UK Health Technology Assessment and Value Based Pricing

Abstract

All state funded healthcare providers have to ensure that they provide value for money and avoid wasting money on less cost-effective interventions. The National Health Service (NHS) is the largest public-funded healthcare service in the world, and as a consequence has developed an international reputation for Healthcare Technology Assessment (HTA). The challenge to provide safe, effective drugs on a budget has underpinned the development of cost-saving measures including cost-utility analysis, providing an assessment of cost-effectiveness that can successfully compare the societal value of disparate interventions and their effect on disease states.

In this chapter, we discuss the evolution of HTA in the UK and how financial pressures have driven a review of how we pay for drugs. Value Based Pricing (VBP), and latterly Value Based Assessment (VBA), have been proposed as novel approaches to updating drug pricing in the UK. These schemes aim to ascertain the perceived value of a drug with reference to societal utility and reimburse drug companies accordingly, with the aim of balancing affordability and innovation. We address VBP methodology, cost-effectiveness thresholds, pricing, the need for evidence and VBP experience beyond the UK. Rejuvenating our approach to drug pricing and replacing an outdated system is an invaluable opportunity, yet care must be taken not to inadvertently limit access to cost-effective drugs for those who need them.