Article

Interview: Value of multi-indication immunotherapies for the treatment of autoimmune diseases in the United States (US)

Long Nguyen

Discover insight from ISPOR US 2025

A conversation with Long Nguyen

In anticipation of the 2025 ISPOR meeting, we had the opportunity to speak with Long Nguyen, PharmD, Research Fellow, Medical Communications, to discuss his poster “Value of Multi-Indication Immunotherapies for the Treatment of Autoimmune Diseases in the United States.” Long's work examines the complexities and strategies involved in launching therapies that can treat multiple indications, offering insights into their clinical and economic value. Sergey Kustov, PharmD, MS, Nicole Fusco, ScD, Tushar Padwal, MS, David Ringger, PhD, and Joseph Washington, PharmD, MS, MPH, served as co-authors.

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What inspired this research?

Long Nguyen: Our research was inspired by a noticeable shift in the pharmaceutical industry toward multi-indication therapies, which are increasingly favored by both manufacturers and patients. This trend is evident in fields like oncology, immunology, and more recently, diabetes. The idea is that a single therapy impacting multiple disease states through the same mechanism can significantly enhance its value. However, this approach presents challenges, particularly in strategic and operational complexity and market access. The research aims to explore these challenges and the clinical and economic value of successful multi-indication therapies in the United States.

Was there a hypothesis that the research confirmed?

Long Nguyen: Before starting the research, the team hypothesized there would be a misalignment between value and price for most multi-indication therapies in the United States. We suspected that under a single-price policy, manufacturers might be incentivized to sequence and withhold indications based on the drug's clinical value and patient prevalence to maximize pricing.¹ Our hypothesis was confirmed, indicating that manufacturers often prioritize launching drugs with the highest clinical value and largest disease prevalence.

What are the key takeaways from your research?

Long Nguyen: The research, though exploratory, suggests that manufacturers tend to launch drugs with the highest clinical value and largest disease prevalence first. This strategy helps set a favorable initial price, which then serves as a reference point for future price negotiations as more indications are introduced. However, we observed a negative correlation between the price and value of each additional indication. As the price increased relative to the first indication, the value of subsequent indications decreased, highlighting a misalignment between value and pricing for multi-indication assets.

Was there anything in the research that was surprising, that you didn't expect, that you found out?

Long Nguyen: One surprising discovery was the limited availability of economic data on multi-indication therapies in the United States. Despite the absence of a formal health technology assessment process in the country, we expected more peer-reviewed publications on cost-effectiveness analyses or economic models from a U.S. healthcare perspective. However, there were fewer publications compared to those from countries with more robust health technology assessment processes, like the United Kingdom or Germany. This lack of data posed challenges in the research, reducing the sample size and potentially affecting the generalizability of the results.

What are the next steps from this research?

Long Nguyen: The team plans to conduct additional research with a larger sample size to enhance the validity and significance of the findings. The goal is to extend the study across other therapeutic areas, using these insights to help smaller biopharmaceutical partners accelerate product launch success and optimize market access strategies. This continued research aims to provide a clearer understanding of the value and pricing dynamics of multi-indication therapies, ultimately benefiting manufacturers and patients alike.

Reference:

Institute for Clinical and Economic Review. Indication-specific pricing of pharmaceuticals in the United States health care system. March 2016. Accessed April 21, 2025. https://icer.org/wp-content/uploads/2021/01/Final-Report-2015-ICER-Policy-Summit-on-Indication-specific-Pricing-March-2016_revised-icons-002.pdf

Citations relevant to the content described herein are provided in the poster mentioned here. Readers should review all available information related to the topics mentioned herein and rely on their own experience and expertise in making decisions related thereto.

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