Go-ahead for “pay for performance” for pharmaceuticals in Germany

Tue, 2018 / 11 / 13

About the author

Ihr Ansprechpartner Prof. Matthias P. Schönermark, M.D., Ph.D.
Prof. Matthias P. Schönermark, M.D., Ph.D.
Founder and Managing Director
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High-priced drugs face high expectations of success. The situation is particularly challenging in the gene therapy sector, where the effect of an expensive single treatment often lasts for many years and only pays off over time. However, pharmaco-chemical drugs, e.g. many cancer drugs, also need to justify high therapy costs with excellent efficacy.

Merck has chosen a possible approach to address this problem with its drug Mavenclad® (cladribine) for the treatment of multiple sclerosis: In the event of cladribine treatment failure, Merck will take over additional therapy costs within the treatment period, if patients treated unsuccessfully with Mavenclad® are switched to an alternative treatment. This agreement was reached between Merck and GWQ ServicePlus AG, a contract service provider for company health insurance funds, and is initially limited to four years. This strategy has been inspired by previous, partly complex reimbursement models already in place in the United States. For example, Sparks Therapeutics grants discounts to health insurers based on the efficacy of its product Luxturna™, a gene therapy drug. Likewise, Novartis has also established discount systems for its product Entresto®.

In the future, more and more companies will increasingly develop and apply innovative reimbursement models. SKC consulting closely follows these developments and regularly publishes about this topic (see also Gene therapy ante portas – Appropriate solutions for the reimbursement dilemma). As a leading strategy consultancy in the healthcare sector we focus on tailor-made price strategies for the pharmaceutical industry inter alia.

BY Prof. Matthias P. Schönermark, M.D., Ph.D., managing director and Dr. Angelika Deichmann

Sources:
Ärztezeitung: Merck zahlt Mehrkosten für MS-Therapie (German only)
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