Value, economics, and equity

Classical, alternate, and novel methods of economic evaluation

From a foundation in “classical” pharmaco- and health economics, MATRIX45 has branched out into alternate and novel methods of economic evaluation of health care interventions and programs. In this, we appraise outcomes on gradients of benefit as well as harm.

At the core, we try to answer pragmatic questions.

• What do we (not) get from a treatment?
• How much does it cost?
• Is it worth it?
• Can we afford it?
• How many patients will (not) be helped?

“Classical” methods of health economic evaluation serve as the foundation. We may add alternate methods to broaden scope and approach. We may even venture into novel methods to deepen our understanding.

• We do not necessarily consider adverse events as negative – to be adjusted for (punitively). Instead, we appraise such events on a gradient of likelihood, consequence, and impact.
• We balance costs with intended and unintended outcomes – benefits and harms.
• We contextualize economic evaluations within the ecosystem of healthcare delivery and financing systems. 
• We focus on value: just as much as we aim to evaluate whether costs are worth the outcomes, we want to assess whether the outcomes are worth the costs.

We aim to balance cost, outcome, affordability, and equity.

The Six Delta Platform

an analytical platform for independently estimating equitable and fair pricing

To date, outcomes-based pricing and contracting have focused mainly on efficacy and effectiveness. We co-developed the Six Delta platform – an analytical platform for independently estimating equitable and fair pricing of drugs (and other treatments) that balances the mutual interests of payers and manufacturers.

It combines six dimensions and methods of pricing:

Drawing on our work in precision health, genetics, and decision analysis, we bring expertise in assessing the value of information – perfect and imperfect – to health, health care, and health economics.

Much of pharmaco-economic analysis focuses on singular treatments. However, much of pharmacotherapy entails trajectories of treatment – from hypertension management to navigating patients with hematological malignancies through episodes of treatment and relapse. Applying complex models, we evaluate the benefits and harms – and their economic implications – of trajectories (“journeys”) in which patients migrate through various treatments as disease progresses.

Health economic analysis is not focused exclusively on achieving efficiencies but also on evaluating options for applying these efficiencies and thus improving access to and equity in healthcare. Driven in part by our work on biosimilars, we have supported manufacturers, payers, and providers by simulating how formulary decisions may yield cost-efficiencies, how these can be optimized, and how they can be applied to provide additional care, expand patient access to care, and contribute to greater equity – often on a budget-neutral basis.

Smaller life sciences companies may not have the volume and continuity of work nor the budget for an in-house Health Economics and Outcomes Research (HEOR) group. MATRIX45 provides such companies with ad hoc health economics and outcomes research and dissemination services typically performed by HEOR departments in mid-size and large organizations.