Reimbursement and payment models in Central and Eastern European as well as Middle Eastern countries: A survey of their current use and future outlook

Callenbach, Marcelien; Ádám, lldikó; Vreman, Rick A; Németh, Bertalan; Kaló, Zoltán; Goettsch, Wim

doi:10.1016/j.drudis.2022.103433

Cited by 4 publications

(7 citation statements)

References 38 publications

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“…Similar results can be found in previously reported international findings. Several studies concluded that financial-based reimbursement and upfront payment models are currently implemented more frequently than outcome-based reimbursement models and delayed payments, respectively [7,21,27,41,[48][49][50][51], as also indicated in cross-country comparisons [17,24,27,36,50]. Outcome-based reimbursement models and delayed payments models are seen as promising alternatives to reduce remaining (clinical) uncertainties, diminish the budget impact, share financial risks, and improve/ensure patient access [21,52,53].…”

Section: Discussionmentioning

confidence: 99%

“…The questions were asked using Likert scales, rankings, and a few open questions (Questionnaire available in Supplementary Materials). The reimbursement and payment models and their taxonomy included in this study were predominantly based on existing literature with minor adjustments to reflect the Dutch setting (Table 1) [7,19,20,23,27]. Specific definitions are reported in the Supplemental Materials, Box S1.…”

Section: Survey Objective and Designmentioning

confidence: 99%

“…In the previous literature, stakeholders emphasized that several goals have been achieved by implementing more complex payment and reimbursement models, such as providing earlier patient access to new treatments, reducing remaining (clinical) uncertainties or managing high budget impact [4,7,24]. Nevertheless, it is argued that these agreements are often not transparent and are complex to implement [22,24,27,28]. Additionally, many examples of unsuccessful implementation also exist [29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, there have been several studies on stakeholders' attitudes toward current and innovative pharmaceutical payment and reimbursement agreements throughout Europe [17,27,36,37]. Previous studies often highlighted the views of one or a few specific stakeholder group(s), most commonly regulators, HTA bodies, payers or manufacturers [17,27,[36][37][38][39]. Additionally, previous literature often focused on making a comparison across countries [17,37,40,41].…”

Section: Introductionmentioning

confidence: 99%

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When Reality Does Not Meet Expectations—Experiences and Perceived Attitudes of Dutch Stakeholders Regarding Payment and Reimbursement Models for High-Priced Hospital Drugs

Callenbach

Vreman

Mantel‐Teeuwisse

et al. 2022

IJERPH

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This study aimed to identify the current experiences with and future preferences for payment and reimbursement models for high-priced hospital therapies in the Netherlands, where the main barriers lie and assess how policy structures facilitate these models. A questionnaire was sent out to Dutch stakeholders (in)directly involved in payment and reimbursement agreements. The survey contained statements assessed with Likert scales, rankings and open questions. The results were analyzed using descriptive statistics. Thirty-nine stakeholders (out of 100) (in)directly involved with reimbursement decision-making completed the survey. Our inquiry showed that currently financial-based reimbursement models are applied most, especially discounts were perceived best due to their simplicity. For the future, outcome-based reimbursement models were preferred, particularly pay-for-outcome models. The main stated challenge for implementation was generating evidence in practice. According to the respondents, upfront payments are currently implemented most often, whereas delayed payment models are preferred to be applied more frequently in the future. Particularly payment-at-outcome-achieved models are preferred; however, they were stated as administratively challenging to arrange. The respondents were moderately satisfied with the payment and reimbursement system in the Netherlands, arguing that the transparency of the final agreements and mutual trust could be improved. These insights can provide stakeholders with future direction when negotiating and implementing innovative reimbursement and payment models. Attention should be paid to the main barriers that are currently perceived as hindering a more frequent implementation of the preferred models and how national policy structures can facilitate a successful implementation.

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Section: Discussionmentioning

confidence: 99%

Section: Survey Objective and Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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When Reality Does Not Meet Expectations—Experiences and Perceived Attitudes of Dutch Stakeholders Regarding Payment and Reimbursement Models for High-Priced Hospital Drugs

Callenbach

Vreman

Mantel‐Teeuwisse

et al. 2022

IJERPH

Self Cite

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“…However, these focused exclusively on speci c sectors, e.g. hospitals [7], [20], pharmaceuticals [19] or speci c situations, e.g. payment adjustments during COVID-19 pandemics [21].…”

Section: Introductionmentioning

confidence: 99%

Health care provider payment schemes across nine Central and Eastern European countries – a comparative analysis

Ndayishimiye,

Tambor,

Behmane

et al. 2023

Preprint

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Health care provider payment schemes consist of a complex set of arrangements used to influence provider behavior towards specific health policy objectives. The study aimed at: 1) providing a structured, comparative overview of current payment methods in selected Central and Eastern European (CEE) countries for different health care providers; 2) identifying and comparing major changes in payment schemes since 2010. Methods included: 1) development of a theoretical framework and data collection form; 2) desk research; 3) national experts’ consultations; 4) comparative analysis. The results indicate that the nine CEE countries (Bulgaria, Croatia, Czechia, Estonia, Latvia, Lithuania, Hungary, Poland, and Romania) show numerous similarities in provider payment method mix and in the general direction of the changes conducted in this field since 2010. Output-based payment methods prevail across all countries and types of providers. Primary health care (PHC) providers are characterized by the most diverse payment method mix, while both PHC and hospital inpatient care have experienced the most substantial changes in their payment schemes within the last 13 years. The most frequently conducted changes focused on modifying existing payment methods (e.g. detailing payment categories), and applying additional methods to pay for specific services or performance (e.g. fee-for-service, bonus payments). The objectives of conduced change were often similar, thus, there is high potential for a shared, cross-country learning.

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Illustrating the Financial Consequences of Outcome-Based Payment Models From a Payers Perspective: The Case of Autologous Gene Therapy Atidarsagene Autotemcel (Libmeldy®)

Callenbach,

Schoenmakers,

Vreman

et al. 2024

Value in Health

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Reimbursement and payment models in Central and Eastern European as well as Middle Eastern countries: A survey of their current use and future outlook

Cited by 4 publications

References 38 publications

When Reality Does Not Meet Expectations—Experiences and Perceived Attitudes of Dutch Stakeholders Regarding Payment and Reimbursement Models for High-Priced Hospital Drugs

When Reality Does Not Meet Expectations—Experiences and Perceived Attitudes of Dutch Stakeholders Regarding Payment and Reimbursement Models for High-Priced Hospital Drugs

Health care provider payment schemes across nine Central and Eastern European countries – a comparative analysis

Illustrating the Financial Consequences of Outcome-Based Payment Models From a Payers Perspective: The Case of Autologous Gene Therapy Atidarsagene Autotemcel (Libmeldy®)

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