A delinked market-entry reward paid by payers when a repurposed generic wins approval

Delinked rewards separate the return on R&D from the price of the product; they have been proposed and partly implemented for antibiotics (UK subscription, PASTEUR Act proposals). For repurposing, the proposal is a pre-announced reward (for example $30-100 million depending on the size of benefit) paid by a consortium of payers to the sponsor of a positive registration-quality trial of an off-patent drug in cancer, conditional on the label being updated and the price remaining at generic levels. Payers benefit because the drug remains cheap while the incentive to run the trial exists.