The use of ‘added benefit’ to determine the price of new anti-cancer drugs in France, 2004-2017.
France has a well-established health-technology-assessment system, dating back to the 1980s.
Market-access in France has two parts. First, the country's Ministry of Health (Ministre Santé et Sécurité Sociale) sets a reimbursement-level and negotiates a price that reflects the added therapeutic value of a product. Second, the country uses a budget-cap to control national drug expenditures.
France sets its maximum reimbursement-level and price for new drugs based on a cardinal metric system reflecting the product's added-value. Each drug product receives two ratings: one reflecting the product’s actual medical benefit (SMR - Service Médical Rendu), which determines the reimbursement level, while the improvement of medical benefit (ASMR - Amélioration du service médical rendu) determines whether a price premium can be achieved or if a discount will be required.
This new article via the European Journal of Cancer (in-press) examines the relationship between added therapeutic benefit and prices for cancer drugs in France over a period of 13 years. In total, 36 medications across 68 indications. Prices were obtained from the French Official Journal. Rating for added therapeutic value were obtained from the HAS.
Seventy percent of drugs had low added value according to its ASMR. And the researchers found, on average, new drug prices increased 2,525 euros over their comparator. There was no correlation between price increases and ASMR.
The authors conclude that prices of cancer drugs increase in France despite little added benefit.