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When two expensive cancer drugs are combined, the price is often the sum of both even though the extra benefit is smaller. A rule for splitting the total value between them is needed.
Combination regimens (checkpoint inhibitor plus targeted agent, ADC plus immunotherapy) frequently fail cost-effectiveness thresholds because each manufacturer prices for the full value, and competition law is cited as blocking joint negotiation. The UK's 2023 ABPI-NICE combination framework allows a backbone manufacturer to offer a rebate when its drug is used as part of a combination. The proposal is to generalise this: payers set a total price ceiling for the regimen based on its incremental benefit, a published attribution rule splits it between components, and competition authorities issue safe-harbour guidance for the resulting arrangements.