The Role of Indication-Based Pricing in Future Pricing and Reimbursement Policies: A Systematic Review |
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| Affiliation: | 1. Epidemiology, Health Policy and Health Management, Escuela Internacional de Doctorado Universidad de Sevilla, Sevilla, Spain;2. Andalusian School of Public Health (EASP), Granada, Spain;3. CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain;4. Instituto de Investigación Biosanitaria (IBS), Granada, Spain;1. Health Economic Assessment Network, Paris, France;2. French National Center for Scientific Research, Paris, France;3. Sciences Po, Center of the Sociology of Organizations, Paris, France;4. Sociology and Anthropology Department, Paris 8 University, Paris, France;5. Rhumatology Department, Cochin Hospital, Paris, France;6. French League Against Rheumatism (AFLAR), Paris, France;7. UCB Pharma, Colombes, France;8. Rhumatology Department, Grenobles Alpes University Hospital, Echirolles, France;9. Kantar Health, Gentilly, France;1. School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada;2. School of Physiotherapy, Western University, London, Ontario, Canada;3. Department of Rehabilitation Medicine and Department of Plastic, Reconstructive, and Hand Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands;4. Hand and Wrist Center, Xpert Clinic and Handtherapie Nederland, Rotterdam, The Netherlands;1. School of Population Health, Curtin University, Perth, Australia;2. Department of Community Medicine, University of Tromsø, Tromsø, Norway;3. Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway;1. Duke University, Durham, NC, USA;2. Durham VA Medical Center, Durham, NC, USA;3. University of North Carolina, Chapel Hill, NC;4. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA;5. Department of Medicine, Duke University Medical Center, Durham, NC, USA;6. Duke Older Americans Independence Center, Duke University Medical Center, Durham, NC, USA;7. Greenville VA Medical Center, Greenville, NC, USA;1. Duke Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA;2. Department of Veterans Affairs, Durham VA Medical Center, Durham, NC, USA;3. Duke University Medical Center, Durham, NC, USA;4. Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA, USA;5. Duke Cancer Institute, Durham, NC, USA;6. Duke Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA;7. Section of Hematology/Oncology, Raymond G. Murphy New Mexico Veterans Affairs Medical Center, Albuquerque, NM, USA;8. Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;9. Department of Veterans Affairs, National Oncology Program, Durham, NC, USA;1. Exeter Test Group, University of Exeter Medical School, St Luke’s Campus, Exeter, England, UK;2. Health Economics Group, University of Exeter Medical School, St Luke’s Campus, Exeter, England, UK;3. PenTAG, University of Exeter Medical School, St Luke’s Campus, Exeter, England, UK;4. University of Exeter, Exeter, England, UK |
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| Abstract: | ObjectivesIndication-based pricing (IBP) has received growing attention because of the expected increase in the number of new medicines with multiple indications. In our systematic review, we assess the potential benefits, barriers, current experiences, and future perspectives of different IBP mechanisms.MethodsWe searched publications in English, Spanish, or French assessing the impact, international experience, and future context of IBP systems on PubMed, Scopus, Cochrane, EconLit, American Society of Clinical Oncology, and National Institute for Health Research Health Technology Assessment from 2000 to 2020. This was complemented by a gray literature search in Google Scholar.ResultsA total of 29 publications that specifically addressed the topic of IBP were retained. The most commonly reported benefits of IBP were a better alignment of medicines’ value and price, optimization of research and development incentives and increase of competition, and improvement of patients’ access to treatments. Data collection and proper infrastructures, and the risk of high administrative burden and associated costs, were seen as the main barriers for proper IBP implementation. International experience lacks concrete examples of IBP. A single weighted average price according to volume, value, or a combination of both, appears to be the most used methodology, followed by different confidential net prices per indication. Different brands with distinct price per indication are less common, although it is considered a pure IBP system.ConclusionsEvidence of IBP impact is still scarce, and there is a need for pilot projects and experiences to monitor its real consequences. An appropriate price and reimbursement model for multi-indication medicines should be a priority, but political will and proper data collection systems remain crucial. |
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| Keywords: | combination therapies differential pricing indication-based pricing indication-specific pricing innovative-pricing mechanism managed entry agreement multi-indication pricing value-based pricing |
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