OBJECTIVES Characterize conditional reimbursement decisions made by the Finnish Pharmaceutical Pricing Board after the enabling legislation allowing confidential agreements came into force 1 Jan 2017, until the end of March 2019.

METHODS Public data on reimbursement decisions were analysed. Trade name level data consisted of accepted reimbursement level, type of agreement, reimbursement limitations and list prices. In addition, preceding rejected applications were identified.

RESULTS : There were 25 positive conditional reimbursement decisions on 23 different medicines, of which 12 had been previously rejected, five of them more than once. Three decisions concerned reimbursement extensions, and five special reimbursement. All decisions were based on economic agreement, indicating a discount scheme based on sales value, volume or number of patients. 17 decisions concerned oncological preparations: haematology(4), lung(3), breast(3), prostate(2), ovarian(2), renal(2) and melanoma(1). Their annual treatment cost at list prices ranged from 35,000€ (breast) to 150,000€ (ovarian). During the period two new oncological medicines (renal, colorectal) were accepted for basic reimbursement without confidential agreement, ranking at the lower end of the cost range. Three decisions concerned diseases with significant number of patients; hypercholesterolemia and migraine. The annual cost of these were significantly lower (6,000€–11,000€), and reimbursed patient populations were considerably restricted. Highest annual cost was for enzyme replacement therapy (hypophosphatasia, 200,000€–1.5 million €). Remaining decisions concerned treatments of cirrhosis (PBC), atopic dermatitis, optic neuropathy (LHON) and polycystic kidney disease (ADPKD), with cost range 20,000€–60,000€.

CONCLUSIONS : Cancer medicines dominate conditional reimbursement decisions. It seems that conditional reimbursement procedure has made reimbursement possible for significant number of new medicines previously rejected. Interestingly, the data also suggests that for oncological medicines conditional reimbursement is currently the primary route in entering into reimbursement system in Finland. Also, the lack of outcome-based agreements so far is noteworthy.