Value-Based Healthcare in practice: IDEATE, a collaboration to design and test an outcomes-based agreement for a medicine in Wales

Value-Based Healthcare in practice: IDEATE, a collaboration to design and test an outcomes-based agreement for a medicine in Wales | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Value-Based Healthcare in practice: IDEATE, a collaboration to design and test an outcomes-based agreement for a medicine in Wales Burton J, Halsby K, Sáinz de la Fuente G, Pearson-Stuttard J, and 11 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4613924/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: To develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges. Methods: Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical model for an OBA in a trusted research environment. A cross-disciplinary collaboration between NHS Wales, industry, and academia was developed. Data were collected from Welsh national datasets and used to inform a novel linked-dataset. OBA scenarios, with different contract parameters, were analysed to assess impact on the proportion of contract payment due and the volatility of payments. Results: An approved, in market, locally advanced and metastatic breast cancer treatment was selected as the test case. The total number of patients in the treatment cohort (2017–2020) was n = 99, and 286 in the control cohort (2014–2016). The final outcome variables selected were: 1) 1-year survival, 2) intolerance to treatment (deferral), and 3) the total days disrupted by care. The primary scenario included all three outcomes measured at the population level and used a linear payment model. Volatility analyses demonstrated contract parameters can dramatically alter the contract output with greatest risk from a single, binary outcome contract design. Conclusions: The design of an OBA is a complex process that requires a multidisciplinary approach. By better pinpointing which medicines are a good fit for an OBA, assessing solutions to data, outcomes, and contracting challenges, IDEATE provides a strong foundation for future success of OBAs in the UK. Health Economics and Outcomes Research Value-Based Healthcare Outcomes-Based Agreement Innovative Procurement Medicines Contract design pricing breast cancer Figures Figure 1 Figure 2 Figure 3 Full Text Additional Declarations The authors declare potential competing interests as follows: • Pfizer Ltd. funded this study and the open access fees, including funding for the collaboration with Lane Clark & Peacock LLP. Pfizer Ltd. is the sponsor of the study. No specific grant or award funded this research. II. Conflicts of Interest • The authors have disclosed the following conflicts of interest: o Burton: Study conducted while employed by Pfizer, Ltd. and may have held stock or stock options. Manuscript completed while self-employed at Patient- Centred Outcomes Consulting Ltd. o Halsby: Employee of Pfizer and may hold stocks or stock options. o Sáinz de la Fuente: Study conducted while employed by Pfizer, Ltd. and may have held stock or stock options. o Pearson-Stuttard: Partner & Head of Health Analytics at Lane Clark & Peacock LLP, Chair of the Royal Society for Public Health and reports personal fees from Pfizer Ltd outside of the submitted work. o Sloan: No conflicts of interest to declare. o Porter: Partner at Lane Clark & Peacock LLP and declares no further conflicts. o John: No conflicts of interest to declare. o Warburton: No conflicts of interest to declare. o Selby: No conflicts of interest to declare. o Povey: No conflicts of interest to declare. o Chowdhury: Employee of Pfizer and may hold stocks or stock options. o Bale: Received a stipend for professional consulting paid by Pfizer Ltd. for this research. o Davies: Received a stipend for professional consulting paid by Pfizer Ltd. for this research. o Clifton-Brown: Employee of Pfizer and may hold stocks or stock options. o Laing H: Employed by Swansea University which has received grant funding from Pfizer Ltd. Tables 1 to 5 are available in the Supplementary Files section. Supplementary Files Tables.pdf SupplementaryFigs.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4613924","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":317053982,"identity":"07581566-daf9-4a67-9d60-5185bf2f37c1","order_by":0,"name":"Burton J","email":"","orcid":"https://orcid.org/0009-0004-9115-8782","institution":"Pfizer Ltd","correspondingAuthor":false,"prefix":"","firstName":"Burton","middleName":"","lastName":"J","suffix":""},{"id":317057113,"identity":"e2d2b61b-5459-4df5-99d4-bcbb872470c7","order_by":1,"name":"Halsby 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Pfizer Ltd. is the sponsor of the study. No specific grant or award funded this research. II. Conflicts of Interest • The authors have disclosed the following conflicts of interest: o Burton: Study conducted while employed by Pfizer, Ltd. and may have held stock or stock options. Manuscript completed while self-employed at Patient- Centred Outcomes Consulting Ltd. o Halsby: Employee of Pfizer and may hold stocks or stock options. o Sáinz de la Fuente: Study conducted while employed by Pfizer, Ltd. and may have held stock or stock options. o Pearson-Stuttard: Partner \u0026amp; Head of Health Analytics at Lane Clark \u0026amp; Peacock LLP, Chair of the Royal Society for Public Health and reports personal fees from Pfizer Ltd outside of the submitted work. o Sloan: No conflicts of interest to declare. o Porter: Partner at Lane Clark \u0026amp; Peacock LLP and declares no further conflicts. o John: No conflicts of interest to declare. o Warburton: No conflicts of interest to declare. o Selby: No conflicts of interest to declare. o Povey: No conflicts of interest to declare. o Chowdhury: Employee of Pfizer and may hold stocks or stock options. o Bale: Received a stipend for professional consulting paid by Pfizer Ltd. for this research. o Davies: Received a stipend for professional consulting paid by Pfizer Ltd. for this research. o Clifton-Brown: Employee of Pfizer and may hold stocks or stock options. o Laing H: Employed by Swansea University which has received grant funding from Pfizer Ltd.\u003c/p\u003e\n\u003cp\u003eTables 1 to 5 are available in the Supplementary Files section.\u003c/p\u003e","formattedTitle":"\u003cp\u003eValue-Based Healthcare in practice: IDEATE, a collaboration to design and test an outcomes-based agreement for a medicine in Wales\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[{"identity":"19f489cf-783f-445d-8f9a-98b463693085","identifier":"10.13039/100009032","name":"Pfizer UK","awardNumber":"na","order_by":0}],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Pfizer (United Kingdom)","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Value-Based Healthcare, Outcomes-Based Agreement, Innovative Procurement, Medicines, Contract design, pricing, breast cancer","lastPublishedDoi":"10.21203/rs.3.rs-4613924/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4613924/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective:\u003c/h2\u003e \u003cp\u003eTo develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eProject IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical model for an OBA in a trusted research environment. A cross-disciplinary collaboration between NHS Wales, industry, and academia was developed. Data were collected from Welsh national datasets and used to inform a novel linked-dataset. OBA scenarios, with different contract parameters, were analysed to assess impact on the proportion of contract payment due and the volatility of payments.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eAn approved, in market, locally advanced and metastatic breast cancer treatment was selected as the test case. The total number of patients in the treatment cohort (2017\u0026ndash;2020) was n\u0026thinsp;=\u0026thinsp;99, and 286 in the control cohort (2014\u0026ndash;2016). The final outcome variables selected were: 1) 1-year survival, 2) intolerance to treatment (deferral), and 3) the total days disrupted by care. The primary scenario included all three outcomes measured at the population level and used a linear payment model. Volatility analyses demonstrated contract parameters can dramatically alter the contract output with greatest risk from a single, binary outcome contract design.\u003c/p\u003e\u003ch2\u003eConclusions:\u003c/h2\u003e \u003cp\u003eThe design of an OBA is a complex process that requires a multidisciplinary approach. By better pinpointing which medicines are a good fit for an OBA, assessing solutions to data, outcomes, and contracting challenges, IDEATE provides a strong foundation for future success of OBAs in the UK.\u003c/p\u003e","manuscriptTitle":"Value-Based Healthcare in practice: IDEATE, a collaboration to design and test an outcomes-based agreement for a medicine in Wales","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-25 14:07:30","doi":"10.21203/rs.3.rs-4613924/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c33208d6-761d-455c-b57d-a2eb457c8624","owner":[],"postedDate":"June 25th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":33528072,"name":"Health Economics and Outcomes Research"}],"tags":[],"updatedAt":"2024-06-25T14:07:31+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-25 14:07:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4613924","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4613924","identity":"rs-4613924","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}