Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Value-based pricing of drugs with multiple indications or in combinations — lessons from Europe

Legislators in the USA have been discussing reforms to reduce the high cost of brand-name drugs, which are much higher in the USA than in other industrialized countries. One solution is to actively negotiate prices based on drugs’ clinical benefits. We discuss two important complexities from such an approach: drugs that have been approved for multiple indications and as part of a combination regimen.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Vokinger, K. N. et al. Analysis of launch and postapproval cancer drug pricing, clinical benefit, and policy implications in the US and Europe. JAMA Oncol. https://doi.org/10.1001/jamaoncol.2021.2026 (2021).

    Article  PubMed  Google Scholar 

  2. OECD. Addressing challenges in access to oncology medicines. Analytical report. OECD https://www.oecd.org/health/health-systems/Addressing-Challenges-in-Access-to-Oncology-Medicines-Analytical-Report.pdf (2020).

  3. IQVIA Institute. Global oncology trends 2021. IQVIA https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/global-oncology-trends-2021/global-oncology-trends-report-2021-05-21-forweb.pdf?_=1630425102649 (2021).

  4. Will cancer drugs get cheaper in 2020? Nat. Rev. Clin. Oncol. 17, 127–127 (2020).

  5. Bach, P. B. Indication-specific pricing for cancer drugs. JAMA 312, 1629 (2014).

    Article  CAS  Google Scholar 

  6. Cherla, A., Naci, H., Kesselheim, A. S., Gyawali, B. & Mossialos, E. Assessment of coverage in England of cancer drugs qualifying for US Food and Drug Administration accelerated approval. JAMA Intern. Med. 181, 490 (2021).

    Article  Google Scholar 

  7. Webster, R. M. Combination therapies in oncology. Nat. Rev. Drug Discov. 15, 81–82 (2016).

    Article  CAS  Google Scholar 

  8. Bach, P. B. New math on drug cost-effectiveness. N. Engl. J. Med. 373, 1797–1799 (2015).

    Article  Google Scholar 

  9. Kesselheim, A. S., Hwang, T. J. & Avorn, J. Paying for prescription drugs in the new administration. JAMA 325, 819 (2021).

    Article  Google Scholar 

  10. Swain, S. M. et al. Pertuzumab, trastuzumab, and docetaxel in HER2-Positive metastatic breast cancer. N. Engl. J. Med. 372, 724–734 (2015).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors are grateful to David L. Carl (University of Zurich) for assistance with a previous version of the manuscript. The work of K.N.V. is partially funded by the Swiss National Science Foundation (SNSF). The work of A.S.K. is supported by Arnold Ventures.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kerstin N. Vokinger.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vokinger, K.N., Kesselheim, A.S. Value-based pricing of drugs with multiple indications or in combinations — lessons from Europe. Nat Rev Clin Oncol 19, 1–2 (2022). https://doi.org/10.1038/s41571-021-00561-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41571-021-00561-6

Search

Quick links

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer