OBJECTIVES: As a result of the introduction of the AMNOG law, the German healthcare system allows free-pricing of drugs within the first 12 months of launch. During this period, the G-BA evaluate a drug’s additional benefit versus comparators. The outcome of the assessment guides pricing negotiations for reimbursement, applicable 13^th month after launch. Value and price are correlated to determine drug prices following G-BA evaluation, referred to as post-assessment price, in Germany. The aim of the study was to assess the relationship between value and price for free-pricing and the post-assessment price of products in a crowded therapeutic area.

METHODS: Using MCDA analysis, a value score framework based on key payer decision drivers was established for rheumatoid arthritis products, using upadacitinib as a case study. Comparators (bariticinib, sarilumab and tofacitinib) and upadacitinib were scored within the value framework based on data within HTA appraisals, EPARs or published literature. Values scores were plotted against free prices and post-assessment prices to derive a linear regression and forecast the price of upadacitinib. Results were validated against actual prices in Germany.

RESULTS: A weak positive correlation between value and price was observed for the free-pricing period (R2=0.46), however, high accuracy of 99.6% in forecast versus actual price ((€14,318 vs €14,272) was seen. On the contrary, a stronger positive correlation was observed for post-assessment prices (R2=0.98), however, reduced accuracy of 89% in forecast vs actual price (€10,731 vs €12,100) was seen.

CONCLUSIONS: The analysis suggests the correlation between value and price is weak during free-price setting, instead, in a crowded market manufacturers may set their prices in line with competitors to increase potential for uptake/sales. On the contrary, following a formal G-BA assessment the relationship between value and price becomes relevant, as price is driven by the additional benefit rating. Further validation of this method is required.