Developing relationship building tools for use by the NHS. Collecting market information and aligning to the analysis and modelling. Projecting disease progression within a local population over time, reflecting projected outcomes (blindness) for treated and untreated users.
As part of a new product rollout toolkit, a major pharmaceutical company required an advanced, research driven, independently developed commissioning support model enabling NHS commissioners to project health outcomes and budget impact based on alternative treatment scenarios from the incorporation of a newly approved treatment for wet age-related macular degeneration (AMD).
Outputs required included prediction and comparison of relative effectiveness and cost of different potential structures over a 10-year time horizon, compared to a baseline structure to identify impact of specific decisions such as increasing levels of identification and treatment within the population. To demonstrate budget impact functionality would require additional treatment costs to be offset against costs saved by a reduction in blindness.
As a key focus was providing users with an overview of existing market prescribing, we helped to drive collection of market information around competitor market share. This included collating outputs from FOI requests and developing existing market data to enable a view of market share at each level of prescribing.
The model was also required to incorporate applicable ophthalmological research into AMD, including specific research into the effectiveness of the new treatment. Double blind studies have resulted in treatment impact tables which showed the disease progression over time in terms of visual acuity for patients adhering to treatment and a placebo best standard care population. These tables would enable projection of health outcomes for treated and untreated patients.
The commissioning support model would need to estimate AMD in local populations and provide the user with full flexibility to quickly adapt the settings to local requirements.
The Ophthalmology Commissioning Support Model was developed by Benson Wintere as a single treatment model using advanced excel and leveraging off available techniques, procedures and templates to provide a robust, research driven tool with instinctive navigation and strong front end conveying key messages.
The specification, development and refinement of the model occurred in conjunction with input received across a series of meetings with client working groups reflecting representation from various parts of the client’s business. This provided ongoing opportunities for the client to increase its ownership and understanding in the project, define the scope and objectives, and identify requirements of the finished model.
The model estimates outcomes occurring within patients in a selected PCT population(s). This is enabled by estimating the visual acuity stratification of all users with AMD. Visual acuity was stratified into 5 levels, aligned with established measurement and available research. The two most severe levels are defined as technical blindness. By defining the population by blind and non blind we could then drive cost outcomes associated with blindness and present the outcomes and budget impact of an increased commitment to the new treatment.
The treatment component of the model establishes the current level of identification and referral to the new treatment and enables both of these factors to be increased in the new scenario to enable the impact of an optimal referral strategy to be estimated.
The model was supported with full guidance, including supporting notes on each settings sheet, and visible references supporting assumptions, calculations and researched data, hyperlinked to comprehensive reference sheet.
The model provided a balance between the needs of the marketing team and the health economics teams – ensuring key messages around treatment impact and outcomes were supported by appropriate research and calculations. The model was delivered to the client and has been rolled out across their national sales team. The next step is for the sales team to introduce the tool as well as other parts of the new product toolkit in a live environment with the NHS.