Global Health Outcomes Strategic Pricing (GHOSP) Carole Dembek.
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Transcript of Global Health Outcomes Strategic Pricing (GHOSP) Carole Dembek.
Global Health Outcomes &
Strategic Pricing
(GHOSP)
Carole Dembek
November 10-11, 2008Confidential
Global Health Outcomes
Establish and communicate the economic value of Mozobil to global markets
Support value-based pricing & market adoption through outcomes research studies, economic models and value dossiers
Collaborate with US and global colleagues to adapt economic models to specific markets or customers to support product adoption
November 10-11, 2008Confidential
Identifying Value Drivers
Reduced cost of remobilization
More patients reach 2m cells -
fewer failed mobilizers
Patients mobilize more
cells for transplant
More cells transplanted associated with less resource use & cost
Fewer apheresis
proceduresLower apheresis
costs
Mozobil is well -tolerated with
few side effects
Eliminates cost of treating side effects of mobilizing with
chemotherapy
Clinical Data* Economic Value
* Data from Phase III trials 3101 & 3102
November 10-11, 2008Confidential
Value Pre- and Post- Transplant
Pre-transplant Period (Mobilization & Apheresis)
Post-transplant Period
Economic Value:Cost savings from fewer side effects of chemomobilizationCost savings from fewer apheresis proceduresPotential for less use of G-CSF compared to chemomobilizationFewer failed mobilizers will result in less remobilization costMore predictability in scheduling apheresis
Economic Value:More CD34+ cells may result in less supportive care, hospital days and lower costMore CD34+ cells may be associated with better survival
Transplant
November 10-11, 2008Confidential
Economic Value Messages
Compared to mobilization with G-CSF alone: Mozobil may reduce cost by reducing apheresis days Mozobil may reduce the cost of post-transplant care by
enabling patients to be transplanted with more cells Mozobil may reduce cost by reducing the number of patients
who require remobilization
Compared to mobilization with G-CSF + chemo Mozobil may reduce cost by eliminating side effects of
chemomobilization and reducing the amount of G-CSF required for mobilization
Mozobil may improve the predictability of scheduling apheresis & provide greater efficiency in the apheresis unit
November 10-11, 2008Confidential
Evidence to Support Value Messages
Mozobil clinical data Good data comparing Mozobil to G-CSF mobilization No data comparing Mozobil to G-CSF + chemotherapy
No economic data collected in Mozobil trials Published literature – not specific to Mozobil
20+ publications Cost data – cost of apheresis day avoided Limitations – old data, small sample sizes, not MM or NHL
Outcomes studies Partner with physicians to generate new economic data
November 10-11, 2008Confidential
Supporting EvidenceMore CD34+ cells = Less resource use
Author Journal Year CountryKlaus Eur J of Haematology 2007 GermanyScheid BM Transplantation 1999 GermanyLimat Eur J of Cancer 2000 FranceKetterer Blood 1998 FranceOlivieri Haematologica 1998 ItalySchulman J of Clinical Oncol 1999 USASola Hematology 1999 Spain
November 10-11, 2008Confidential
Supporting EvidenceSide effects of Chemomobilization
Author Journal Year CountryCorso Haematologica 2002 ItalyJantunen BM Transplantation 2003 FinlandFitoussi BM Transplantation 2001 FranceDesikan J of Clinical Oncology 1998 USAPetrucci Acta Haematologica 2003 ItalyAlegre BM Transplantation 1997 SpainMilone Leuk & Lymphoma 2007 ItalyGojo BM Transplantation 2004 USA
November 10-11, 2008Confidential
Outcomes Research Studies
Pr. Michallet – France200 MM pts
Comparison of resource use and cost of patients transplanted with >4m vs. <4m CD34+ cellsStatus – Preliminary data expected Q4
Pr. Einsele – Germany200 MM & NHL pts
Resource use and CD34+ cell dose Treatment of chemomobilization side effects Status – Data collection underway for cell dose study
Pr. Apperley – UK150 MM & NHL
Outcomes of mobilizing with chemotherapy - % febrile neutropenia, cost, failure rateStatus – Preliminary data received; ASH abstract accepted
Dr. Gertz – US (Mayo)
500-700 MM & lymphoma pts
Comparison of resource use in patients mobilized with G-CSF alone vs. G-CSF + 3g Cytoxan (no cost data)Status – Preliminary data expected Q4
November 10-11, 2008Confidential
Pharmetrics Private Payer Data
Study #1 – Cost of ASCT
Objectives Determine total cost of ASCT Determine proportion of cost
associated with mobilization & apheresis
Findings Total cost = $150,000 Mobilization/apheresis = 26%
Abstract accepted for poster presentation at ASH
Study #2 – Cost comparison of chemo + G vs. G alone
Objectives Determine cost of mobilization
with chemo vs. G-CSF alone Findings
Cost of mobilization with chemo was 27% higher than G-CSF
More inpatient hospital days & drug use in chemo pts
Excluding Rituxan & G-CSF, cost difference in drugs was $1,600 per patient
Abstract submitted for Tandem
November 10-11, 2008Confidential
Tools to Support Economic Value
Cost-effectiveness Model
Model will support global health technology appraisals & reimbursement submissions Preliminary model for frontline use completed Rescue model under
development Validating with KOLs Models to be finalized in Q4 GHOSP will work with
affiliates to adapt models for specific country needs
Budget Impact Model
Model will demonstrate the budgetary impact of adopting Mozobil Can be used for hospitals, payers, HTA organizations, local, regional and national health systems Model to be completed in Q4 Adapt to specific
hospitals, payers or countries
Value Dossier will be used to communicate the clinical & economic value story to global decision makers
Dossier to be completed end of 2008
Dossier will be updated as new data become available through clinical trials, outcomes studies
and published literature
Value Dossier
November 10-11, 2008Confidential
Next Steps
Complete economic models & value dossier by end of 2008 Collaborate with country affiliates to adapt for local
reimbursement submissions & HTA reviews Adapt models to support formulary adoption by
transplant centers
Complete outcomes studies, present & publish data ASH Tandem EBMT
Training on economic messages, models, value dossier