OBJECTIVES

: Could innovative agreements between biopharmaceutical manufacturers be a potential way to maximise access to COVID-19 technologies while minimising budget impact? This study aims to assess payers’ and public health officials’ views on the potential for innovative contracting models for SARS-CoV-2 vaccines and COVID-19 drugs and therapies.

METHODS

: The study was conducted across US, EU5, China and Brazil during April and May 2020. 77 in-depth interviews with relevant stakeholders were conducted to assess expectations in changes to current payment models and rate the attractiveness and feasibility of five potential innovative contracting models (outcomes-based agreements, coverage with evidence development, patient cap, annuity and subscription-based) for both SARS-CoV-2 vaccines and COVID-19 drugs and therapies.

RESULTS

: The majority of stakeholders anticipate either no or slight changes to current payment models for COVID-19 technologies. Due to the need to ensure rapid access to the population by concluding pricing negotiations as quickly as possible, classical contracting arrangements such as flat discounts and price-volume agreements are preferred.

However, some see a potential role for innovative contracting, particularly in Italy, the UK and Brazil. There is more openness to these models for drugs and therapies than for vaccines due to greater prior experience.

CONCLUSIONS

: Assuming the state of urgency remains at the time of marketing authorisation of COVID-19 technologies, any innovative contracting model proposed by the manufacturer would need to be demonstrably able to be implemented quickly, without delaying access to patients. The proposed design should align to models currently being used in each country – now is not the time to try something new.