In the last decade, new therapies to treat rheumatoid arthritis (RA), a progressive and painful autoimmune disorder, have expanded patients’ treatment options and significantly improved outcomes, helping people with RA achieve disease remission, avoid disability and experience an improved quality of life. And since the approval of these therapies and biologics, clinical evidence has grown, and these treatments are demonstrating far greater benefits to patients than understood at the time of their initial approval.
According to new research from Boston Healthcare Associates, as new evidence regarding RA and RA treatments has emerged, our understanding of the value of these treatments has evolved significantly. Key findings from the research include:
- Individual patient characteristics can be important predictors of treatment response. For example, gene expression tests can identify as much as 60 percent of patients who will not respond to TNF-inhibitor therapy, a main class of biologic RA treatments. This allows providers and patients to select the appropriate treatment and helps avoid the use of ineffective medicines.
- Receiving treatment earlier in the progression of the disease can result in sustained disease remission. More recently, studies have shown that biologic therapy earlier in the treatment sequence substantially improves rates of remission and the durability of remission once achieved.
- Advances in treatment, resulting in better outcomes, have substantially changed the way we define clinical success of RA therapy. ACR20, a measurement developed in 1995, defines the treatment efficacy of a therapy as a greater than 20 percent improvement in tender and swollen joint counts. In 2008, the American College of Rheumatology updated the outcome measure to include 50 percent and 70 percent improvements, reflecting the additional value revealed by ongoing research that demonstrates that the use of biologic therapies in combination with synthetic disease-modifying anti-rheumatic drugs (DMARDs) and earlier in patients’ progression can deliver clinical benefits well beyond ACR20.
Conventional methods for assessing the value of new medical interventions capture only a point-in-time estimate of value, frequently devaluing new treatments by failing to recognize the potential benefits that emerge over time. Unlike the Institute for Clinical and Economic Review, which recently undertook an assessment of RA treatments, we need approaches to value assessments that can keep pace with changes in research and treatment options over time. Static, population-level assessments of the value of biopharmaceutical therapies that do not account for sustained remission and targeted treatment significantly undervalue the clinical and economic benefits of innovation in the treatment of RA.
As a result of the complexity of the disease and the evolving body of evidence on treatment options, patients and their physicians must have the autonomy to make the treatment decisions that best accommodate individual needs and preferences. That is why it is essential that tools to measure and assess the value of treatments, including value frameworks, capture how value evolves over time.
Read more at www.phrma.org/value-collaborative.
Lauren Neves
Lauren Neves is Vice President of Policy at PhRMA focusing on the value of cancer medicines, medication adherence, and payment and delivery reform. Prior to joining PhRMA, Lauren earned her law degree and worked as a market access and health policy consultant to health care and pharmaceutical clients.
Incomplete evaluations undermine patient access to transformational medicine
You won’t fix what you don’t value: Two reasons why traditional cost-effective analyses can perpetuate health inequities
PhRMA presents research at ISPOR 2022
Innovative contracts continue to gain traction and improve quality of care
Study finds nearly half of payers believe innovative contracts can lead to lower patient out-of-pocket costs
Growth in innovative, value-based contracts holds promise for the health system and for patients
Innovative contracts drive access for patients and value for the system
ICYMI: Patients saved nearly $800,000 out of pocket through innovative contracting arrangements
Low-value health care costs $345B each year and provides little benefit
Addressing barriers that inhibit value-based contracts
Guest post: Value-based agreements can improve outcomes and even save patients money at the pharmacy counter
New data show how ICER’s value framework could prevent or delay access to treatments for Medicaid patients across the country
5 Ways to improve ICER’s value assessment framework
Assessing value top of mind at ISPOR 2019
New analysis shows 820,000 prescriptions would be in jeopardy if ICER’s value framework is used in Medicaid
Value assessments should include all the outcomes that matter to patients and families
Event tomorrow: Leaders convene to discuss solutions to advance value-driven health care
New whitepaper identifies reasons why ICER’s cost-effectiveness analyses are not useful for payers
Guest post: Developing new payment models to ensure patients have access to high-investment therapies
Number of value-based contracts continues to rise
ICER’s budget impact threshold: Sounding a false alarm on affordability and access
PhRMA submission to HHS on blueprint to lower drug prices and reduce out-of-pocket costs
How ICER’s assessment of a new class of migraine treatments fails patients
Aspen Spotlight Health: Discussing the forefront of innovation
New analysis shows that HTA organizations may frequently restrict access to cancer treatments
New analysis shows negative impact of ICER’s value framework on patient access in Medicare Part B
ICYMI: Recent survey adds to growing body of research on barriers to innovative payment approaches
Event tomorrow: Improving patient access to lifesaving medicines
Reality check: Value-based contracts are good for patients
Video: Barriers to results-based contracts
Improving care quality by engaging patients in shared decision making
ICYMI: Research shows promise of innovative payment arrangements in reducing costs, improving access
Clarity around anti-kickback statute needed to promote innovative payment arrangements
Video: What is a results-based contract?
PhRMA Foundation recognizes inaugural Challenge Award recipients
Johnson & Johnson, Pfizer, Walgreens and other CEOs discuss value in the future of health care
The journey to better health care requires a holistic view
Medicare Monday: How Part B has evolved over the years
Modernizing FDA regulations to advance a value-driven health care system
PhRMA CEO in Forbes - How to negotiate better deals for prescription medicines
ICYMI: Avalere and FasterCures develop new value framework from patient perspective
ICYMI: Innovative payment models helping provide patient access to new medicines
This is not a special effect: New video shows the destruction of a rogue cell
New analysis: More than half of patients’ out-of-pocket spending for brand medicines is based on full list price
Stakeholders Agree: Modernize the legal framework to support move to value-driven health care
How do multiple sclerosis patients define value?
PhRMA CEO talks White House meeting, innovation & jobs with POLITICO’s Pulse Check
VIDEO: PhRMA CEO discusses #GOBOLDLY campaign and White House meeting with CNNMoney’s Maggie Lake
The Value Collaborative: Advancing private market solutions to achieve better health, lower costs
RA medicines often demonstrate far greater benefits to patients than initially understood
Rheumatoid Arthritis
Value-Driven Health Care
The Value Collaborative
RA medicines often demonstrate far greater benefits to patients than initially understood
RA medicines often demonstrate far greater benefits to patients than initially understood