Edition 3/2019: How do we pay for a cure? The risks and rewards of innovative payment schemes

Setting drug prices is a high-stakes endeavor, and that is especially true for the latest round of gene and curative products coming to market in Europe. Drugmakers need to consider several factors that can help them set their product prices appropriately, including the risk of recurrence/ relapse, differences in efficacy among cures, and comparators, including full lifecycle costs of a disease and the burden of health economic costs on budgets. They also need to design innovative payment models that will be attractive to health systems facing increased budgetary pressures as more gene and curative products enter the market. This includes outcomes- and performance-based
schemes, which have gained momentum across Europe. However, drugmakers need to be cautious because such models could leave them vulnerable to “known unknowns,” including whether a cure can be sustained throughout a patient’s lifetime, given the lack of long-term data.

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