HTA Quarterly | Winter 2017

t is not uncommon for a single health technology to have clinical benefit in multiple indications or patient populations. The magnitude of clinical benefit and value of a technology may vary substantially across indications, which can complicate pricing strategies. Indication-specific pricing (ISP) of health technologies, however, may better align reimbursement with value. In this article, we describe models in which ISP may be implemented, and the pricing policies and use of ISP in France, Germany, Italy, Spain, the United Kingdom (UK) (EU-5), and the United States (US).

With a 5-year prevalence of 230,000 patients worldwide, Multiple Myeloma (MM) represents 15% of all hematologic cancer malignancies. Deaths related to MM are estimated at 11,090 in the US in 2014 and 10,390 in Europe in 2012. In the last decade, advancements in genomics have increased the understanding of disease biology, cellular mechanisms and pathogenesis, which has led to tremendous improvements in the diagnosis and treatment of MM. We examine the approved therapies in both the US and in Europe.

Controlling the rapidly growing healthcare spend in Europe is a frequent topic of discussion for many stakeholders, including politicians, insurers, national health technology assessment (HTA) agencies, and manufacturers. Reining in cost is even more critical in European countries like Portugal that were hardest hit by the global financial crisis and were subject to tough austerity measures. In response to health- and policy-related financial pressures, in 2014, Portugal instituted an overhaul of their HTA and pricing/reimbursement system via the SiNATS (Sistema Nacional de Avaliação de Tecnologias de Saúde). We take a closer lookt at SiNATS, which may be the harbinger for market access reform in Europe and abroad.