​​Practical application of Outcomes-Based Pricing in Scotland: a retrospective data quality and feasibility study in Non-Hodgkin’s Lymphoma

New medicines for cancer are improving patient outcomes such as increased survival and quality of life. Accelerated regulatory schemes for new medicines are speeding up access. This presents challenges for reimbursement decision makers such as the Scottish Medicines Consortium. All of these factors lead to high financial risk to the NHS if an upfront fixed drug price is agreed.

“Outcomes Based Pricing” (OBP) is a flexible payment mechanism for helping the NHS managing financial risk of drug adoption with a company. Scotland has benefited from recent advances in the digitisation of healthcare records, which would support the automated rapid data capture necessary for the operation of an OBP scheme.  

We wish to propose an OBP study, as a proof of concept, by using data from NHS Lothian patients affected by Non-Hodgkin’s Lymphoma diagnosed. These patients undergo multiple treatments which would be a great example to test the above rationale, whilst placing little burden on front-line healthcare services. Treatments, medical and survival characteristics will also be described.  

The implementation of OBP for the NHS will lead to accelerated patient access to new drugs, and care improvement, in a manner that protects NHS resources from commercial exploitation by the pharmaceutical industry. The project output will enable the NHS to make safer, better informed and more timely decisions on future medicines to ensure the NHS is providing high value care to the patients it serves. The summary report from the project will be presented to the project steering group and used by Scottish Government Medicines team, Scottish Medicines Consortium and national medicines procurement services to help in the understanding of what is currently possible in NHS Scotland, and what needs to improve.