OBJECTIVES: Value-based pricing supports HTA decision-making in England, France and Germany. Within a crowded therapeutic area, products may have the same HTA recommendations and benefit scores, but different prices. This research aimed to determine the suitability of using a value-price relationship to forecast price within a crowded landscape.

METHODS: Products in rheumatoid arthritis (RA), assessed since 2017, were included; three comparators (bariticinib, sarilumab, and tofacitinib) and upadacitinib for price forecasting. A MCDA model with key attributes reflecting payer drivers in RA was developed. Value scores were derived for each product using HTA appraisals, EPARs or published literature. Annual cost of comparators was calculated from current list prices. Comparator value score and price were plotted on a linear regression, used to forecast updacitinib price in each market and compared to actual prices.

RESULTS: Different payer value drivers produced variable value scores. German value scores were driven by clinical trial outcomes, providing the lowest value scores and the greatest range (97–136; range=39). England and France had similar ranges (17 versus 18), but different numerical scores (145–163 versus 180–197), reflecting value driven by modelling considerations only in England.

Value-price relationship varied; England (R²=0.44) and France (R²=0.86) had a negative correlation, whereas Germany had a strong positive correlation (R²=0.98). Upadacitinib forecast price versus actual price was estimated at -2% in England (€12,319 versus €12,572), -5% in France (€6,835 versus €7,200) and -11% in Germany (€10,731 versus €12,100), which did not reflect R².

CONCLUSIONS: This analysis suggests that payer-perceived value varies within a crowded landscape and a value-price relationship can be used to forecast price. However, the association between correlation strength and forecast price accuracy varies due to country-specific considerations. Exclusion of pricing drivers, e.g., reference pricing and England net prices, are limitations. Further research is needed in other indications, scenarios, and markets.