Pricing of innovative drugs: correlation between incremental cost and survival gain in four countries

In pharmacoeconomics, ICER (incremental cost-effectiveness ratio) is a recognized parameter that quantifies the cost-effectiveness for the comparison between an innovative drug and the standard of care [McCabe et al. 2008]. An extensive literature has been published on how ICERs should be interpreted and how their values ultimately translate into pricing decisions (e.g. value-based pricing). Given that ICER algebraically is the ratio of incremental cost and incremental benefit (i.e. survival gain), we designed a study to assess the correlation between these two parameters in different developed countries. A strong correlation would indicate that drug prices are strictly related to the benefit, while a poor correlation would indicate that prices are unrelated to benefits. To our knowledge, while hundreds of papers have been focused on theoretical and practical implications of ICERs, only a few studies have assessed the above mentioned correlation, and no study at all has performed an international comparison. The present analysis was restricted to anticancer agents and was aimed at carrying out this specific international comparison.