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

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.

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. 

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.

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.