Reassess cancer drug prices at three years using real-world outcomes
Set the price of a new cancer drug provisionally, then adjust it up or down after three years depending on how well patients actually did.
Prices are set at approval on trial data and rarely revisited. Outcome-based agreements exist but are bespoke and opaque. The proposal is a standard pricing rule: initial price tied to trial evidence, mandatory structured outcome capture, and a scheduled reassessment at three years using pre-specified real-world survival and toxicity metrics, with published adjustment formulae. Italy's AIFA registries and Germany's AMNOG reassessments are partial precedents.
- Weak real-world evidence and registries · We do not reliably know what happens to patients after approval, so we cannot tell which drugs deliver in practice.
- 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.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
Pages like this
not linked directly; found by shared links- IdeaLinked prescribing and outcome data to find drug interactions with cancer therapy
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- IdeaWearable activity data as a validated real-world endpoint
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- IdeaNo mCODE, no payment: tie oncology reimbursement to a minimal structured record
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- IdeaGood practice standards and inspection for real-world data sources
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- IdeaOne international registry, not one per country, for conditional approvals
Shares Weak real-world evidence and registries, Real-world evidence.
- IdeaRequire genetic and target-trial evidence before funding any repurposing phase 3
Shares Weak real-world evidence and registries, Real-world evidence.
- IdeaAn automated pipeline emulating trials of every common drug against every cancer
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- IdeaBundled episode payments for cancer care with bonuses for guideline concordance
Shares Incentives reward me-too drugs and marginal gains, Prices and value.