Indication-specific pricing for cancer drugs
Cet article analyse les enjeux associés à un systéme de fixation du prix des médicaments anticancéreux en fonction de leur efficacité par pathologie
As policy makers consider how to handle high-priced drugs, an important concern is that the price of the drug is not currently linked to its benefits. “Value,” the benefit of a treatment with respect to its cost, has become an increasingly important consideration, following some explicit models in Europe, where value is considered although not directly integrated into pricing. The UK National Institute for Health and Care Excellence (NICE) makes formulary determinations by considering effectiveness and cost together. It uses a common value threshold to determine which drugs qualify for inclusion. In Germany, the IQWIG (Institute for Quality and Efficiency in Health Care) uses a reference pricing system, whereby unless a new drug demonstrates superiority over the best existing comparator, it will be reimbursed at the same level as that comparator with any additional cost borne out-of-pocket by the patient. This anchors only the portion of the price of the drug that is paid by the government to its value.