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  • Writer's pictureFederico Nutarelli

Risk and Reward: Innovating Payment Models for ATMPs

Updated: Dec 30, 2023

Advanced Therapy Medicinal Products (ATMPs) are groundbreaking in the medical field, offering life-saving treatments that surpass traditional pharmaceutical methods. These innovative therapies excel by delivering faster, more effective results, often through a single application. ATMPs stand out for their ability to save more lives in a shorter time frame, revolutionizing patient care. They represent a leap forward in treating diseases, providing hope where conventional treatments may fall short. Below a short videos provides an overview of the fascinating world of ATMPs:

While ATMPs offer significant health benefits, their high costs pose a reimbursement challenge for governments. Considering the millions of patients in need of ATMPs in regions like the EU and the US, and the average price of these treatments ranging from €800,000 to €1 million per dose, traditional lump sum payment models become impractical. This challenge is evident as, by 2021, only a few of the 20 ATMPs approved in the EU have been reimbursed. For more detailed insights on the complexities of reimbursing ATMPs, you can explore dedicated resources and posts on this topic.

In the work that this post refers to, we propose an innovative payment scheme which involves an installment plan over 4 to 5 years, based on the average cost of these therapies and annual expenses of traditional treatments (comparators). It includes a "success fee-like" model, where payments can be suspended if the therapy fails, such as in cases of patient death or if additional treatments like transplants are needed. This scheme also allows for renegotiation or suspension of payments based on the therapy's real-world performance and patient outcomes, adding flexibility to manage uncertainties in efficacy and cost-effectiveness. Here is a schematized version:

The initial payment reflects the value of traditional therapies (DVC) minus uncertainties specific to ATMPs (PUB). Subsequent payments incorporate real-world data and expected outcomes to adjust for decreasing uncertainty. Final payments account for residual uncertainties and potential new therapies that may emerge. Renegotiation after initial terms allows for adjustments based on additional real-world outcomes, which could influence the overall cost effectiveness and value of the therapy.

ATMPs herald a new era in healthcare, offering groundbreaking treatments. Yet, their market debut comes with high costs and uncertainties. Our proposed payment scheme is pivotal, linking payments to the gradual resolution of these uncertainties and supporting evidence, alleviating financial pressure on healthcare systems. As we refine this model, it's crucial for healthcare regulators to work with financial authorities to adapt fiscal policies. This collaboration could effectively manage the impact of ATMPs on public healthcare spending, ensuring sustainability and continued innovation in patient care.


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