Abstract

The study conducted by Mladsi et al explores the pricing dynamics of new drugs designed to extend overall or progression-free survival, adopting a “health system payer perspective” within healthcare systems that demand evidence of cost-effectiveness, albeit without specifying a particular jurisdiction. Moreover, the drugs in question grapple with healthcare costs that lie “beyond [their] influence.” The study meticulously explores 3 distinct cost scenarios, encompassing “[high] disease background costs, costs of existing drugs used in a combination regimen, and costs of future health interventions patients may become eligible to receive.” Notably, in the first and third scenarios, the novel drugs extend overall survival, whereas in the second scenario, they extend progression-free survival. The authors intriguingly reveal that, across all 3 scenarios, “a new drug might not be cost-effective at zero price,” potentially necessitating the counterintuitive notion of a “negative price” for it to be deemed cost-effective.