The Dental and Pharmaceutical Benefits Agency, TLV is following the example of other Nordic countries – assessments involving secret prices will become more of a “black box”
Last week, TLV published a new standard procedure for assessing reimbursement status for pharmaceuticals where a confidential price has been negotiated for the comparator. Previously, due to TLV’s interpretation of “party insight,” the secret price of comparator could not be used in their assessment. Instead, TLV had to employ complex methods to circumvent this issue, for instance by comparing ICER to ICER. Now, TLV will use the secret price of the comparator – without sharing this price (or any other information that can be used to calculate it backwards) with the applicant.
Applicants will not know the ICER on which TLV bases their decision, and for cost comparisons, the applicants will only know if the price of their product is higher/lower or in range with the comparator. TLV’s decisions will become less transparent and it may add another layer of complexity to three-party negotiations. However, this will facilitate TLV’s work and enable true price comparisons, which may also benefit applicants.
Don’t hesitate to reach out to Quantify’s Modelling, Access & Strategy Team if you want to discuss the implications!
Read more here (in Swedish):
