OBJECTIVES: Recognizing broader benefits of healthcare interventions depends on how budgets and price setting methodologies are defined. This research explores the extent to which patient and broader societal benefits are recognized by healthcare payers in Europe in the context of value-based pricing frameworks, and the main obstacles to fully shifting to patient-centric decision-making.

METHODS: Literature searches were conducted to identify the value attribute categories considered as part of value-frameworks for HTA assessments. A semi-quantitative payer survey was conducted across four European countries (UK, FR, ES and IT) between April- May 2023, to test what value attributes have highest impact on pharmaceutical pricing decisions.

RESULTS: Clinical and economic value attributes were found to have highest impact on price setting (i.e., objectively-measured investigator-assessed clinical endpoints and evidence of cost-offsets from a healthcare perspective). In contrast, non-clinical parameters such as patient perspectives and broader societal impact, such as QoL impact on caregivers, were found to have lowest impact. The results of this survey suggest that pricing decisions are largely based on the added clinical benefit and the healthcare cost-offsets provided; reflecting payer’s pursuit of maximizing health impact with a finite budget. Methodological difficulties in objectively measuring patient and societal benefits, as well as budget silos, were the main obstacles preventing payers from adopting a more holistic approach to recognizing broader value attributes for price setting.

CONCLUSIONS: This research highlights the need for policy makers to address budget silos that exist between healthcare and other social-welfare services, to create incentives for the development of innovative therapies that improve not only clinical outcomes but also deliver broader patient and societal benefits, that deliver efficiency gains outside of healthcare budgets. There is also a need for the development of more robust methodologies that can objectively measure such endpoints.