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​​Practical application of Outcomes-Based Pricing in Scotland: a retrospective data quality and feasibility study in Non-Hodgkin’s Lymphoma

Safe People

Organisation name

University of Edinburgh

Applicant name(s)

Dr Mahéva Vallet

Funders/ Sponsors

AbbVie

Safe Projects

Project ID

DL_2023_009

Lay summary

New medicines for cancer are improving patient outcomes such as increased survival and quality of life. Accelerated regulatory schemes for new medicines are speeding up access. This presents challenges for reimbursement decision makers such as the Scottish Medicines Consortium. All of these factors lead to high financial risk to the NHS if an upfront fixed drug price is agreed. “Outcomes Based Pricing” (OBP) is a flexible payment mechanism for helping the NHS managing financial risk of drug adoption with a company. Scotland has benefited from recent advances in the digitisation of healthcare records, which would support the automated rapid data capture necessary for the operation of an OBP scheme. We wish to propose an OBP study, as a proof of concept, by using data from NHS Lothian patients affected by Non-Hodgkin’s Lymphoma diagnosed. These patients undergo multiple treatments which would be a great example to test the above rationale, whilst placing little burden on front-line healthcare services. Treatments, medical and survival characteristics will also be described. The implementation of OBP for the NHS will lead to accelerated patient access to new drugs, and care improvement, in a manner that protects NHS resources from commercial exploitation by the pharmaceutical industry. The project output will enable the NHS to make safer, better informed and more timely decisions on future medicines to ensure the NHS is providing high value care to the patients it serves. The summary report from the project will be presented to the project steering group and used by Scottish Government Medicines team, Scottish Medicines Consortium and national medicines procurement services to help in the understanding of what is currently possible in NHS Scotland, and what needs to improve.

Public benefit statement

Outcomes-Based Pricing (OBP) is a flexible payment mechanism for cancer medications. Accelerated regulatory schemes for new medicines, implemented by Scottish Government to improve access to new drugs to patients, lead to reimbursement challenges for decision makers such as the Scottish Medicines Consortium. OBP is one example of a way of managing this, but requires timely capture of administrative and outcomes data to inform pricing decisions. A previous report recommended the need for a proof of concept to demonstrate if Electronic Health Records are now sufficiently robust to enable an OBP scheme. This is the project we are submitting here. The exemplar context of Non-Hodgkins Lymphoma is suggested as providing a good proof of concept due to the use of multiple treatments in sequence, and will provide important insight to the adoption of new drugs and their cost plans set by the NHS for their patients. The summary report from the project will be used by Scottish Government Medicines team, Scottish Medicines Consortium and national medicines procurement services to help in the understanding of what is currently possible in NHS Scotland, and what needs to improve. As with any service evaluation, the project output will enable the NHS to better understand current care and therefore how changes such as the introduction of new medicines and their costing might affect future patient care.

Request category type

Other

Other approval committees

Latest approval date

15/03/2024

Safe Data

Dataset(s) name

Data sensitivity level

Anonymous

Safe Setting

Access type

Release