Getting cancer is bad enough. The high price of treatment makes it even worse. Some drugs cost tens of thousands of dollars a month, and there is no guarantee that they will work.
Italy’s state-run health service is asking pharmaceutical companies for money-back guarantees if their drugs don’t work. In 2015, it collected €200 million ($220 million) in refunds.
Since 2005, a national registry has been tracking treatments and outcomes. The Italian Medicines Agency makes use of the data for its pay-for-performance deals with pharma companies. If a drug isn’t performing as well as was promised, the agency will pay less money for its use.