Facilitating the Implementation of a Subscription Pricing Model Aimed at Broadening Access to All Eligible Patients Within the HER2 Indication
Author(s)
ABSTRACT WITHDRAWN
OBJECTIVES:
Amid the growing incidence of HER2 breast cancer in Ireland, budget uncertainty poses a significant challenge for the healthcare system. This model endeavors to offer both the pharmaceutical company and private health insurer enhanced budget certainty, while simultaneously ensuring that price is not the barrier to access for the most appropriate care for patients.METHODS:
To enable and encourage broad accessibility to HER2 breast cancer treatment in Ireland, a pharmaceutical company and private health insurer engaged to co-create an innovative pricing model, resembling a subscription-based payment system. The subscription model was developed by analyzing historical payment data, vial usage and patient figures. Accounting for the increased HER2 competition, patient volumes were forecasted, thereby determining an average rebate value per patient, which will provide coverage to all HER2 products in the drug schedule. This will form the fixed fee that will be issued to the payer every month.RESULTS:
A shadow contract will operate in parallel to the annual commercial agreement to capture the model's accuracy and validate its proof of concept throughout 2024.CONCLUSIONS:
This subscription model and risk sharing partnership is expected to provide budget certainty for the private insurer and pharmaceutical company. Potential cost savings, continuous care and a reduced administrative burden are additional benefits of this innovative pricing model.Conference/Value in Health Info
2024-11, ISPOR Europe 2024, Barcelona, Spain
Code
EE147
Topic
Clinical Outcomes, Economic Evaluation, Health Policy & Regulatory, Methodological & Statistical Research
Topic Subcategory
Performance-based Outcomes, Risk-sharing Approaches, Trial-Based Economic Evaluation
Disease
Oncology