Combined therapies, a new pricing methode proposed in Sweden!

An innovative and forward-thinking solution has emerged in Sweden regarding the pricing of intricate combination therapies for cancer treatment. A collaborative report from various stakeholders, including regional representatives, the New Therapies Council, and the industry association Lif, presents a visionary approach to address this challenge. The report emphasizes the importance of voluntary commitment from all interested parties to foster the advancement of combination therapies.

Under this proposal, pharmaceutical companies would actively engage in negotiations, working towards a national recommendation from the New Therapies Council. These negotiations would serve as a platform for the development of a streamlined process, allowing the regions to effectively handle cases involving prioritized prescription medicines used in combination.

To enhance transparency in health economic evaluations, the report suggests the inclusion of specific non-confidential information in the documentation. The responsibility for managing the disclosure of health economic data between pharmaceutical companies would be entrusted to TLV.

In a departure from traditional pricing approaches, the proposal incorporates forward-looking assumptions regarding the future utilization of medicines. This dynamic pricing framework acknowledges that the cost of a medicine may differ based on its application in a health economic evaluation. However, it is important to note that this does not imply variations in the actual cost of the medicine across different uses. The New Therapies Council would be responsible for determining the appropriate weighting mechanism to assign to different prices, ultimately leading to a comprehensive and defined pricing structure within agreements.

Effective communication within the negotiating group is crucial, and the report emphasizes the need to outline clear conditions for willingness to pay and weighting. These conditions would be tailored to each individual case, allowing companies to submit tenders for their products during a predetermined number of tender rounds. After each round, the negotiating team would assess whether the resulting price level enables a positive recommendation. The communication of specific information following each round would be decided on a case-by-case basis, striking a balance between achieving an affirmative recommendation and preventing potential pricing coordination among companies.

Recognizing the dynamic nature of medicine usage and knowledge advancement, the report suggests continuous refinement of the initial assumptions regarding weighting. For each medicine recommended based on the weighting mechanism, a straightforward follow-up protocol would be developed. The NT Council would be responsible for determining the design of this protocol, which could evolve over time.

As a concrete step forward, the authors propose the initiation of a pilot project that employs horizon scanning to identify suitable candidates. Ensuring compliance with competition law, a meeting with the Swedish Competition Authority would be arranged to guarantee a fair and competitive environment.

It is important to underscore that this innovative approach is intended to address the pricing complexities associated with a limited number of combination regimens. By adopting this groundbreaking pricing methodology, the field of cancer treatment stands to benefit from improved accessibility and affordability.

In the short term, the implementation of this approach would require active participation from stakeholders, including pharmaceutical companies, the New Therapies Council, and regional representatives. Negotiations would take place to establish a national recommendation, and the inclusion of non-confidential health economic data in documentation would enhance transparency.

In the mid term, the dynamic pricing structure based on forward-looking assumptions would lead to differentiated pricing depending on the area of application during health economic evaluations. The refining of weighting assumptions and the development of a follow-up protocol would ensure continuous improvement.

In the long term, the successful pilot project and compliance with competition law would pave the way for broader adoption of this innovative pricing methodology. The combination therapies market would benefit from a comprehensive and adaptable pricing structure, resulting in improved accessibility and affordability for patients.

By setting these short-term, mid-term, and long-term expectations, the report envisions a transformative impact on the pricing landscape for intricate combination therapies in cancer treatment. The implementation and refinement of this approach have the potential to revolutionize the field, ultimately benefiting patients and healthcare systems alike.