Will pay-for-performance boom in U.K.?

Can we look for more risk-sharing discounts for pricey drugs in the U.K.? If the government's new pharma pricing scheme is any indication, yes we can. In the wake of several high-profile arrangements--think Johnson & Johnson's pay-for-performance Velcade deal, under which the company rebates the drug's cost if a patient doesn't respond; or Roche's rebate on Tarceva, which brings its cost in line with rival Taxotere, made by Sanofi-Aventis--the PPRS is codifying risk-sharing deals.

Since the PPRS was released a few months ago, the U.K. health authorities have been in talks with several companies about new pricing schemes for their costly drugs, In Vivo reports.

Thing is, the risk-sharing schemes to date were spawned by a "No" from the National Institute of Clinical Excellence. NICE said Velcade wasn't worth the cost, so J&J offered the rebate for patients who don't respond. And so on. Now, NICE says it wants drugmakers to propose those sorts of deals up front, rather than as a last resort.

Obstacles? It's already complicated to administer rebates and track outcomes, as In Vivo notes. If every high-priced drug has different terms and conditions around it, then how will NHS and drugmakers keep track. NICE may have to come up with a few standardized deal templates to get a sizable number of pharma companies to play.

- read the In Vivo story