OnCo
ideasIdea

A combination pricing rule so two-drug regimens are not priced as two monopolies

When two expensive cancer drugs are combined, the price is often the sum of both even though the extra benefit is smaller. A rule for splitting the total value between them is needed.

Combination regimens (checkpoint inhibitor plus targeted agent, ADC plus immunotherapy) frequently fail cost-effectiveness thresholds because each manufacturer prices for the full value, and competition law is cited as blocking joint negotiation. The UK's 2023 ABPI-NICE combination framework allows a backbone manufacturer to offer a rebate when its drug is used as part of a combination. The proposal is to generalise this: payers set a total price ceiling for the regimen based on its incremental benefit, a published attribution rule splits it between components, and competition authorities issue safe-harbour guidance for the resulting arrangements.

Hypothesis
Under the framework, the proportion of combination regimens recommended by HTA bodies rises by at least a third, and total regimen prices fall relative to the sum of monotherapy prices.
Rationale
The best new regimens are increasingly combinations of drugs from different companies; without an attribution mechanism, patients lose access to the most effective treatments because of a pricing coordination failure rather than any scientific limitation.
What would test it
Evaluate uptake and prices of combinations assessed under the UK framework over three years; adopt the framework in two other payers with competition-authority guidance and compare recommendation rates.
Maturity
early clinical
Who has to act
payer
Cost to try
Small (under $1M)
Years to first evidence
3
Bottlenecks it attacks
  • Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
  • Too many combinations to test · There are thousands of possible drug pairs and sequences. Trials can test a few dozen a year.

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