NHTA

𝗕𝗿𝗶𝗻𝗴𝗶𝗻𝗴 𝗛𝗧𝗔 𝗮𝗻𝗱 𝗥𝗪𝗘 𝗘𝘅𝗽𝗲𝗿𝘁𝘀 𝗧𝗼𝗴𝗲𝘁𝗵𝗲𝗿 𝗠𝗮𝗸𝗲𝘀 𝗔𝗹𝗹 𝘁𝗵𝗲 𝗗𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝗰𝗲 In today’s fast-paced healthcare landscape, cross-functional collaboration is more essential than ever. Having both Health Technology Assessment (HTA) and Real-World Evidence (RWE) expertise on the same team is a true game-changer. At NHTA, we unite these critical insights to deliver solutions that are strategic, pragmatic, and actionable.   Here are a few ways NHTA’s RWE and HTA collaboration can support you: 𝗟𝗮𝗻𝗱𝘀𝗰𝗮𝗽𝗲 𝗮𝗻𝗮𝗹𝘆𝘀𝗲𝘀: Gain a competitive edge by combining RWE and HTA insights to shape your strategic direction 𝗛𝗧𝗔 𝘀𝘂𝗯𝗺𝗶𝘀𝘀𝗶𝗼𝗻𝘀: Strengthen your submissions with Real-World Evidence aligned to payer needs, guided by our integrated expertise 𝗟𝗶𝗳𝗲-𝗰𝘆𝗰𝗹𝗲 𝗺𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁: Drive sustained product value with collaborative strategies that evolve through every phase of the life cycle   No matter where your product is in its life cycle, our RWE and HTA experts are ready to support you through the next phases!

Join us on November 6th for our first community event in partnership with Medtech Meetup! The Nordic startup ecosystem is thriving with health tech innovation, filled with groundbreaking ideas and solutions. At NHTA, we’re passionate about supporting this ecosystem and are excited to contribute to its growth and success. Industry experts note that only 1 out of 10 companies achieve commercial success after receiving regulatory approval. This event will dive into this critical challenge, featuring insights from our very own Anders Mærkedahl on the importance of health economics and market access in the journey to the first sales! "MedTech startups shouldn’t wait until regulatory approval is close to plan their market approach. By using Health Economics and Outcomes Research (HEOR) early on, they can shape their access strategy, set optimal pricing, and demonstrate value to both payers and investors right from the start" - Anders Mærkedahl, Partner at NHTA Sign up for the event in the link below. https://lnkd.in/dRHBQr2s Bjørn Broby Glavind Tore Victor Chrom Allerup

🌟 Leveraging the Power of RWE! 🌟   Once again, Real-World Evidence (#RWE) has been recognized as the top trend in Health Economics and Outcomes Research (#HEOR) by ISPOR— and we couldn't agree more! While it might seem obvious, RWE studies offer a more accurate reflection of patients, clinical practice, and health outcomes in real-world settings, providing insights into real people and real experiences. As highlighted in the ISPOR report, agencies like #NICE and #CADTH continue to provide guidance on RWE's generation and use, solidifying its importance in healthcare decision-making.   At NHTA, we’re proud and humbled to work with some of the best real-world data (RWD) globally. With a population of approximately 27 million in the Nordics, linked to a variety of registries through personal identification numbers, we gain unique insights that support our clients throughout the product lifecycle.   📍 Attending ISPOR this year? Let’s connect! Don’t miss out on the opportunity to stay ahead with the #1 HEOR trend. Reach out, and let’s explore how RWE can drive value for you! Johanna Simin, PhD MSc Anders Mærkedahl

Happy Halloween from all of us at NHTA! 🎃 Wishing you a spooktacular time filled with treats and no tricks! 👻 #HappyHalloween #TeamNHTA

𝐇𝐨𝐰 𝐚𝐫𝐞 𝐧𝐨𝐧-𝐬𝐦𝐚𝐥𝐥 𝐜𝐞𝐥𝐥 𝐥𝐮𝐧𝐠 𝐜𝐚𝐧𝐜𝐞𝐫 𝐦𝐨𝐝𝐞𝐥𝐬 𝐝𝐞𝐬𝐢𝐠𝐧𝐞𝐝 𝐢𝐧 𝐍𝐈𝐂𝐄 𝐬𝐮𝐛𝐦𝐢𝐬𝐬𝐢𝐨𝐧𝐬? A recent review in the European Journal of Health Economics examined NICE’s appraisals of non-small cell lung cancer (NSCLC) models from 2012 to 2022. There is substantial unmet need in the NSCLC context. For example, in Sweden there are about 4,200 new cases of lung cancer diagnosed annually, with a 10-year survival rate of 20%, much lower than for other common cancers like breast or prostate. Despite this, the drug pipeline for lung cancer care has not been insignificant. The review identified 30 NICE appraisals for NSCLC, with 24 recommended for the NHS and 3 via the Cancer Drugs Fund. The most prevalent model in these submissions was the Partitioned Survival Model (PSM), typically with 3 health states, employing a lifetime horizon and informed by indirect comparisons (mostly based on network meta-analyses or matching-adjusted indirect comparisons). The increasing complexity of economic models within cancer emphasizes the continued need for advanced HEOR work in the future. - Mikael Svensson, 𝐶𝑜𝑛𝑠𝑢𝑙𝑡𝑎𝑛𝑡 𝑎𝑛𝑑 𝑆𝑡𝑟𝑎𝑡𝑒𝑔𝑖𝑐 𝐴𝑑𝑣𝑖𝑠𝑜𝑟 𝑁𝐻𝑇𝐴 𝐅𝐮𝐥𝐥 𝐩𝐨𝐬𝐭: https://lnkd.in/d8fgjbhm

We are happy to announce Zhiheng Xu has joined NHTA in our Swedish office.   Zhiheng holds a MSc in Economics from Stockholm School of Economics with a focus on macroeconomics. Prior to joining us, Zhiheng was a PhD researcher in Stockholm University focusing on the foreign exchange market. He also worked as a Strategy Consultant and a Market Analyst prior to his academic journey. Zhiheng has extensive experience in processing and analyzing large datasets, designing algorithms and creating strategies for clients.   We are looking forward to having Zhiheng. Please join us in welcoming him to NHTA!

𝐇𝐨𝐰 𝐚𝐫𝐞 𝐩𝐫𝐞𝐬𝐜𝐫𝐢𝐩𝐭𝐢𝐨𝐧 𝐝𝐫𝐮𝐠 𝐜𝐨𝐬𝐭𝐬 𝐝𝐞𝐯𝐞𝐥𝐨𝐩𝐢𝐧𝐠 𝐢𝐧 𝐭𝐡𝐞 𝐒𝐰𝐞𝐝𝐢𝐬𝐡 𝐫𝐞𝐢𝐦𝐛𝐮𝐫𝐬𝐞𝐦𝐞𝐧𝐭 𝐬𝐲𝐬𝐭𝐞𝐦? Data from a recent TLV report (Kostnadsutveckling och långsiktigt hållbar finansiering av läkemedel, 2024) indicate that prescription drug costs increased by 9% in 2023, reaching 39 billion SEK. The recent cost growth exceeds the average annual increase of 5% over the past decade. 𝐃𝐫𝐮𝐠𝐬 𝐝𝐫𝐢𝐯𝐢𝐧𝐠 𝐭𝐡𝐞 𝐢𝐧𝐜𝐫𝐞𝐚𝐬𝐞 𝐢𝐧 𝐜𝐨𝐬𝐭𝐬 Around half of the 2023 drug cost increase (3.2 billion SEK) came from higher spending on treatments targeting cystic fibrosis, cancer, and inflammatory diseases. TLV also noted that new drugs tend to see substantial cost increases in their first 5 years after reimbursement, largely stable costs in years 5 to 15, and significant reductions after 15 years due to generic competition. 𝐇𝐨𝐰 𝐚𝐛𝐨𝐮𝐭 𝐢𝐧𝐟𝐥𝐚𝐭𝐢𝐨𝐧-𝐚𝐝𝐣𝐮𝐬𝐭𝐞𝐝 𝐩𝐫𝐞𝐬𝐜𝐫𝐢𝐩𝐭𝐢𝐨𝐧 𝐝𝐫𝐮𝐠 𝐜𝐨𝐬𝐭𝐬? While many goods and services have seen sharp price increases over the last few years, prescription drug costs have remained relatively stable in real terms. The figure below shows the nominal (dashed line) and real (solid line) prescription drug costs from 2014 to 2023. Compared to 2014, inflation-adjusted drug costs have risen by 21%, a slightly higher rate than the 18% increase in real healthcare costs for outpatient and inpatient services over the same period. 𝐓𝐋𝐕’𝐬 𝐰𝐨𝐫𝐤 𝐭𝐨 𝐜𝐨𝐧𝐭𝐫𝐨𝐥 𝐜𝐨𝐬𝐭𝐬 TLV’s recent report highlights current policies such as the "15-year rule" and a stronger focus on reassessing previously reimbursed drugs as tools to address growing costs. The 15-year rule reduces prices by 7.5% for drugs with 15 years in the reimbursement system without significant generic competition, saving around 30 million SEK in 2023 (i.e., 0.08% of total costs). In addition, six reassessments were completed in 2023, including updates to reimbursement criteria based on price changes which can lead to more efficient use of resources. 𝐓𝐋𝐕’𝐬 𝐯𝐢𝐞𝐰𝐬 𝐨𝐧 𝐚𝐜𝐡𝐢𝐞𝐯𝐢𝐧𝐠 𝐬𝐮𝐬𝐭𝐚𝐢𝐧𝐚𝐛𝐥𝐞 𝐥𝐨𝐧𝐠-𝐭𝐞𝐫𝐦 𝐟𝐮𝐧𝐝𝐢𝐧𝐠 Focus areas include dedicating more resources to reassessing drugs already in the reimbursement system and accounting for patient volumes in reimbursement decisions. I have previously discussed TLV’s plans to adjust CE thresholds depending on patient volumes, which has been seen as a way to allow higher ICERs (cost per QALY) for orphan and ultra-orphan drugs. However, this report shows that TLV views this policy as a cost-saving measure, aiming to set lower CE thresholds for drugs with large patient populations. TLV also aims to increase participation in 3-party negotiations with the regions to offer “hidden” discounts from drug producers, addressing concerns raised by the industry about limited access to these negotiations currently. - Mikael Svensson, 𝐶𝑜𝑛𝑠𝑢𝑙𝑡𝑎𝑛𝑡 𝑎𝑛𝑑 𝑆𝑡𝑟𝑎𝑡𝑒𝑔𝑖𝑐 𝐴𝑑𝑣𝑖𝑠𝑜𝑟 𝑁𝐻𝑇𝐴

Let’s Kick Off ISPOR Europe 2024 Together in Barcelona! ✈ 🎉 We are excited to invite you to a relaxed evening as we kick off the ISPOR Europe 2024 conference. On Sunday, 17 November 2024, at 20:00, we’ll gather at Ocana restaurant in Barcelona to enjoy great food, good company, and to catch up before the conference kicks off. If you’re a friend of the house, a valued client, or even a potential new one, we would love to see you there. This is the perfect opportunity to connect with colleagues, partners, and new faces before the conference begins. We’ll be serving some nice tapas and finger food. This is a casual event, so if your plane lands late or if you only have limited time available, feel free to drop by whenever it suits you. If you’d like to join us, please comment below or send one of us a message (Anders Mærkedahl, Asger Lindvig, Andreas Pagh, Thomas Kristensen). We’re looking forward to kicking off ISPOR 2024 with you! Event Details: ·        Venue: Ocana Restaurant ·        Address: Plaza Real 13, 14 y 15, Barcelona ·        Metro: Drassanes (L3) ISPOR—The Professional Society for Health Economics and Outcomes Research

🌟 **Off-Site Success in Sweden!** 🇸🇪   This past week, our team had the incredible opportunity to gather for an off-site in Sweden, focusing on strengthen how we work together as a group. It was a chance to step away from the daily grind, reflect, and strengthen our collaboration.   From team-building exercises to creative strategy sessions, the energy and ideas that came out of these days were deeply inspiring. We’re more aligned than ever on how we can best serve our clients, innovate, and continue growing as a team.   Excited to take these insights forward and deliver even greater value in our internal collaboration and for our clients! A special shout-out to the team members who couldn’t join us — you were missed, and we look forward to sharing the insights and energy from our time together! Christos Papagiannopoulos, Simone Rosquist, Jan Marcus Sverre, Mikael Svensson, Nicklas Vistoft Kleemann and Diogo Adegas

📝 𝐑𝐞𝐦𝐚𝐫𝐤𝐬 𝐨𝐧 𝐓𝐋𝐕𝐬 𝐢𝐧𝐭𝐞𝐧𝐭𝐢𝐨𝐧 𝐭𝐨 𝐚𝐩𝐩𝐥𝐲 𝐯𝐚𝐫𝐲𝐢𝐧𝐠 𝐜𝐨𝐬𝐭-𝐞𝐟𝐟𝐞𝐜𝐭𝐢𝐯𝐞𝐧𝐞𝐬𝐬 𝐭𝐡𝐫𝐞𝐬𝐡𝐨𝐥𝐝𝐬 𝐝𝐞𝐩𝐞𝐧𝐝𝐢𝐧𝐠 𝐨𝐧 𝐩𝐚𝐭𝐢𝐞𝐧𝐭 𝐯𝐨𝐥𝐮𝐦𝐞𝐬 📝   In Swedish prescription drug reimbursement decisions by TLV, it is well established that the highest acceptable cost per QALY (ICER) is dependent on the severity of the disease. Although TLV has never published any formal ICER thresholds, it is often considered that a drug targeting a non-severe disease must be priced so that the ICER comes in below (about) 500,000 SEK/QALY. In contrast, a drug targeting a (very) severe disease is often reimbursed at ICERs up to 1,000,000 SEK/QALY.   There has been a long-standing discussion about other criteria besides severity that should affect the cost-effectiveness threshold, often centered around how to assess orphan drugs. TLV has now explained that they aim to consider patient volumes when evaluating a reasonable cost per QALY. Chief economist at TLV, Douglas Lundin, has during a recent IHE Forum expressed that a higher ICER threshold will be accepted for drugs targeting very rare diseases, whereas a lower ICER threshold will be required for drugs targeting common diseases.   The economic motivation for varying thresholds concerning patient volume is that it facilitates access to orphan drugs, where it may be challenging to reach conventional cost-effectiveness targets.   TLV has presented an idea for a “staircase”-model where the highest acceptable cost per QALY may reach a few million SEK per QALY in a setting with a very rare disease with very high severity and clinically meaningful patient benefits. In parallel, for drugs with an indication that allows for a very large patient population, the message from TLV is that a lower ICER threshold will be applied. The lower ICER threshold could be achieved by requiring a lower cost per QALY at the time of the reimbursement decision or by having mandated discounts if the producer reaches certain sales volumes.   It remains to be seen how patient volumes will affect price-setting criteria at TLV in practice. Still, it seems clear from TLV messaging that there will be a more explicit variation in the accepted cost per QALY depending on patient volumes.   - Mikael Svensson, 𝐶𝑜𝑛𝑠𝑢𝑙𝑡𝑎𝑛𝑡 𝑎𝑛𝑑 𝑆𝑡𝑟𝑎𝑡𝑒𝑔𝑖𝑐 𝐴𝑑𝑣𝑖𝑠𝑜𝑟 𝑁𝐻𝑇𝐴