CER/HEOR in the US vs Europe.
By Tijana Ignjatovic, Lead Analyst
23 March 2016
I am a Lead Analyst for market access and strategy at Datamonitor Healthcare. My team covers a diverse range of topics r...
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As the largest pharmaceutical market, the US is often a key influencer of global model design that pertains to the development, regulation, and application of drug therapies.
However, CER/HEOR frameworks are one area in which other countries – particularly in Europe – have outpaced the US healthcare system. This is due in large part to the more centralized healthcare systems in European countries: public payers shoulder most (if not all) of the healthcare costs, and therefore have a singularly keen interest in maximizing the return on healthcare expenditures; and public payers are generally in a centralized, broadly administrative function that allows comprehensive and consistent application of CER-supported decisions.
This contrasts with the US, where multiple public and commercial payers control different segments of the healthcare market and thus have limited incentive to use or ability to implement CER/HEOR in coverage decisions.
Thus, while the US has lagged, many European countries have developed CER/HEOR authorities and processes over the last several decades in order to systematically assess new drugs’ relative value and to provide guidance for prescribers. The following table compares key features of CER/HEOR processes in the UK, Germany, and France with the most recent US attempt at a federal-level CER organization, PCORI.
|Federal agency/organization||Key programs||Types of research||Audience||Utilizes CER/HEOR in coverage/payment decisions?|
|PCORI||CER research funding PCORnet research network/database||CER; drugs and devices||Public – all healthcare decision-makers||No|
|AHRQ||Centers for Education and Research on Therapeutics (CERTs) Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Program Evidence-based Practice Centers (EPCs) Research Initiative in Clinical Economics (RICE)||CER and HEOR; drugs and devices||Public – all healthcare decision-makers||No|
|National Institutes of Health (NIH)||Not organized into programs or centers. Varies by institute.||CER and HEOR; drugs and devices||Public – all healthcare decision-makers||No|
|Centers for Disease Control and Prevention (CDC)||Disease-specific research programs including HIV cost-effectiveness guides and cancer CER/patient outcomes collection project (jointly with AHRQ)||CER and HEOR; primarily drugs||Public – all healthcare decision-makers||No|
|Veterans Health Administration||Pharmacy Benefits Management Service (PBM Services)||CER and HEOR; drugs||Internal||Yes|
|Department of Defense||Pharmacoeconomic Center (PEC)||CER and HEOR; drugs||Internal||Yes|
Source: Datamonitor Healthcare
Datamonitor Healthcare’s CER, HEOR, and Value-Based Frameworks in the US explores the evolving use of CER and HEOR and their impact on drug reimbursement in the country, as well as the emergence of independent drug value assessment frameworks.
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