From the outset, health technology companies need to integrate health economics and Health outcomes research in their product development strategy in order to ensure a focus on the market and to maximise reimbursement, funding, uptake and market access at launch and beyond.

In order to help companies achieve this, Fourth Hurdle Consulting offers a full range of consulting services including:
• Provision of strategic advice
• Evaluation of existing evidence and recommendations on other evidence needed
• Information and analysis to support pricing decisions and positioning options
• Communication and publications for market preparation and support

Why a Health Economics Strategy is Important

Evidence of the value for money represented by an intervention is increasingly important for health care decision-makers in controlling market access, informing formulary listing decisions and in reimbursement decisions. Health technology companies should be prepared to meet these needs with health economics information in order to demonstrate a product’s value.

The opportunity to demonstrate value must not be missed, however. Because clinical development programmes are designed to generate data for registration, the data collected may not be appropriate for reimbursement, funding or formulary listing. For example, the data needed may be for:
• Different patients
• Different settings
• Different end points

To ensure smooth access to market and to maximise sales potential, planning the generation of health economics information needs to be included in a company’s strategy from the outset.

What Needs to be Done

When setting price bands, health technology companies should take into account the following factors:
• Cost-effectiveness of an intervention
• Patient groups indicated
• Likelihood of reimbursement difficulties

Cost-effectiveness is also important when choosing a product’s positioning. This is because health care
decision-makers and reimbursement agencies often attempt to limit the financial impact of an intervention by restricting the indications that are eligible for reimbursement. The choice of indication, patient group and comparator all determine the cost-effectiveness of an intervention, which in turn, determines the chance for successful reimbursement.

Local country data collection is often necessary to make analysis relevant to local health care
decision-makers. Due to differences in pricing, treatment practices and customer incentives, economic data collection in one country will not necessarily be useful in another. For this reason, local data collection and analysis is often needed in order to supplement core information (such as data from registration trials) to make it relevant to a particular country’s health care decision-makers.

How Fourth Hurdle Consulting Can Help

Information Assessment
Fourth Hurdle Consulting can provide an accurate and impartial assessment of the health economics and health outcomes evidence available to the client. Since the requirements of UK customers, for example, differ from those of other countries, a timely assessment of the available data is essential. This assessment will allow decision-makers to determine the need for local data collection or analysis without delaying the launch of a new product.

Expert Advice for Making Strategic Decisions
The Fourth Hurdle Consulting Directors have many years of experience within the pharmaceutical industry, and of supporting health technology companies internationally. They also have expertise across all stages of the product life cycle. This strong foundation enables us to provide sound strategic advice to our clients, from early product development through to support for mature products.

Pricing and Positioning
Fourth Hurdle Consulting can help inform the pricing decision by generating Value Based Pricing evaluations that allow companies to examine the cost-effectiveness of different price points and use in different patient
sub-groups. We conduct “what if” analyses to help clients understand the implications of pricing for market access, product uptake and the cost-effectiveness of products in “real world” use. In addition these analyses can be used to advise on the economic consequences of positioning decisions and help clients understand how such decisions may affect potential market size, pricing, reimbursement and market access.

Communication and Publications
It is vitally important for health technology companies to communicate key economic information effectively throughout the company if they are to realise a return on their investment in health economics through improved access in each market.

One particularly useful vehicle for effective communication is a Health Outcomes Assessment Dossier, designed to collate and summarise all the relevant health economics and outcomes data that has been developed in support of the new product. Topics included are:
• Burden-of-disease information in the main markets, including epidemiological information,
   treatment pathways, estimates of cost-of-illness and patient impact
• Clinical effectiveness and patient-reported outcomes data
• Supporting economic analyses
• Cost-effectiveness and budget impact models that may be adapted for local market use

Fourth Hurdle team members have extensive experience in preparing Health Outcomes Assessment Dossiers, as well as presentations, slide kits and other promotional materials, and can help clients produce these highly effective communications tools to maximise market access. The information included in these materials is delivered in a style that will be readily understood by staff in local affiliate organisations with responsibility for pricing, reimbursement negotiations and marketing in their country.