PURPOSE: Combination therapies are often used in diseases such as cancer. However, combination therapies often fail to be cost-effective, especially when the component drugs are priced independently by different manufacturers. Manufacturers of component drugs cannot coordinate prices since this is prohibited by anti-trust law. The purpose of this workshop is to illustrate and discuss a value attribution framework for combination therapies grounded in the standard rules of cost-effectiveness that can be used to assist in negotiations around prices when evaluating combination therapies by reimbursement authorities, such as the National Institute for Health and Care Excellence (NICE) in the UK. 

DESCRIPTION: We will present a proposed value attribution framework that can be used to address the problem of pricing combination products fairly to manufacturers of the component products AND payers within the health system. We present solutions to four scenarios of combination therapies that are characterized by key features of the problem: perfect/imperfect information about the monotherapy effect of component therapies (individual effects are known/unknown) and balanced/unbalanced market power between their manufacturers (unbalanced being where one manufacturer already has market access and a new entrant seeks to add to this 'backbone' therapy) . Case studies are used to illustrate each scenario drawn from publicly available information of recent combination therapy submissions to NICE. Consideration will be given to the process of negotiation that can help navigate anti-trust rules designed to prevent price collusion.