The Value-Based Pricing and Market Access of Valbenazine: A Cost Effective Evaluation in Japan

By Danélia Botes

November 29, 2023

The Centre for Outcomes Research and Economic Evaluation for Health (C2H) is an esteemed department of the National Institute of Public Health in Japan, established in 2018. The organisation conducts rigorous academic research on cost-effectiveness evaluations and plays a crucial role in the official evaluation process. In a nation where public healthcare expenditure is continually increasing, C2H’s work is invaluable. They strive to balance the cost and outcome of healthcare technologies, providing crucial data and materials for evidence-based health policy. The ultimate goal is to enhance the sustainability of the public healthcare system. C2H is a beacon of knowledge for experts conducting cost-effectiveness evaluations, offering guidelines and analytical tools. Furthermore, they also guide manufacturers in conducting scientifically sound analyses and help citizens and healthcare professionals understand the value and implications of their evaluations.

Valbenazine: A Breakthrough in Tardive Dyskinesia Treatment

In May 2023, Valbenazine was reimbursed and its drug price was set at JPY 2331.2 for a Dysval® capsule 40mg in Japan, determined via the Similar Efficacy Comparison Method with a 5% premium. This pricing strategy is an example of dynamic pricing, a common practice in pharmaceutical pricing strategy. The drug was designated for the Cost-effectiveness Evaluation with an H2 classification, reflecting its significant value story.

Target Population and Treatment Options

The target population for Valbenazine is patients with tardive dyskinesia whose symptoms have not improved sufficiently by reducing or discontinuing drugs for underlying diseases. Given the limited treatment options for this group, the comparator for the cost-effectiveness evaluation was “watchful waiting”.

Evaluating the Additional Benefits of Valbenazine

The manufacturer conducted a systematic review of randomised controlled trials to evaluate the drug’s additional benefits. This review included a mixed-model meta-analysis that compared Valbenazine with a placebo. The results showed that Valbenazine significantly improved patients’ symptoms. This reaffirms the value-based healthcare benefits of the drug. 

Cost-Effectiveness Analysis of Valbenazine

The manufacturer conducted a cost-utility analysis using a microsimulation model. This model accounted for responses from interventions, prescription of antipsychotic drugs, and recurrence of underlying diseases. Interestingly, the results of this analysis further substantiated the benefits of Valbenazine, demonstrating its cost-effectiveness and aligning with the principles of value-based healthcare 2024. 

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