BEACON: A Summary Framework to Overcome Potential Reimbursement Hurdles

Pharmacoeconomics. 2016 Oct;34(10):1051-65. doi: 10.1007/s40273-016-0427-7.

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.

Publication types

  • Review

MeSH terms

  • Abbreviations as Topic
  • Drug Design*
  • Drug Industry / economics
  • Drug Industry / organization & administration
  • Guidelines as Topic
  • Humans
  • Pharmaceutical Preparations / economics*
  • Reimbursement Mechanisms*

Substances

  • Pharmaceutical Preparations