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Deep dive: The Patient Access Indicator

After reimbursement, to what extent are European countries able to ensure cancer patients access to innovative therapies? As part of the Time to Patient Initiative (read more about the project), Vintura’s Patient Access Indicator provides a benchmark. The first of its kind, it identifies actual prescription and use of new therapies in 10 European countries. Key outcome: from country to country, patient access varies tremendously. Remarkably, countries that perform well on time to market access, don’t necessarily perform well on patient access after reimbursement.

In oncology, it was anecdotally known to all stakeholders: after reimbursement, the implementation speed and level of actual use varies significantly from country to country. Just how big the inequalities between European countries were, we didn’t know: due to its complexity, a formal analysis of this dimension of patient access had never been conducted, leaving the field with an immense information gap.

Filling the information gap on patient access

Yet, what value lies in innovation, if new therapies don’t find their way to patients? The first of its kind, Vintura’s Patient Access Indicator provides a European benchmark study to identify European differences in the use of new cancer treatments 12 months after reimbursement. We found that countries that perform well on time to market access do not necessarily perform well on patient access. This is the case in Germany and The Netherlands. We also found the opposite, for example for France.

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Figure 1: What are country differences in cumulative use, 12 months after a positive reimbursement decision?

Research methodology: dealing with complexity

For this benchmark, ‘use’ was measured by analysing sales volume per month per capita, using routinely collected business information from pharmaceutical companies and data providers. ‘Post-reimbursement’ was defined as the phase that starts when the first patient is treated under a formal reimbursement scheme. 10 European countries were included as well as 13 oncology therapies, covering 8 cancer types. Per therapy, the cumulative use at 12 months post-reimbursement was expressed as a relative use, compared to the country with the highest use of that therapy. And per country, the average relative use across all therapies was calculated to arrive at one single indicator of post-reimbursement use compared to other countries.

The outcomes may also serve as a reminder that patient access doesn’t stop at reimbursement, making it not just the market access department’s business.

Next step: understanding the differences

As part of the Time to Patient Access Initiative, we found four important factors that delay patient access in Europe: multiple layers of decision-making, insufficient budget to implement decisions, suboptimal healthcare structure and low frequency of clinical guideline updates. In countries facing patient access challenges one or more of these factors are playing a role. A benchmark, The Patient Access Indicator illustrates differences between countries rather than explanations. However, since the study covers multiple therapies in multiple indications, it provides a good indication of health system factors posing a barrier to patient access. Combined with the aforementioned factors, the outcomes of the Patient Access Indicator may serve as input for national discussions aimed at identifying the key factors underlying a relatively low level of patient access. The outcomes may also serve as a reminder that patient access doesn’t stop at reimbursement, making it not just the market access department’s business.

LET’S DISCUSS

Inspired to share your thoughts? Or would you like to learn more on how to accelerate patient access? We would be delighted to hear from you. Please feel invited to contact Christel Jansen or Bas Amesz.

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