OBJECTIVES: To examine price evolution over time for select oncology drugs in major European markets.

METHODS: Historical prices for three haemato-oncology treatments (ibrutinib [Imbruvica], obinutuzumab [Gazyvaro], venetoclax [Venclyxto]) were obtained from nationally available list price databases, covering the period 2015 to 2022. Changes in price were plotted over time as additional indications were obtained from the European Medicines Agency (EMA) and reimbursement decisions were made in France, Germany, Italy, and the United Kingdom (UK).

RESULTS: Price reductions were seen in each of the markets as additional indications were obtained and populations increased. In France, the list prices for Imbruvica, Gazyvaro, and Venclyxto decreased by 8%, 10% and 8% respectively between 2015-2020. Each of the products had additional indications and/or populations approved by the French National Authority for Health (HAS) during the study period. Similar trends in price reduction were seen in Germany, Italy, and the UK as additional indications or sub-populations were reimbursed or recommended by respective national Health Technology Assessment (HTA) agencies.

CONCLUSIONS: In this analysis, the initial list price achieved for a product was the highest price in its lifecycle. By adding indications or populations and increasing volume, prices go down even if the additive population is smaller and has a greater positive effect and might therefore on its own have attracted a higher price. When considering additional indications for a product reimbursed in Europe, modeling price erosion and additional volumes to understand revenue implications is essential. Policymakers might also consider whether the fact that prices only ever go down is creating a barrier to innovation or to access for European patients in need of new treatments.