Value of biologic therapy: A forecasting model in three disease areas

Abstract

Objective:

Forecast the return on investment (ROI) for advances in biologic therapies in years 2015 and 2030, based upon impact on disease prevalence, morbidity, and mortality for asthma, diabetes, and colorectal cancer.

Methods:

A deterministic, spreadsheet-based, forecasting model was developed based on trends in demographics and disease epidemiology. ‘Return’ was defined as reductions in disease burden (prevalence, morbidity, mortality) translated into monetary terms; ‘investment’ was defined as the incremental costs of biologic therapy advances. Data on disease prevalence, morbidity, mortality, and associated costs were obtained from government survey statistics or published literature. Expected impact of advances in biologic therapies was based on expert opinion. Gains in quality-adjusted life years (QALYs) were valued at $100,000 per QALY.

Results:

The base case analysis, in which reductions in disease prevalence and mortality predicted by the expert panel are not considered, shows the resulting ROIs remain positive for asthma and diabetes but fall below $1 for colorectal cancer. Analysis involving expert panel predictions indicated positive ROI results for all three diseases at both time points, ranging from $207 for each incremental dollar spent on biologic therapies to treat asthma in 2030, to $4 for each incremental dollar spent on biologic therapies to treat colorectal cancer in 2015. If QALYs are not considered, the resulting ROIs remain positive for all three diseases at both time points.

Conclusions:

Society may expect substantial returns from investments in innovative biologic therapies. These benefits are most likely to be realized in an environment of appropriate use of new molecules.

Limitations:

The potential variance between forecasted (from expert opinion) and actual future health outcomes could be significant. Similarly, the forecasted growth in use of biologic therapies relied upon unvalidated market forecasts.

Key words::

• Asthma
• Biologics
• Colorectal cancer
• Delphi techniques
• Diabetes mellitus
• Forecasting
• Return on investment

Transparency

Declaration of funding

Financial support for this study and paper was received from Amgen.

Declaration of financial/other relationships

L.C.P., C.A.H., and B.R.L. have disclosed that they are employees of United BioSource Corporation, which performed this work under contract for Amgen. R.J.N. has disclosed that he is an employee of Amgen. R.J.H. has disclosed that he is an Adjunct Assistant Professor in the Department of Community Health Sciences in the UCLA School of Public Health and a Principal Consultant with Bezalel Consulting.

Some peer reviewers receive honoraria from CMRO for their review work. Peer reviewer 1 has disclosed that he/she has received grants from Cerner Corporation and Pfizer and has been a consultant for, and holds stocks in, Mannkind Corporation. The other reviewer of this paper has disclosed that he/she has no relevant financial relationships.

Acknowledgment

Editorial assistance was provided in the research, preparation and writing of this manuscript by Katy Hospital, Emily Sargent and Corey Parker, all employees of United BioSource.