Swedish society retained two-thirds of the value generated by trastuzumab and the remainder was allocated to the innovator.

Data from the registry reveal that the foregone benefit due to undertreatment, especially in women aged ≥ 70 years, is substantive.

Leveraging real-world evidence along the lifecycle of innovative therapies, to evaluate value derived from therapeutic and other types of benefits actually delivered, may support better allocation decisions based on a reward mechanism that adapts to incorporate new information generated once the treatment is in use.