Steven D Pearson1, William B Dreitlein1, Chris Henshall2, Adrian Towse3. 1. Institute for Clinical & Economic Review, Two Liberty Square, 9th Floor, Boston, MA 02109, USA. 2. Brunel University London, Kingston Ln, London, Uxbridge UB8 3PH, UK. 3. Office of Health Economics, Southside,7th Floor 105 Victoria Street, London SW1E 6QT, UK.
Abstract
AIM: To explore the potential of indication-specific pricing (ISP) of pharmaceuticals and to discuss prospects for implementation in the US healthcare system. MATERIALS & METHODS: The Institute for Clinical and Economic Review convened a policy forum with 44 healthcare leaders from 22 payer and life sciences companies. Models of ISP were discussed. RESULTS: Payers and drug manufacturers saw the potential benefits of an ISP system that balances affordability for payers, sustainability for manufacturers and access for patients. The US healthcare system presents many challenges to implementation, including potential conflicts with existing pricing policies (Medicaid Best Price, average sales price and 340B) and insufficient data systems and analytic capabilities. CONCLUSION: Possible solutions and policy recommendations for payers and manufacturers are provided.
AIM: To explore the potential of indication-specific pricing (ISP) of pharmaceuticals and to discuss prospects for implementation in the US healthcare system. MATERIALS & METHODS: The Institute for Clinical and Economic Review convened a policy forum with 44 healthcare leaders from 22 payer and life sciences companies. Models of ISP were discussed. RESULTS: Payers and drug manufacturers saw the potential benefits of an ISP system that balances affordability for payers, sustainability for manufacturers and access for patients. The US healthcare system presents many challenges to implementation, including potential conflicts with existing pricing policies (Medicaid Best Price, average sales price and 340B) and insufficient data systems and analytic capabilities. CONCLUSION: Possible solutions and policy recommendations for payers and manufacturers are provided.
Entities:
Keywords:
Institute for Clinical and Economic Review; health policy; indication-specific pricing; multi-indication drugs; payers; pharmaceutical manufacturers; reimbursement; value-based pricing
Authors: Rositsa Koleva-Kolarova; James Buchanan; Heleen Vellekoop; Simone Huygens; Matthijs Versteegh; Maureen Rutten-van Mölken; László Szilberhorn; Tamás Zelei; Balázs Nagy; Sarah Wordsworth; Apostolos Tsiachristas Journal: Appl Health Econ Health Policy Date: 2022-04-04 Impact factor: 3.686