This illustrative playbook demonstrates how the analysis could be translated into sequenced actions. Timings, thresholds and market choices would require validation for a live asset.
Illustrative timing
Months 0 to 6 | Evidence and framing before any authority sees a price
- Consider early scientific advice with G-BA and HAS to explore whether the comparator can be framed as the treated refractory pathway rather than generic mycophenolate alone
- Build the cost offset model that converts oral dosing into avoided infusion visits, travel, and monitoring
- Explore a single European list corridor of 17,200 EUR, the illustrative German list price input used in the reference cascade simulator, and consider making confidentiality of net price a launch precondition
- Map every referencing basket and rank the eight markets by assumed referencing influence
Illustrative decision checkpoint. Reassess the target corridor and value proposition if the intended comparator strategy is not accepted.
Illustrative timing
Months 6 to 12 | Sweden, the Netherlands, and the UK
- Consider filing and launching in Sweden and the Netherlands at the corridor list price
- Consider taking the UK appraisal early, where cost effectiveness may reward the adherence and offset case
- Start a prospective adherence and flare registry from the first patient treated
- Keep net price out of the public domain, and assess carefully any arrangement requiring a visible discount, considering its potential wider-market implications
Illustrative decision checkpoint. Three defensible prices on the record and around twelve months of adherence data would be a useful position before the German dossier is filed.
Illustrative timing
Months 12 to 20 | Germany and France
- Consider using the German free pricing window at the corridor list rather than above it, so any negotiated step down stays small
- Bring the Nordic and UK price record and the registry data into the AMNOG and CEPS discussions
- Explore volume commitments and outcome guarantees in place of visible price cuts
- Model the referencing spillover of any offer received in advance, and consider delaying or restructuring offers where the modelled wider-market impact exceeds local value
Illustrative decision checkpoint. Illustrative decision threshold, not the expected German achievable net price: if the German net price were to land above 12,500 EUR the corridor would remain viable in the model, while the separately modelled net under the preferred scenario is 13,522 EUR. Below that threshold, the sequencing decision would be worth reopening.
Illustrative timing
Months 20 to 30 | Italy, Spain, and Poland
- Consider entering Italy and Spain only under confidential managed entry agreements
- Consider later entry in Poland if suitable confidential or risk-sharing arrangements are unavailable that keep the list price at the corridor
- Consider early access or named patient supply where reimbursement is still open, to support patients without setting a price
Illustrative decision checkpoint. If a confidential net price is unavailable, delaying entry may be preferable to accepting a visible cut, with the position revisited periodically.
Illustrative timing
Ongoing | Governance
- Review the reference cascade regularly and re-run the sequencing model before every new market decision
- Track parallel trade volumes and consider adjusting supply quotas where arbitrage appears
- Feed real world outcomes back into each market at reassessment, and use them to help resist erosion
Illustrative decision checkpoint. A single owner for the global price corridor, able to consider delaying or restructuring any country deal where the modelled wider-market impact exceeds local value.