Barriers and Solutions to the Inclusion of Broader Benefits in Biopharmaceutical Value Assessments.

Abstract

OBJECTIVES Evaluate how institutional barriers prevent the inclusion of broader individual and societal benefits associated with new health care innovations from being considered when assessing the value of medical treatments and making health care coverage determinations. METHODS A survey of health insurance providers, pharmacy benefit managers, employee benefit consultancies, and employer group representatives in the US queried respondents' opinions regarding the feasibility of evaluating indirect treatment benefits in four domains: absenteeism, presenteeism, caregiver burden, and quality of life. RESULTS Inclusion of indirect benefits (including absenteeism and presenteeism) in the assessment of a treatment's value was of low importance to payers, but higher importance to employer stakeholders. CONCLUSIONS Therapies that improve physical or mental function accrue benefits both directly and indirectly and can only be adequately assessed if measurement standards for indirect benefits and quantifiable measures are established.