Reimbursement of licensed cell and gene therapies across the major European healthcare markets.

Objective : The aim of this research is to identify the pricing, reimbursement, and market access (PR 2) Validating the secondary research findings and addressing any data gaps in primary research, by qualitative interviews with national, regional, and local-level payers and their clinical and economic advisors; 3) Collating of primary and secondary findings to compare results across countries. Results : The incremental clinical benefit forms the basis for all PR however, only the United Kingdom has a defined threshold that links the cost per quality-adjusted life year (QALY) specifically and methodologically to the reimbursed price. Funding mechanisms to enable adoption of new and more expensive therapies exist in all countries, albeit to varying extents. Willingness to pay is typically higher in smaller patient populations, especially in populations with high disease burden. Outcomes modelling and risk-sharing agreements (RSAs) provide strategies to address the data gap and uncertainties often associated with trials in niche populations. Conclusions : The high cost of ATMPs, coupled with the uncertainty at launch around their long-term claims, present challenges for their adoption at a commercially viable reimbursed price. Targeting populations of high disease burden and unmet needs may be advantageous, as the potential for improvement in clinical benefit is greater, as well as the potential for capitalising on healthcare cost offsets. Also, targeting small populations can also help reduce both payers’ budget impact concerns and the risk of reimbursement restrictions being imposed. Keywords: Pricing and reimbursement; market access; healthcare funding; advanced therapy medicinal products (ATMPs); specialised care; health technology assessment (HTA); cross country comparison; Big5EU (France, Germany, Italy, Spain and the United Kingdom) (Published: 30 September 2015) Citation: Journal of Market Access & Health Policy 2015, 3: 29321 - http://dx.doi.org/10.3402/jmahp.v3.29321