PURPOSE: The objective of this workshop is to discuss the pricing and reimbursement challenges posed by innovative one-time treatments, such as CAR-Ts and gene therapies, explore implementation considerations of potential novel payment models (outcomes-based, annuity payments & coverage with evidence development) and their feasibility for different global payer archetypes.
DESCRIPTION: Majority of new drugs are priced with the expectation that they will be used on a regular basis for an extended period, spreading total cost over months or years. The price tags of CAR-T treatments or gene therapies, on the other hand, will correspond to a single one-time treatment cost that may create a potential affordability challenge in many markets. Moreover, while such new therapies offer potential long term clinical benefits there is often a lack of robust long-term data at launch that creates “uncertainty” in the value of the product. New payment schemes are emerging in the context of high-cost one-time treatments to overcome payer objections and make these novel, often curative treatments available. Manufacturers and payers might also accept novel “instalment or annuity payment” schemes that can distribute cost over a longer period. During the workshop, panelists and the participants will discuss implementation considerations of different emerging payment models from different stakeholders’ perspective. The moderators will guide the conversation to ensure that differences among different market archetypes are reflected in the feedback. The final output will be feedback on a set of payment strategies prioritized based on the technology, disease and treatment outcomes as well as market archetype, HTA system, and payer value drivers.