With the emphasis on getting lower prices even for cost-effective drugs, England’s proposed commercial framework may be sending a negative signal to global companies.

Hearing direct from HTA agencies on what evidence they want to see is now an option through early dialogue. With many options for early dialogue available, it is hard for companies to know whether to get advice, from which agency and how to get the most out of the dialogue.

Plans for a new commercial framework for publicly funded medicines in England are out for consultation. The concept of fair and responsible pricing figures large in the proposals.

The Pink Sheet’s freedom of information request relating to the 2019 pricing and access to branded medicines scheme has shed light on the metrics being used to gauge whether the scheme is delivering on its promise.

Novartis has managed to temporarily overcome payer reservations about the real-world value of Kymriah by engaging early with payers and heath technology assessment bodies and by developing tailored outcomes-based deals for key European markets. Approaching each payer with a responsible attitude has helped too.

Payment for outcomes has played an important role in enabling Gilead to secure reimbursement for Yescarta in some EU markets. It is likely to be the key focus for the company as it works to expand patient access to the potentially transformative CAR-T therapy across Europe.