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.

As the National Institute for Health and Care Excellence conducts a review of its health technology assessment methods, the Association of the British Pharmaceutical Industry has laid out the key changes it would like to see.

Payments have now been made under the UK’s 2019 pricing and access to branded medicines scheme, but industry will have to wait longer for promises on access to materialize.