A Health Impact Fund pilot that pays for measured health gain instead of price
Companies could choose to sell a new cancer drug at cost worldwide and instead be paid from a pooled fund according to how much health it actually delivers.
The Health Impact Fund proposal: an optional, government-financed pool that pays registered products annually for ten years in proportion to their measured health impact (quality-adjusted life years gained across all countries), on condition that the product is sold at the cost of manufacture everywhere. For oncology this rewards drugs that deliver large gains to many patients, including in low-income countries, rather than drugs that extract high prices from few. An oncology-only pilot with a few billion dollars and two or three products would test measurement feasibility and industry appetite.
- 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.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
- 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.