Price and reimbursement of medicines when new indications are approved: the results of a survey on ISPOR Italy Rome Chapter members


  • Eugenio Di Brino Alta Scuola di Economia e Management dei Sistemi Sanitari, Università Cattolica del Sacro Cuore, Roma - Italy
  • Claudio Jommi Dipartimento di Scienze del Farmaco, Università del Piemonte Orientale, Novara - Italy



Indication, Italy, Medicines, Pricing


Multi-indication pricing models for medicines and some international impact evidence are available in the literature. Data on the Italian context are more limited. This paper illustrates the results of a study aimed at gathering the opinion on this topic of experts, members of the ISPOR Italy Rome Chapter.

The opinion was collected through a structured questionnaire, validated by two potential responders, and administered online in the period October/July 2022.

There were 45 responders (20% of the members); 67% of responders work in pharmaceutical companies and 13% in consultancy firms. The remainder belongs to regulators/payers and universities.

The survey highlighted a preference for (i) non-automatic models, as automatic approaches are mainly based on price cuts/discount increases in relation to an increase in volumes, (ii) an “indication-based-pricing” model (where prices are differentiated by indication through discounts/risk sharing agreements), since it is more consistent with a value-based approach, even if more complex to manage, (iii) a mix of discounts/agreements according to existing evidence.

The opinion collected is consistent with the opinions available in the literature, but not consistent with the Italian trend, where, compared to the past, a blended approach is prevailing. A blended pricing envisages a renegotiation of the single price for all indications, essentially based on a change in the discount. Our hope is that in the future the experts’ opinion will be taken into consideration and that a targeted indication-based-pricing will be adopted again.


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Preckler V, Espín J. The Role of Indication-Based Pricing in Future Pricing and Reimbursement Policies: A Systematic Review. Value Health. 2022;25(4):666-675. PMID:35227598 DOI:

Campillo-Artero C, Puig-Junoy J, Segú-Tolsa JL, Trapero-Bertran M. Price Models for Multi-indication Drugs: A Systematic Review. Appl Health Econ Health Policy. 2020;18(1):47-56. PMID:31523756 DOI:

Cole A, Neri M, Cookson G. Payment Models for Multi-Indication Therapies. Online (Accessed July 2022). DOI:

Antonanzas F, Juárez-Castelló C, Lorente R, Rodríguez-Ibeas R. The Use of Risk-Sharing Contracts in Healthcare: Theoretical and Empirical Assessments. PharmacoEconomics. 2019;37(12):1469-1483. PMID:31535280 DOI:

Whittal A, Jommi C, De Pouvourville G, et al. Facilitating More Efficient Negotiations for Innovative Therapies: A Value-Based Negotiation Framework - Corrigendum. Int J Technol Assess Health Care. 2022;38(1):e43. DOI:

Xoxi E, Rumi F, Kanavos P, et al. A Proposal for Value-Based Managed Entry Agreements in an Environment of Technological Change and Economic Challenge for Publicly Funded Healthcare Systems. Front Med Technol. 2022;4:888404. PMID:35782579 DOI:

Riccaboni M, Swoboda T, Van Dyck W. Pharmaceutical net price transparency across european markets: insights from a multi-agent simulation model. Health Policy. 2022;126(6):534-540. PMID:35459584 DOI:

Michaeli DT, Mills M, Kanavos P. Value and Price of Multi-indication Cancer Drugs in the USA, Germany, France, England, Canada, Australia, and Scotland. Appl Health Econ Health Policy. 2022;20(5):757-768. PMID:35821360 DOI:

Pani L, Cicchetti A, De Luca A, et al. Pricing for multi-indication medicines: a discussion with Italian experts. Pharmadvance 2022; 4 (2): 163-170. Online (Accessed July 2022). DOI:

Additional Files



How to Cite

Di Brino, E., & Jommi, C. (2023). Price and reimbursement of medicines when new indications are approved: the results of a survey on ISPOR Italy Rome Chapter members. Global and Regional Health Technology Assessment, 10(1), 40–45.



Point of View


Received 2023-01-15
Accepted 2023-04-25
Published 2023-05-02


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