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Newsletter Article


New Pay-for-Outcomes Pricing Models in Germany Focus on Immunotherapies

Country Correspondent: Michael Laxy

New cell- or gene-based immunotherapies are often very expensive, despite the lack of rigorous, long-term clinical evidence of their effectiveness or safety. That’s why German payers are testing different reimbursement models that pay pharmaceutical manufacturers based on achieved health outcomes. One prominent example is the contract between a German insurance service provider and pharmaceutical giant Novartis for reimbursement of Kymriah, a cell-based leukemia therapy, under which the payer is refunded if a treated patient dies within a defined period. Another approach, followed by one of the largest statutory health insurance providers, advocates for a system of “dynamic price assessment” based on the most current postlicensing data.

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