Payers and pharma face pricing dilemmas as cancer clinics use combination drugs - EFPIA

by Richard Staines
LONDON, Jan 14 (APM) - Payers and pharma companies will increasingly have to adopt new pricing agreements as tailored combination therapies become used by clinics, European pharma leader Richard Bergstrom told APM.
In an interview on Tuesday looking forward to developments in 2015, European Federation of Pharmaceutical Industries and Associations (EFPIA) director general Bergstrom made his comments as the National Health Service in England controversially pulled funding for 25 treatments on the cancer drugs fund (APMHE 41078).
Bergstrom said the trend in cancer clinics in Europe was towards hitting tumours hard with a cocktail of drugs from the beginning to prevent them building resistance.

Pay by results?

“The approach of starting off with an old cheap drug to see what happens, wait six weeks, we have to recognise that is inhumane. We have to do what we do with HIV and go hard from the beginning and use combinations. So when it comes to pricing and reimbursement, you have to have different models,” he said.
One approach is to use a pay-by-results model, with funding split between different manufacturers, he said. “I hear this from leading cancer clinics. They would like to see a new model where they pay for results.”
Bergstrom acknowledged this was problematic for companies that are competitors. “It is difficult for us to respond to that,” said Bergstrom.

Long-term patients

The trend towards immuno-oncological combination drugs will see a greater emphasis on longer-term treatment for cancer patients, who may survive for several years and need to be re-treated to boost their immune systems, Bergstrom noted.
This could also lead to changes in pricing and reimbursement models, although he was less specific about how pharma and payers will respond to this challenge.
Existing trends where pharma companies offer discounts on list prices will continue, he predicted. “Beyond the list price there is something going on,” he said.
Bergstrom said he was disappointed with the developments in England. “It is the failure of the system. Some of our members are very upset about this."



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