Combination regimens: reimbursement challenges and solutions Research Report and Summary from a Canadian

They must also consider whether the new labeling should affect the labeling of any of the individual components in the combination, and what rules may govern the promotion of the individual components of the combination product. [...] When one of the medicines in the combination regimen is already reimbursed by the national health service, its price is generally considered a fixed parameter (although price negotiations can occur) and the price of the second part of the combination is defined so that the total cost of the combination reflects its added value. [...] Summary of open discussion The high-level discussion of the nature of the problem and its urgency, along with preliminary issues that require resolution led to the following observations: Is there agreement as to the extent and urgency of the problem posed by combination therapies? • Participants provided a range of opinions on this: Some felt it was not much of a problem at all, and others more s. [...] • Ideally, a framework for assessment, pricing, and reimbursement of a new combination regimen will need to include: • A review and negotiation of the price of existing components (i.e., backbone therapies) when used in this combination, as well as negotiation of the price of the new entrant, to be appealing to payers; AND • Usage-specific (or blended) pricing based on utilization, to be appealing. [...] What are some general solutions to the issues that may be appropriate and feasible in Canada? • A framework that helps payers to understand the value of the combination (i.e., not simply the value of the add-on therapy) coupled with an approach to adjusting prices of the individual components would be required.