BEACON: A Summary Framework to Overcome Potential Reimbursement Hurdles

William C. N. Dunlop (), C. Daniel Mullins, Olaf Pirk, Ron Goeree, Maarten J. Postma, Ashley Enstone and Louise Heron
Additional contact information
William C. N. Dunlop: Mundipharma International Limited
C. Daniel Mullins: University of Maryland School of Pharmacy
Olaf Pirk: Olaf Pirk Consult
Ron Goeree: Goeree Consulting
Maarten J. Postma: University of Groningen
Ashley Enstone: Adelphi Values Limited
Louise Heron: Adelphi Values Limited

PharmacoEconomics, 2016, vol. 34, issue 10, No 9, 1065 pages

Abstract: Abstract Objective To provide a framework for addressing payers’ criteria during the development of pharmaceuticals. Methods A conceptual framework was presented to an international health economic expert panel for discussion. A structured literature search (from 2010 to May 2015), using the following databases in Ovid: Medline® and Medline® In-Process (PubMed), Embase (Ovid), EconLit (EBSCOhost) and the National Health Service Economic Evaluation Database (NHS EED), and a ‘grey literature’ search, were conducted to identify existing criteria from the payer perspective. The criteria assessed by existing frameworks and guidelines were collated; the most commonly reported criteria were considered for inclusion in the framework. A mnemonic was conceived as a memory aide to summarise these criteria. Results Overall, 41 publications were identified as potentially relevant to the objective. Following further screening, 26 were excluded upon full-text review on the basis of no framework presented (n = 13), redundancy (n = 11) or abstract only (n = 2). Frameworks that captured criteria developed for or utilised by the pharmaceutical industry (n = 5) and reimbursement guidance (n = 10) were reviewed. The most commonly identified criteria—unmet need/patient burden, safety, efficacy, quality-of-life outcomes, environment, evidence quality, budget impact and comparator—were incorporated into the summary framework. For ease of communication, the following mnemonic was developed: BEACON (Burden/target population, Environment, Affordability/value, Comparator, Outcomes, Number of studies/quality of evidence). Conclusions The BEACON framework aims to capture the ‘essence’ of payer requirements by addressing the most commonly described criteria requested by payers regarding the introduction of a new pharmaceutical.

Date: 2016
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DOI: 10.1007/s40273-016-0427-7

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