Feasibility and attractiveness of indication value-based pricing in key EU countries

Abstract

Indication value-based pricing (IBP) has been proposed in the United States as a tool to capture the differential value of drugs across indications or patient groups and is in the early phases of implementation. In Europe, no major country has experimented with IBP or is seriously discussing its use. We assessed how the reimbursement and pricing environment allows for IBP in seven European countries, evaluating both incentives and hurdles. In price setting countries such as France and Germany, the Health Technology Assessment and pricing process already accounts for differences of value across indications. In countries where differential value drives coverage decisions such as the United Kingdom and Sweden, IBP is likely to be used, at least partially, but not in the short-term. Italy is already achieving some form of differential value through managed entry agreements, whereas in Spain the electronic prescription system provides the infrastructure necessary for IBP but other hurdles exist.

Fighting healthcare rocketing costs with value-based medicine: the case of stroke management

“…As an example, Germany (from 2000) and the Netherlands (from 2010) introduced such a system for various chronic diseases as diabetes and chronic obstructive pulmonary disease, which are endowed with complex and long-term post-discharge services [8]. A similar transformation is underway in drug reimbursement schemes, where an indication value-based pricing (IBP) framework is gaining popularity [9] across US and some European Countries, e.g. Italy.…”

“…Italy. In this case, the reimbursement is proportional to the value a molecule has for each specific pathology, and it is not defined according to standard volume-price logics [9,10].…”

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“…55,70 If the price of a drug is related to its added value, it should be lower in indications where the benefit for the patient is less evident. Currently, the price is the same for all indications whatever the results and the duration of treatment.…”

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“…Indication-based pricing or OB-MEAs should be implemented if value differs across indications, as long as health care providers are able to track a medicine's use per indication. 8 Finally, VBP for medicines usually refers to the ex-factory price. Pharmacy and wholesaler remuneration is set by law and should reflect the value of the service they provide and not the intrinsic value of the drug.…”