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Pricing and Reimbursement: Innovative Risk-Sharing Strategies

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Date Published:
July 16, 2009
Price:
$3800
Source:
Datamonitor

Novel niche biologics entering the market require high price points in order to provide manufacturers with a return on investment. However, with heightening regulatory scrutiny and increasing cost-pressures, a balance must be struck between incentivizing Pharma to develop novel drugs with high unmet needs, and that of the healthcare payers which fund healthcare costs.

Scope of this research

  • Overview of the different types of risk-sharing agreements adopted by manufacturers
  • Insight into the utilization of such schemes in the UK, US, Italy and Australia
  • Examination of the pros and cons of risk-sharing agreements
  • Identification of key strategic recommendations for optimizing risk-sharing strategies

Research and analysis highlights

Risk-sharing schemes are ideal if a well-established biomarker can be used to unambiguously determine if a patient has responded to treatment, however for many other oncology drugs relevant biomarkers still need to be discovered hence impeding a more widespread adoption of these schemes.

The new NICE end-of-life guidance rule can be useful for drugs struggling to gain a positive NICE opinion. By targeting terminal patients with months to live, they can achieve market access and a route into the treatment of other stages of a disease, but only if further concessions are made to reduce the drug's QALY.

If a Health Technology Assessment (HTA) is introduced in the US, it could create a more cost-effective use of current US healthcare resources, however it is important to note this will increase the burden on Pharma to produce data, and could also effectively lead to the end of free pricing in the US.

Key reasons to purchase this research

  • Understand the importance of cost-effectiveness and its impact on pricing and reimbursement of pharmaceuticals
  • Gain insight into risk-sharing schemes and identify how these can be implemented and optimized
  • Case study analysis of recent risk-sharing agreements in US, UK, Italy, and Australia
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