How Can We Make Innovative Payment and Pricing Schemes Work? Findings of the European Union Research Project HI-PRIX
Author(s)
Michael Drummond, MCom, DPhil1, Vittoria Ardito, MSc2, Mikel Berdud, PhD3, Ludovico Cavallaro, MSc2, Matthias Hofer, PhD3, Sian Hodgson, MSc3, Oriana Ciani, BSc, MSc, PhD2;
1University of York, Professor Emeritus, York, United Kingdom, 2SDA Bocconi School of Management, Milan, Italy, 3Office of Health Economics, London, United Kingdom
1University of York, Professor Emeritus, York, United Kingdom, 2SDA Bocconi School of Management, Milan, Italy, 3Office of Health Economics, London, United Kingdom
OBJECTIVES: Innovative payment schemes have been widely proposed as a solution for dealing with uncertainties, in cost and outcomes, associated with the introduction of new health technologies. However, payers’ and manufacturers' experiences with these schemes are mixed. This research explores how to increase the success of these schemes
METHODS: A work package of the Health Innovation Next Generation Payment and Pricing Models (HI-PRIX) project has obtained new evidence on the design and implementation of these schemes by (i) undertaking a scoping review and classification of existing schemes, supplemented by interviews with national experts to identify schemes not in the published or grey literature, (ii) conducting a Delphi exercise with the key stakeholder groups involved in these schemes (payers, patient representatives, technology manufacturers and healthcare decision-makers), to identify the barriers and facilitators to developing schemes (iii) undertaking case studies of several key technologies.
RESULTS: Around 200 innovative pricing schemes/applications have been identified, across a broad range technologies, including financed-based and outcomes-based schemes, from 19 countries. In addition, a 21-item classification has been developed to enable policy makers to search for schemes meeting specific objectives, or having particular characteristics. Analysis of the database of schemes, the Pay-for-Innovation Observatory (hiprixhorizon.eu), and feedback from stakeholders suggests that is possible to determine schemes with certain characteristics that are more likely to be successful when applied to certain types of technologies (eg cell and gene therapies, rare disease treatments, medical devices), or designed to meet particular objectives, including equity-enhancing purposes.
CONCLUSIONS: Despite the challenges, innovative payment and pricing schemes still represent one of the best approaches for facilitating the cost-effective introduction of new technologies under uncertainty. If policy makers can be assisted in selecting the best schemes to meet their particular objectives, and are better informed of the main barriers and facilitators, the success rate of these schemes will increase.
METHODS: A work package of the Health Innovation Next Generation Payment and Pricing Models (HI-PRIX) project has obtained new evidence on the design and implementation of these schemes by (i) undertaking a scoping review and classification of existing schemes, supplemented by interviews with national experts to identify schemes not in the published or grey literature, (ii) conducting a Delphi exercise with the key stakeholder groups involved in these schemes (payers, patient representatives, technology manufacturers and healthcare decision-makers), to identify the barriers and facilitators to developing schemes (iii) undertaking case studies of several key technologies.
RESULTS: Around 200 innovative pricing schemes/applications have been identified, across a broad range technologies, including financed-based and outcomes-based schemes, from 19 countries. In addition, a 21-item classification has been developed to enable policy makers to search for schemes meeting specific objectives, or having particular characteristics. Analysis of the database of schemes, the Pay-for-Innovation Observatory (hiprixhorizon.eu), and feedback from stakeholders suggests that is possible to determine schemes with certain characteristics that are more likely to be successful when applied to certain types of technologies (eg cell and gene therapies, rare disease treatments, medical devices), or designed to meet particular objectives, including equity-enhancing purposes.
CONCLUSIONS: Despite the challenges, innovative payment and pricing schemes still represent one of the best approaches for facilitating the cost-effective introduction of new technologies under uncertainty. If policy makers can be assisted in selecting the best schemes to meet their particular objectives, and are better informed of the main barriers and facilitators, the success rate of these schemes will increase.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
P51
Topic
Health Technology Assessment
Topic Subcategory
Systems & Structure
Disease
No Additional Disease & Conditions/Specialized Treatment Areas