ISSUE: Subscription-based reimbursement models are where manufacturers are paid a lump sum to provide an unlimited supply of drugs for a given population for a given timed period (as opposed to revenues being linked to the volume of drugs sold). These are now being used in the reimbursement of hepatitis C therapies in Australia as well as for Medicaid recipients in Louisiana and Washington. Further, in 2018, NHS England offered Vertex an unprecedented pricing agreement whereby, in return for a guaranteed £1 billion over the next 10 years, NHSE would secure unlimited access for its existing and future cystic fibrosis therapies. The potential growth of such a new model of reimbursement offers new opportunities to meet access challenges, in terms of providing payers a more affordable option and manufacturers guaranteed revenues. However, this also poses some significant implementation, including integrating this into the traditional pricing, reimbursement and HTA processes, which this panel will discuss.

OVERVIEW: Our issue panel aims to present and discuss the differing perspectives of a UK payer (Andrew Walker), a local budget holder (Diar Fattah), and a Australian payer (Erika Turkstra) on the opportunities and challenges associated with the subscription-based pricing model. Each panelist will give a short 10-minute presentation (after a 10-minute situation overview from the moderator, Richard Macaulay) of their views on the topic of subscription-based reimbursement models before a wider 20-minute panel discussion and audience Q&A.