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Cost-effectiveness model and report for Jakavi in the treatment of patients with Myelofibrosis in Belgium

HEMAR
06 juni 2019

Novartis, a large international pharmaceutical company had applied for Class 1 reimbursement of Jakavi for adult patients with myelofibrosis. The company asked Hict for support in the pharmaco-economic section of this reimbursement submission.

Expertise: Health Economics

Project Highlights

  • Customer: Novartis
  • Main Goal: Data collection of Belgian-specific data, validated and populated CEA model, CEA report conform the KCE guidelines
  • Main Result: Reimbursement of Jakavi in Belgium for adult patients with myelofibrosis

This support includes:

  • Collection of the necessary Belgian cost data for the CEA model
  • Critical review of the CEA model and (clinical) inputs
  • Population of the CEA model with the collected data, and generation of results
  • Development of a CEA report
  • Answering questions regarding the pharmacoeconomic part of the dossier requested by RIZIV/INAMI in the report D60, and if necessary report D120)

Approach

Hict’s approach consisted of the following four phases:

Phase 1 – Intake phase

During the intake phase, the context, strategy and key parameters of the submission and CEA model were discussed and analysed. An in-depth analysis of the provided CEA model, data inputs and sources of this model was performed. Based on the model requirements a complementary high-level desk research was performed and a gap analysis outlining the missing data and potential data sources was provided. This gap analysis served to identify the optimal data collection approach to be used during the data collection phase.

Phase 2 – Data collection

The data collection phase is designed to capture relevant Belgian inputs for the CEA model and was comprised of 3 sub phases:

  1. Desk research (e.g. MZG-MKG national data, literature, etc.)
  2. Expert opinion

    • Development of 2 surveys: one on the clinical practice of myelofibrosis in Belgium and one on the treatment of AEs
    • Processing of all data
    • Interviews with 4 experts to discuss the results of the surveys
    • Development of 2 reports

      • Expert opinion report on the clinical practice
      • AE cost report

3. Collection of unit costs out of national databases.

Phase 3 – CEA model support

During the CEA model support phase, the data collected during the intake and data collection phase was used to adapt the model to the Belgian context and populate the model with Belgian data. Results were generated (conform strategy on base case and scenario analyses) and discussed extensively with the pharmaceutical company.

Phase 4 – CEA report support

During this phase a CEA report was developed that is in line with the overall reimbursement strategy, meets KCE guidelines and is comprehensible for all readers.

Extra phase – Support answering questions in report D60

During this additional phase, answers to the pharmacoeconomic questions present by RIZIV/INAMI in the report D60 were formulated. This was done in close collaboration with Novartis and in collaboration with the model developers (for the respective questions). After which a comprehensible report, drafting the answers to all pharmacoeconomic questions, was written by Hict to be used/included in the response to RIZIV/INAMI. In addition, additional analyses (scenario’s) were performed and new model settings were used to generate results to comply with the questions/comments made by RIZIV/INAMI.

Results

  • Gap-analysis between required data and available data
  • Kick-off meeting
  • Data collection of all key information to populate the CEA model
  • Survey on the current Belgian clinical practice
  • Survey on the current Belgian resource use necessary to treat specific AEs
  • A transparent and detailed AE cost calculation model in excel
  • Expert opinion report
  • AE cost report
  • A validated and populated CEA model, adapted for Belgium
  • A clear and validated CEA report conform the KCE guidelines, describing the model, methodology, analyses, data inputs and results
  • A comprehensible report formulating the answers posed by RIZIV/INAMI about the pharmacoeconomic section of the dossier. Including additional results from new scenario analyses