Presentation (CTI)

OBJECTIVES: The acquisition costs of advanced therapy medicinal products are substantial compared to other products. For this reason, healthcare payers are looking into innovative payment methods to alleviate this budgetary strain. This research aims to further the discussion on one of these payment methods, namely spread payments, by analysing the economic and disease factors that determine whether spreading payments over time might solve the affordability problem.
METHODS: First, a literature study was conducted to identify the economic and disease factors that were likely to influence the decision of whether spread or single payments were the most suitable payment method. Subsequently, these key factors were used to construct a model in Excel to compare the evolution of drug costs under spread and single payment methods in the case of sickle cell disease. The following key factors were used to construct the model: price, uptake, prevalence, and incidence. In addition to the base case, this research also considered the following scenarios: a large backlog of untreated patients, price reductions, increasing incidence over time, and managed-entry agreement-inspired payment structures.
RESULTS: Single payment methods were generally more favoured in the modelled scenarios, especially in cases where the prevalence and incidence were of similar magnitude. However, spread payments can be a useful tool when the immediate financial burden is substantial such as cases wherein the uptake is high or when the prevalence of a disease is particularly large.
CONCLUSIONS: Spreading payments over time can be a useful tool under certain circumstances but they must not be seen as the solution to the affordability problem. Whether to use a single payment or spread payment system should be evaluated on a case-by-case basis taking into account the benefits of spreading payments versus the increased administrative burden and implications of committing to a multi-year payment method.