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In Reply Dr Messori and colleagues describe an approach to paying for cancer therapies in Italy that shares some essential features with indication-specific pricing as I discussed in a Viewpoint, but it is not the same. What the approaches share is the premise that payment should not be associated with the drug but instead with its use. Likewise, both approaches ultimately reward pharmaceutical companies more when their drugs are more effective.
Where the approaches differ is that the Italian system focuses on the results of the drug when used in a particular patient and payment levels are altered based on that. My indication-specific pricing proposal focused on paying the same amount for a drug when used in each patient with a condition, regardless of whether it was effective in that patient or not. Instead, the payment amount would be anchored to the average effect of the drug.
Bach PB. Alternative Pricing Strategies for Cancer Drugs—Reply. JAMA. 2015;313(8):858. doi:10.1001/jama.2014.17817