Defining therapeutic innovation is a key point to determine the price of newly marketed drugs; however, a pre-requisite for an appropriate management of innovation is that some general rules have been identified to recognize the therapeutic value of any pharmacological agent. These issues are a matter of debate for Regulatory Agencies and for the scientific community as well.Cost-effectiveness principles still represent the main approach to quantify the economic value of a drug based on its clinical effectiveness, and QALYs still represent the main tool to compare outcomes across different therapeutic areas. The main problem in this area is represented by the difficulty in translating general principles into practical decisions. Factors that still hamper the application of the value-based approach include organizational constraints (e.g. drug fixed budgets), the lack of familiarity with cost-effectiveness by most decision-makers, and the history of local decisions.
