PERSPECTIVE article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1590944
This article is part of the Research TopicAdvancing Oncology Drug Development, Approval and Access Through Multi-Stakeholder CollaborationView all 3 articles
Value attribution for oncology combination regimens: Going beyond frameworks to balance innovation, access, and affordability
Provisionally accepted
Jennifer Gaultney1,2*
Daniel Ollendorf3Medha Sasane4
Céline Fernandez5Krupa Paranjpe4Ting-yen Chen2Hera Sandhu2Steven Simoens6- 1IQVIA Ltd, London, United Kingdom
- 2IQVIA (United Kingdom), London, United Kingdom
- 3Center for the Evaluation of Value and Risk in Health, Tufts Medical Centre, Boston, Massachusetts, United States
- 4Sanofi, Bridgewater, New Jersey, United States
- 5Sanofi, Paris, France
- 6KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
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Combination therapies are a mainstay in cancer treatment, but reimbursement access can be limited, owing to complexities around value assessment and pricing, and budget impact. Traditional frameworks for value assessment lack specific methodologies for evaluating combinations. A key challenge is value attribution between components. Here we provide the authors’ perspectives on this challenge, along with a summary of current market approaches and two proposed value attribution frameworks (VAFs), including their limitations and what would be needed to apply them in practice. Access to combination therapies varies by country, with each nation adopting different strategies to address challenges. Many have focused their efforts on competition laws, pricing, and overall affordability rather than value attribution. A value attribution solution could provide a basis for pricing and reimbursement negotiations for combinations. The two proposed VAFs offer a possible quantitative solution to assess the value of combination therapy components. However, existing VAFs are still limited by their data requirements and high levels of uncertainty, and are not applicable in certain market archetypes. Further work is needed before such VAFs can be widely applied. In addition, value attribution is only one component of the issue; locally tailored frameworks, agreement on criteria, multi-stakeholder collaboration, and a broader negotiation strategy encompassing other solutions are also necessary. We summarize key challenges and market approaches, as well as factors needed to make the proposed approaches acceptable.
Keywords: Value attribution framework, combination therapy access, oncology combinations, Value assessment, Health Technology Assessment, reimbursement
Received: 10 Mar 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 Gaultney, Ollendorf, Sasane, Fernandez, Paranjpe, Chen, Sandhu and Simoens. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jennifer Gaultney, IQVIA Ltd, London, United Kingdom
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