OBJECTIVES: As International Reference Pricing (IRP) and in-class reference pricing become increasingly impactful variables in pharmaceutical commercial strategy, the question of how best to sequence product introduction to market for multiple indications becomes a critical element in strategic planning. EVERSANA reviews models for handling the challenge of modeling the impact of indication sequencing in trials for oncology compounds, and the impact on price and access. The models cross time, price landscape, indication expansion, probability of success and new therapy approvals that cross indications.

METHODS: EVERSANA leverages in-house global pricing data from its Pricentric pricing data and IRP platform to track and forecast the price evolution of major multi-indication oncology products over the course of product indication expansion. Price levels are then considered as weighed against estimated clinical trial probability of success, market opportunity, and price pressures, both from in-class competitors and based on referencing.

RESULTS: Differences in indication sequencing approaches show that choice of initial approval paths can yield differences in pricing outcomes, time to patient access, and priorities in clinical trial planning.

CONCLUSIONS: We show that there are potential impacts to payers, patient access, and pharmaceutical manufacturers by taking a price-based indication sequencing approach to planning clinical studies in ways that optimize price over initial target efficacy under certain key circumstances. Guidance is provided on how optimally to deliver value and access to patients while aligning strategic incentives towards value.