The New York Times recently profiled pay-for-performance and risk-sharing pricing arrangements for high-cost drugs, including cancer drugs.For example, Johnson & Johnson has proposed that the NHS in Britain pay for the cancer drug Velcade, but only for people who benefit as evidenced by tumor shrinkage. Velcade can cost $48,000 per patient. According to industry analysts quoted in the article, such a pricing scheme would probably only work in countries where there are single-payer health systems.
According to Dr. Lee N. Newcomer, senior vice-president for oncology at UnitedHealthcare, such risk-sharing arrangments would be harder to manage in the U.S. Newcomer says, "There's no way we could ask for it and have any leverage." He explains that state regulations and market forces make it impossible for an insurer to refuse to pay for a drug that has been approved by the FDA.
Other drugs cited in the article as potential targets for risk sharing between the manufacturers are Avonex for multiple sclerosis and even statins.
