Multi-indication therapies commonly experience list price decreases following indication expansion. This blog post explores these dynamics in more detail by zooming in on the ‘average weighted list price markets’ of Germany and France. Understanding these dynamics allows stakeholders to navigate the complexities of multi-indication therapy pricing more effectively.
Multi-Indication Pricing Dynamics Unveiled
Between 2012 and 2022, 87 therapies received authorization for multiple indications. Out of these, 40 treatments were authorized for three or more indications. These treatments underwent year-on-year price fluctuations, with average fluctuations ranging from -4% to 0% in France, and from -11% to +2% in Germany.
Higher clinical value: Catalyst for price increases of new indications
In total 11 therapies encountered price increases, of which 10 occurred in the German market (Figure 1). Notably, 3 products, Forxiga, Xigudo, and Jakavi, underwent substantial price increases of ≥20%. Conversely, in France, only HyQvia underwent a price increase of ≥20%. A closer examination of GB-A evaluations revealed that Germany’s price increases were linked to re-assessments, triggered by the submission of additional data. These re-assessments were driven by changes in comparator therapies and indication expansions with higher benefit ratings (Figure 2). The reasons behind HyQvia’s price increase in France could not be identified from publicly available data.
Value-based pricing: More flexibility in Germany than in France
While it’s common for the launch of new indications to drive price decreases in both Germany and France (29 out of 40 therapies with more than 3 indications), there are noteworthy exceptions. When new indications bring significant clinical value that outweighs the budget impact of a larger patient population, prices can rise. In Germany, a higher benefit rating for new indications occasionally triggers substantial price increases of more than 20%, often prompted by the submission of additional data. This indicates that the German system offers more flexibility in applying value-based pricing compared to France.
Stakeholders commercializing multi-indication therapies can leverage these insights to fine-tune their launch- and evidence generation strategies, maximizing the commercial success of their products.