abstract only (n = 2). Frameworks that captured criteria developed for or utilised by the pharmaceutical industry (n = 5) and reimbursement guidance (n = 10) were reviewed. The most commonly identified criteria—unmet need/patient burden, safety, efficacy, quality-of-life outcomes, environment, evidence quality, budget impact and comparator—were incorporated into the summary framework. For ease of communication, the following mnemonic was developed: BEACON (Burden/target population, Environment, Affordability/value, Comparator, Outcomes, Number of studies/quality of evidence). Conclusions The BEACON framework aims to capture the ‘essence’ of payer requirements by addressing the most commonly described criteria requested by payers regarding the introduction of a new pharmaceutical.

Suggested Citation

  • William C. N. Dunlop & C. Daniel Mullins & Olaf Pirk & Ron Goeree & Maarten J. Postma & Ashley Enstone & Louise Heron, 2016. "BEACON: A Summary Framework to Overcome Potential Reimbursement Hurdles," PharmacoEconomics, Springer, vol. 34(10), pages 1051-1065, October.
    • Handle: RePEc:spr:pharme:v:34:y:2016:i:10:d:10.1007_s40273-016-0427-7
    DOI: 10.1007/s40273-016-0427-7
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    References listed on IDEAS

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    1. P. Thokala & A. Duenas, 2012. "Multiple Criteria Decision Analysis for Health Technology Assessment," Post-Print hal-00800398, HAL.
    2. Valérie Paris & Annalisa Belloni, 2013. "Value in Pharmaceutical Pricing," OECD Health Working Papers 63, OECD Publishing.
    3. Office of Health Economics, 2015. "A Framework for Payer Assessment of the Value of New Technologies: A US Approach," Seminar Briefing 001589, Office of Health Economics.
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    Cited by:

    1. Jonathan Dando & Maximilian Lebmeier, 2020. "A novel valuation model for medical intervention development based on progressive dynamic changes that integrates Health Technology Assessment outcomes with early-stage innovation and indication-speci," Journal of Innovation and Entrepreneurship, Springer, vol. 9(1), pages 1-28, December.
    2. Dunlop, William C.N. & Staufer, Alexandra & Levy, Pierre & Edwards, Guy J., 2018. "Innovative pharmaceutical pricing agreements in five European markets: A survey of stakeholder attitudes and experience," Health Policy, Elsevier, vol. 122(5), pages 528-532.

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