Session (CTI)

Issue: Innovative payment and pricing schemes have been proposed as a solution for allowing patient access in situations where payers have concerns about uncertainty in the costs and outcomes of new health technologies, or their affordability. However, these schemes are difficult to implement in practice, in part due to the challenges in aligning the interests of the various stakeholders. Potentially these schemes are a ‘win’ for all parties. The financial risk to payers is reduced, manufacturers can sell their products, and patients gain earlier access to therapies. Yet the main stakeholders must have concerns or else it would be easier to implement schemes. The purpose of this panel is to explore in depth the barriers and enablers of innovative schemes, with a view to identifying key actions that can be taken to increase their likely success. The discussion will be informed by the findings of the recent EU Horizon Europe research project on Health Innovation Next Generation Payment and Pricing Models (HI-PRIX). Overview: Michael Drummond (5) minutes) will moderate the session and give a brief overview of the current landscape surrounding innovative payment and pricing schemes. Then Mikel Berdud (15 minutes) will report the main findings from stakeholder surveys and a nominal group exercise exploring barriers and enablers, undertaken as part of the HI-PRIX project. This research covered the perspectives of manufacturers, HTA bodies, payers, providers, academics, patients and policy makers. Kate Morgan (10 minutes) will then discuss in more detail the issues and concerns from the perspective of patients, especially those with rare diseases. Then, Ilaria Villa (10 minutes) will outline the issues and concerns from a manufacturer perspective, particularly smaller companies with large stakes in the products concerned. Finally, following a general discussion (15 minutes), involving the audience, some key actions to improve the likely success of schemes will be identified (5 minutes)