No Cure No Pay incassobureau  direct debit is a form of salvage contract under which the salvor receives no payment if the vessel he is salvaging fails to make a successful claim. It has been applied to marine insurance policies since 1908.

The current tensions between pharmaceutical companies and health authorities have grown in recent decades. The former wants the best drug for their money whereas the latter fears losing market share and profits. Clearly this situation cannot continue, not least for patients.

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A No Cure No Pay strategy is a win-win solution for all parties. It promotes rational pharmacotherapy and ensures the right drug in the right patient, but it also helps companies to be more competitive by preventing them from paying for drugs that do not work. However, before this strategy can be widely adopted, a number of practical and ethical questions need to be answered. We therefore call for an open debate on this subject.