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. 2025 Sep 6.
doi: 10.1007/s10198-025-01834-y. Online ahead of print.

Price determinants and pricing policies concerning potentially innovative health technologies: a scoping review

Nicolas S H Xander  1   2 , Tom Belleman  3   4 , Maximilian Salcher-Konrad  5   6 , Anne Hendrickx  7 , Jeffrey Chen  3 , Anne-Sophie Klein Gebbink  3   8 , Peter Schneider  5 , Kate Morgan  9 , Oliver Groene  10   11 , Isabelle Durand-Zaleski  12   13 , Frederick W Thielen  3   4 , Carin A Uyl-de Groot  3   4   14
Affiliations

Price determinants and pricing policies concerning potentially innovative health technologies: a scoping review

Nicolas S H Xander et al. Eur J Health Econ. .

Abstract

Background: Policymakers face challenges in developing pricing policies for potentially innovative healthcare technologies (pIHTs) that balance limited budgets, access, and incentives for innovation. This study aimed to map existing evidence and identify knowledge gaps regarding price determinants and pricing policies for pIHTs and their effect on access and sustainability.

Methods: We conducted a scoping Review of scientific and grey literature in English published between 2014 and September 2023 with pre-specified inclusion and exclusion criteria to identify stakeholder-informed price determinants, pricing policies applied by European Economic Area (EEA) or Organisation for Economic Cooperation and Development (OECD) member states, and their access-related impacts. Literature databases and various stakeholder organisation websites were searched. Further records were included through snowballing and manual addition.

Results: 135 Records were included. Stakeholder views on price determinants were available from 15 records and predominantly involved value-based determinants. Pricing policies in EEA/OECD member states are heterogeneous and often feature a mix of policy interventions and implementation methods. External price referencing (EPR), while yielding short-term affordability improvements, is associated with price inequities and launch strategies impairing patient access. Policies combining pricing methods and considering a pIHT's value have more positive access-related impact but may face feasibility and implementation challenges. Two records mentioned medical device pricing; none featured environmental aspects.

Conclusion: While EPR is commonly applied across Europe, value-informed pricing in connection with health technology assessment is more favoured regarding pIHT access in the literature. Knowledge gaps concern medical device pricing, stakeholder views on price determinants, and the implementation of environmental aspects in pIHT pricing.

Keywords: Innovation; Patient access; Pharmaceutical pricing; Price determinants; Pricing policies.

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Conflict of interest statement

Declarations. Conflicts of interest: The authors have no competing interests to declare that are relevant to the content of this article. Maximilian Salcher-Konrad reports receiving nonfinancial support from Medicines for Europe (travel and accommodation fees for attendance at a conference) outside the submitted work. Kate Morgan has no personal conflicts of interest, but Myeloma Patients Europe received funding from the following companies in 2023 and 2024: AbbVie, Amgen, Alexion, AstraZeneca, BeiGene, Binding Site, Bristol Myers Squibb, GlaxoSmithKline, Janssen, Kite, A Gilead Company, Novartis, Oncopeptides, Pfizer, Regeneron, Roche, Sanofi, Menarini Stemline, Takeda, Sebia, Prothena, SkylineDx, and Sandoz. Frederick Thielen resports that previous and ongoing research he was involved in was or is partly funded by Celgene B.V., NICE (UK National Institute for Health and Care Excellence), CADTH (Canadian Agency for Drugs and Technologies in Health), the Dutch Ministry of Health, Welfare and Sport, the Dutch Health Care Institute, and the European Haematology Association.

References

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