By NextBestFitCover new treatments at launch, then reassess
New drugs and devices are covered immediately at a provisional price while evidence is collected; the price is reset after one or two years.
Cover new drugs at launch, reassess later.
Review ledgerHow this path connects
This path
Cover new treatments at launch, then reassess
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Cover new drugs at launch with provisional prices
- Reset prices after evidence review
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Slower access to new drugs and technology
Immediate coverage at a provisional price gives patients fast access to new drugs and keeps the United States an attractive launch market.
What it creates or worsens
- Depends on uncertain evidence or judgments
Immediate provisional coverage pays high prices for drugs that may not work while evidence is collected.
- Faces political, industry, or legal opposition
Once new drugs or devices receive immediate coverage, withdrawing that coverage later is difficult.
Who's affected
Who gains
- People with ongoing or specialist care needs
- Slower access to new drugs and technology: Strict value assessment can delay or refuse new therapies.
- Drug and device makers
- Slower access to new drugs and technology: Lower prices reduce research returns for biotech workers and investors.
Who loses
- Taxpayers and public budgets
- Slower access to new drugs and technology: Strict value assessment lowers payment for new products in the short run.
- Health insurers, brokers, and their shareholders
- Slower access to new drugs and technology: Strict value assessment lowers payment for new products in the short run.
Other ways to soften the losses
- Rebate the difference if the reassessed price is lower
Where it has been tried
- Germany (AMNOG): Free launch price for the first year; Germany has some of the fastest drug availability in Europe.
- UK Cancer Drugs Fund: Temporary funding while data mature.
- Germany: In Germany, where AMNOG provides immediate coverage at launch before price reassessment, new drug availability averaged 128 days in 2024, compared to an EU average of 578 days.