Steuten Lotte, Lothgren Mickael, Bruce Andrew, Campioni Marco, Towse Adrian
Office of Health Economics, London, England, UK.
Global Value and Access, Ipsen, Zug, Switzerland.
Value Health. 2025 Jan;28(1):81-87. doi: 10.1016/j.jval.2024.07.019. Epub 2024 Aug 9.
Valuing and pricing the components of combination therapies can be difficult because of competition law issues, difficulty implementing different prices for the same product in alternative uses, and attributing value to each component of the combination. We propose a value attribution solution that allows all combination components to be priced according to their relative value in the combination.
We developed a value attribution solution that is universal, symmetrical, and neutral to each combination constituent, regardless of whether it is the backbone or the add-on, and complete, meaning that it will always attribute the full value of the combination between the component parts. Moreover, it can be applied to any number of components in the combination (eg, triplets or quadruplets). We compared this solution with 2 other existing approaches.
The results of the proposed value attribution solution sit between those of the 2 other value attribution approaches as it combines elements of each. As the degree of additivity moves further away from one in either direction, then our general approach ratios also move, reflecting the impact of the incremental value.
The proposed value attribution solution for combination therapies differs from 2 existing approaches by being universally applicable and allowing for symmetry when neutral to the constituent components of the combination. To optimally contribute to policy debate and practice, various requirements for its implementation need to be well understood, including how to overcome (1) partial information, (2) whether its assumptions can be relaxed, and (3) implementation issues.
由于竞争法问题、在替代用途中对同一产品实施不同价格存在困难以及对联合疗法的每个成分进行价值归因，对联合疗法的成分进行估值和定价可能会很困难。我们提出了一种价值归因解决方案，该方案允许根据联合疗法中各成分的相对价值对所有成分进行定价。
我们开发了一种价值归因解决方案，该方案具有通用性、对称性，并且对联合疗法的每个成分保持中立，无论其是主要成分还是附加成分，而且是完整的，这意味着它总能在各成分之间分配联合疗法的全部价值。此外，它可应用于联合疗法中的任何数量的成分（例如三联疗法或四联疗法）。我们将该解决方案与其他两种现有方法进行了比较。
所提出的值归因解决方案的结果介于其他两种值归因方法之间，因为它结合了每种方法的要素。随着相加性程度在任一方向上进一步偏离1，那么我们的一般方法比率也会变动，反映出增量价值的影响。
所提出的联合疗法价值归因解决方案与现有的两种方法不同，它具有普遍适用性，并且在对联合疗法的组成成分保持中立时允许对称性。为了对政策辩论和实践做出最佳贡献，需要充分理解其实施的各种要求，包括如何克服（1）信息不完整、（2）其假设是否可以放宽以及（3）实施问题。
