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. 2022 Jul 11;20(5):757–768. doi: 10.1007/s40258-022-00737-w

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

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Fig. 1 — Indication launch decisions under single-price policies: A theory and B evidence. A shows the differential value and number of patients for a given drug per indication. Indication development follows the natural order A, B, C, then D - priced at $P_{A}$ then $P_{D}$ . Theory suggests that manufacturers may be incentivised to sequence and withhold indications according to clinical value and number of patients to extract the highest possible prices ( $P_{B}$ and $P_{C}$ ) under a single pricing mechanism [6, 7, 12]. B illustrates evidence from a sample of 25 multi-indication cancer drugs. This evidence suggests that launch sequences are indeed prioritized by number of patients (measured by disease prevalence [23]) and clinical value (measured by incremental QALYs extracted from health technology assessment reports). Indications offering marginal incremental QALYs for a small population group are not launched. QALY quality-adjusted life year. Source(s) [6, 7, 12, 23]