Challenge
A pharmaceutical company sought to assess the budget impact of a treatment for peripheral neuropathic pain in adults within Portuguese National Health Service (NHS) hospitals.
The analysis covered three relevant aetiologies of peripheral neuropathic pain: painful diabetic neuropathy, post-surgical neuropathic pain, and neuropathic pain associated with chemotherapy.
The objective was to assess the impact of using a cutaneous patch, either as monotherapy or in combination with other pain medications, on costs and healthcare resource utilisation within Portuguese NHS hospitals, including its potential impact on reducing the need for concomitant pain medication.
The assessment required an approach that captured not only treatment acquisition and administration costs, but also the consequences of differences in analgesic efficacy and tolerability on treatment pathways, concomitant medication use, and healthcare resource utilisation. The analysis also needed to account for the specific characteristics of each aetiology in terms of patient population, treatment approach, available clinical evidence, and resource use.
Solution
Clevidence developed Microsoft Excel-based budget impact models tailored to the Portuguese hospital setting and to the specific characteristics of each of the three peripheral neuropathic pain aetiologies.
The models compared the use of the cutaneous patch, either alone or in combination with other pain treatments, with a scenario in which the intervention was not used. The modelling approach linked treatment efficacy and tolerability with their downstream clinical and economic consequences over a one-year time horizon.
Key model inputs and cost drivers included:
· eligible patient populations and assumptions regarding treatment use;
· treatment acquisition and administration costs;
· concomitant medication for pain management;
· analgesic efficacy and treatment discontinuation due to lack of efficacy;
· incidence and management of adverse events;
· primary care and pain clinic visits;
· emergency department visits and hospital admissions; and
· use of other therapies and healthcare resources associated with neuropathic pain management.
The model structure enabled the assessment of the intervention’s impact on both pharmaceutical expenditure and overall healthcare resource utilisation, while reflecting the clinical pathways relevant to each aetiology.
Scenario analyses were also conducted to explore uncertainty around key assumptions and identify the main drivers of budget impact.
Impact
The analyses enabled the client to quantify the budget impact of adopting the intervention within Portuguese NHS hospitals across three distinct peripheral neuropathic pain populations.
By jointly considering treatment costs, concomitant medication use and other healthcare resources, the models allowed the client to assess how differences in treatment efficacy and tolerability could translate into changes in the overall cost of managing patients with peripheral neuropathic pain.
The project provided the client with locally adapted HEOR evidence to strengthen the intervention’s value proposition, inform its hospital market access strategy, and support discussions with healthcare decision-makers regarding the clinical and financial implications of treatment adoption.
By integrating clinical evidence, treatment pathways, healthcare resource utilisation and local cost data within transparent and flexible budget impact models, Clevidence developed a decision-support tool tailored to the Portuguese healthcare setting.