Abstract
METHODS
We surveyed experts to evaluate seven promising proposals to reduce drug prices: Transparency, Combined European purchasing, Public drug development, Public clinical trials, Two-part-pricing, Orphan drug reform, and De-linkage. Experts were asked to rank proposals, identify main risk and success factors, and to reflect on missing proposals. The survey was distributed via the networks of the European Cancer League and the Organisation of European Cancer Institutes.
CONCLUSION
We recommend expanding on these results to further specify actionable policies that can be tested. Pilots should consider uncertainties and conducted with a focus on international collaboration, preferably in cooperation with the pharmaceutical industry.
RESULTS
Respondents (n = 41) originated from 19 European countries and included stakeholders in health economics, law, medicine, drug discovery, and healthcare policy.Transparency (M = 2; SD = 2 1) and Combined purchasing (M = 3; SD = 1 9) were ranked as the most promising proposals, Two-part pricing (M = 5; SD = 2 3) and De-linkage (M = 6; SD = 2 4) were considered as the most controversial. Main risk categories were a negative impact on R&D (n = 47), technical feasibility (n = 38), and reduced access to medicines (n = 33). Main success categories were international collaboration (n = 34) and agreement of pricing mechanisms (n = 25). Experts considered value assessment and strengthening of the competitive market as additional proposals for further analysis.
BACKGROUND
Novel cancer treatments come with high price tags that compromise access to treatment and the sustainability of healthcare systems. Innovative policies are needed to reach a system that balances innovation and reasonable prices. However, structured approaches to explore, test, and compare innovative proposals are lacking.