Presentation (CTI)

OBJECTIVES: Multi-indication medicines have led to transformative advances in patient outcomes but still face challenges that can delay or hinder patient access. These challenges point to a need for novel solutions developed through multi-stakeholder collaboration. One potential solution is the multi-year, multi-indication (MYMI) financial agreement between manufacturers and payers, which spans multiple indications and years. Recognising that MYMI agreements may not be feasible or appropriate in all country contexts, this work used them as a starting point to develop a more comprehensive and flexible access framework. The aim of the framework is to 1) offer a practical approach to the assessment and reimbursement of multi-indication medicines, with a menu of options that can be selectively used to fit local contexts, and 2) provide an initial solution that can be further co-created and implemented in practice in different countries.
METHODS: Based on a review of the literature and collaboration with seven health economists, a MYMI-inspired access framework and implementation blueprint were developed via questionnaires and direct engagement. Planned next steps include further co-creation with a variety of stakeholders.
RESULTS: The framework encompasses three overarching components and several key pillars. Examples of pillars include agreement negotiation and establishment, adapted health technology assessment (HTA), comprehensive pricing and reimbursement (P&R) and data infrastructure. Each key pillar comprises a range of specific elements that can be applied in different combinations, allowing users to select the options most relevant to their context without needing to implement every element.
CONCLUSIONS: The MYMI-inspired access framework goes beyond the concept of a pure financial agreement, offering a broad, adaptable structure that can support the management of multi-indication medicines in a way that fits local country contexts, works for all stakeholders, and enables more efficient patient access to multi-indication medicines.