In countries with pricing regulations, authorities monitor and revise medicine prices according to changing market conditions and therapeutic landscape.
Countries that manage the pricing of prescription drugs routinely monitor and revise to ensure prices reflect market conditions. The most commonly employed methods for revision are based upon time-on-market and the loss of market-exclusivity of a product.
This chart via the WHO's 2018 Technical Report on Cancer Pricing outlines revision of drug prices, by jurisdiction. For example, through an agreement with the pharmaceutical industry, the Australian Government has set rules for reducing the prices of single-brand medicines listed on the Pharmaceutical Benefits Scheme (PBS) at 5%, 10% and 5% after 5 years 10 years and 15 years of listing, respectively.
Price revision may also be considered when a medicine has extension of indications. Some manufacturers and government authorities have used or proposed to use multi-indication pricing.
For example, the manufacturer of Everolimus marketed two brands with different prices in Sweden, for its use in preventing transplant rejection and oncology indications. In Switzerland, the rebate specified in a cost-sharing agreement for Bevacizumab was only applicable when the medicine is used for lung cancer in low dose regimen but not for other indications. And in Italy, risk-sharing agreements for the same product were applied on the basis of indication according to information collected through mandatory indication-specific registries maintained by the Italian Medicines Agency.
Routine monitoring and revision of medicine prices ensure prices reflect market conditions.