Presentation (CTI)

OBJECTIVES: To assess emerging access policy risks for branded-branded oncology combinations in Australia, Korea, Taiwan and Brazil and identify lessons from European HTA experience to inform value framework adaptation.
METHODS: A targeted comparative review of HTA and payer frameworks is conducted across selected markets in APAC, LatAm, and Europe. Publicly available HTA guidance, reimbursement criteria, and literature are analysed, alongside evidence on access outcomes for oncology combination therapies. The review focuses on how frameworks assess multi‑branded regimens, including approaches to cost‑effectiveness, pricing, value attribution, and negotiation processes.
RESULTS: Across Europe, oncology combination therapies have lower availability and longer time to access than other oncology medicines, reflecting structural limitations in HTA and pricing frameworks. Key barriers include difficulty meeting cost‑effectiveness thresholds, challenges in attributing value across regimen components, and constraints in coordinating pricing across multiple manufacturers. APAC and LatAm systems show similar structural characteristics, including reliance on single‑drug frameworks, limited pricing flexibility, and strong emphasis on budget impact, which may hinder access to combination regimens. Collectively, the evidence indicates a high risk that delays, restrictions, and inequities observed in Europe may be replicated as HTA systems in international markets mature.
CONCLUSIONS: Structural limitations in current HTA frameworks create persistent barriers to access for branded-branded oncology combinations, as seen in Europe. Given similar system characteristics in APAC and LatAm, there is a high risk that these challenges will be replicated.Proactive adaptation of HTA approaches (particularly around value recognition, pricing flexibility, and multi‑manufacturer coordination) will be essential to ensure timely and equitable patient access to combination therapies.