Personalized Medicine: Pricing and Reimbursement Policies as a Potential Barrier to Development and Adoptio
Some have expressed disappointment in the rate at which personalized medicine has advanced since the sequencing of the human genome in 2001. There are a number of potential barriers to its development and use, including factors related to the science, regulation, evidence generation, value assessment, and pricing and reimbursement. This presentation focuses on the barriers that national pricing and reimbursement systems often pose for innovative medicines and their companion diagnostics: administered, cost-based reimbursement systems are seen as a barrier to rewarding value for innovation. Furthermore, the unique challenge of defining value contributions for a combination product is highlighted. From a static perspective, the division of this value can be seen as arbitrary. However, a new approach is proposed that would embrace flexible pricing based on valuae with the aim of rewarding the contributions of the medicine and the diagnostic in a manner that would encourage dynamic efficiency, i.e., optimal innovation, by aligning rewards with value creation.