Value-Added Services in Oncology: What motivates payers?

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Publication Date:
December 2017
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Are your value-added services (VAS) in oncology meeting the needs of payers as well as patients and physicians? Payers are increasingly taking interest in beyond-the-pill services that improve patient adherence, positively impact health outcomes and reduce the overall cost burden. Yet pharma does not consult with payers on VAS development and fails to fully utilise the real world data VAS generates to build evidence of a product's value. The value of VAS is being recognised by payers and, ultimately, could influence reimbursement and formulary decisions.

This expert report provides a full understanding of what payers would like to see in VAS oncology programmes, the current services they value and what factors pharma should take into account when creating VAS offerings.

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  • Why this report is important to you
  • What the report will enable you to do
  • DFull Report Contents
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Why this report is important to you

Oncology is the most high-profile therapy area with drug innovation delivering significant improvements in outcomes. Yet innovation comes at a cost, and the rising price of oncology drugs and the complexities of managing the disease have led to rising stakeholder expectations about the beyond the pill services industry provides. Value-added services have traditionally been aimed at patients and physicians, and the payer community has not been involved in the type of VAS being developed. That needs to change. Payers increasingly recognise that VAS can improve patient adherence and clinical outcomes, reduce drug wastage and limit expensive hospital readmissions. Powerful and engaging VAS not only differentiate products in a competitive market space but may prove advantageous in reimbursement/formulary discussions where VAS outcomes help payers control costs. What VAS motivates payers, how best to develop them and the pitfalls to avoid are all revealed in this expert driven report.

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This report will enable you to…

  • Understand the specific issues facing VAS planners in the complex cancer therapy area
  • Know why long-term VAS programmes are critical in oncology
  • Effectively engage with payers to develop VAS that meet their needs
  • Know why branded VAS may be working against you
  • Mobilise real world data from patient monitoring and engagement to strengthen your value case in a way that is trusted
  • Understand how VAS are viewed and used in the US and EU5
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Report Contents

Executive summary

Research objectives

Research methodology

Experts interviewed

What are value-added services?

  • Key Insights
    • Better patient outcomes
    • Improved patient education
    • Greater patient access
    • Opportunities for dialogue with payers
  • Considering patient centricity
  • The understanding of value-added services
  • Working with value-added services
  • How would payers rate the eight most common types of value-added service?
    • Digital, mobile and telehealth
    • Practice and provider support
    • Collaborative and integrated care
    • Healthcare professional education
    • Patient education
    • Patient support
    • Nursing support
    • Health and disease outcomes
  • Value-added services not used by experts
  • Different uptake of value-added services between countries

What would make a value-added service particularly useful in oncology?

  • Key insights
  • Application of VAS in chronic diseases and its translation to oncology
  • Would this differ for patients, payers or physicians?
  • Value-added services outside oncology
  • How would value-added services in oncology influence reimbursement decisions?

Specific approaches to oncology value-added services

  • Key insights
  • Services that help with the complexity of cancer treatment
    • Helping patients and families understand cancer and its impact
    • Helping patients deal with the complexity of treatment
  • Services that treat cancer as a chronic disease
  • Services that ensure patients can access high-cost cancer drugs
  • Services that support patients with cancer and their families
  • Services that support cancer survivors
  • Services that educate patients with cancer and their families
  • Value-added services within oncology

Payer evaluation: the value of VAS from a payer's perspective

  • Key insights
  • How do payers evaluate oncology VAS?
  • How is the information communicated?
  • Positive or negative impact on outcomes
  • What is the most important role of VAS within oncology?
  • Are there particular types of drugs or cancers where VAS are most useful/valuable?
  • Examples where VAS have improved healthcare systems or increased market access for oncology drugs?
  • Have value-added services ever influenced payer decisions?

Learning about VAS

  • Key insights
  • How do payers hear about oncology VAS?
  • How would payers prefer to hear about oncology VAS?
  • What information do payers get from pharma in relation to oncology VAS?
  • Is the information useful?
  • What information are payers not interested in?
  • What information is lacking?

What payers want/need from VAS

  • Key insights
  • What do payers actually want from a VAS for oncology?
  • Do payers want branded or drug agnostic services?

VAS and data

  • Key insights
    • Wearables
  • Do certain types of oncology VAS generate more reliable data than others? If so, which types?
  • How is RWD influencing assessment of drug value in oncology?

VAS and the pharmaceutical industry

  • Key insights
  • Are companies consulting with payers about oncology VAS?
  • How willing are payers to support pharma in developing oncology VAS?
  • Do payers want to work with pharma companies in developing oncology VAS?
  • Is pharma being proactive enough with oncology VAS?
  • Is pharma understanding payer and patient needs enough?

VAS and the pharmaceutical industry

  • Key insights
  • The top five challenges presented by VAS in oncology
  • What is the future of VAS in oncology?
  • What factors should pharma take into consideration when creating VAS offerings?
  • What kind of oncology VAS will be beneficial for the healthcare system?
  • Could the learning from oncology VAS programmes be applied to other therapeutic areas?
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