Subscription-based reimbursement models involve a lump sum payment to manufacturers who then provide an unlimited supply of drugs to treat a defined population for determined time period. This model has been referred to as the “Netflix model” and contrasts with payment based on the volume of actual drugs sold.
Panelists for this session included:
- Richard Macaulay, PhD, Parexel Access, London, England, UK (Moderator)
- Diar Fattah, MSc, MPharm, NHS DGS and Swale CCG, Chatham, England, UK
- Erika Turkstra, PhD, Parexel, London, England, UK
This panel discussed this innovative, new reimbursement model offering their respective views that included the perspective of payers and a budget holder. This model is currently being used for reimbursement of hepatitis C therapies in Australia and for Medicaid recipients in the United States in the Louisiana and Washington states. Additionally, National Health Service England offered Vertex an unprecedented pricing agreement for unlimited access for its existing and future cystic fibrosis therapies in return for a guaranteed £1 billion over the next 10 years.
The potential growth this type of reimbursement model offers unique opportunities to meet access challenges by providing payers a more affordable option and manufacturers guaranteed revenues. It also, however, poses some significant implementation challenges, including integrating this new approach into traditional pricing, reimbursement, and health technology assessment processes. Drs Walker and Erika Turkstra offered their perspectives as payers. Mr Fattah provided the a budget holder’s point of view .
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ISPOR, the professional society for health economics and outcomes research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
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