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International pricing index ‘accomplishes nothing it sets out to do’

By Sue Peschin and Duane Schulthess, 21 October 2019

Even with all of the political chatter in Washington, D.C., talk about controlling prescription drug prices is still rising above the din. Of all the proposals being batted around, one that bases prices on an international average of prices in mostly European countries has bipartisan support. This strategy, known as the international pricing index, is particularly worrisome.

First proposed by U.S. Health and Human Services Secretary Alex Azar in the fall of 2018 for Medicare Part B drugs, House Speaker Nancy Pelosi’s drug pricing plan expands it to allow the federal government to negotiate the cost of 250 prescription medicines that aren’t facing market competition. It also extends the negotiated price to insurers and the commercial market at large.


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Vital Transformation has conducted two studies examining the impact of the proposed international reference pricing in Medicare Part D (H.R. 3, the Lower Drug Costs Now Act of 2019) on the world-class innovative biotechnology sector in California and the United States. The California Life Sciences Association (CLSA) – the statewide public policy organization representing California’s life sciences innovators – commissioned the California study, while the U.S. wide research has been conducted with the support of the Pharmaceutical Research and Manufacturers of America (PhRMA) – the trade group representing companies in the pharmaceutical industry in the United States.

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Find all our communication projects on Better Science, Better Health


Making Real World Data Real – New RWE Methodologies for HTAs

With the increasing use of accelerated regulatory tools like the Food and Drug Administration’s breakthrough designation, there are mounting challenges for European health technology assessors (HTAs) to make an accurate assessment of the long- term value and performance of many new therapies. Data presented in evidence is often extrapolated from outcomes six months or less, and what’s good enough for regulatory approval often doesn’t meet the needs for comparative effectiveness, value, and outcomes measures for HTAs. Vital Transformation’s recent BMJ publication demonstrates a novel, practical approach to harnessing electronic health records and RWE to help solve this problem. However, access to robust deidentified patient records in Europe is key.

Azar’s Plan To Tie U.S. Drug Prices To Foreign Ones Will Impact Investments In R&D

Photographer: Al Drago/Bloomberg © 2019 BLOOMBERG FINANCE LP Publish date: June 21, 2019 By John LaMattina, Contributor for Forbes Azar claims that HHS can reduce spending on Medicare Part B drugs with little impact on biopharmaceutical R&D investment. Duane Schulthess, Managing Director at VitalTransformation, questioned Azar’s claim on this. As he delved into specific compounds on Azar’s list of 27, he found some startling data. One striking case is with Biogen’s Multiple Sclerosis drug, Tysabri.

The International Pricing Index: What will be the Impact on Patients, Outcomes, and Innovation?

According to research from the US Health and Human Services, US tax payers pay 1.8 times the international price for medicines and are ‘subsidizing’ global healthcare. In order to combat this imbalance, the Trump administration is proposing the “International Pricing Index” (IPI) payment model to reduce reimbursement levels for the Centers for Medicare & Medicaid Services (CMS). Following Vital Transformation's research on investment success factors for biotech companies released at the European Health Forum Gastein, Vital Transformation presented original research modelling the potential impact both short and long term for patients, payers, and industry for such proposals, and show how the IPI can impact access and innovation broadly. As well, the panellists placed the IPI into the context of other models currently being investigated internationally such as value based payments, managed entry agreements, and adaptive pathways.




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