2011
DOI: 10.1377/hlthaff.2010.1147
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Risk-Sharing Arrangements That Link Payment For Drugs To Health Outcomes Are Proving Hard To Implement

Abstract: Risk-sharing agreements, under which payers and pharmaceutical manufacturers agree to link payment for drugs to health outcomes achieved, rather than the volume of products used, offer an appealing payment model for pharmaceuticals. Although such agreements have been widely touted, the experience to date mainly demonstrates how hard they are to implement. Barriers include high implementation costs, measurement challenges, and the absence of a suitable data infrastructure. Risk-sharing arrangements could gain t… Show more

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Cited by 89 publications
(88 citation statements)
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“…Italy, UK) used them at a much higher scale than others. It also showed that most countries opted for financial MEA that are easier to handle, than performance-based MEA [76]. Since that study, more MEA have been implemented for new products, and even European countries (e.g.…”
Section: Managed-entry Agreementmentioning
confidence: 98%
“…Italy, UK) used them at a much higher scale than others. It also showed that most countries opted for financial MEA that are easier to handle, than performance-based MEA [76]. Since that study, more MEA have been implemented for new products, and even European countries (e.g.…”
Section: Managed-entry Agreementmentioning
confidence: 98%
“…Over the past few years, such schemes have become more common in Europe and the US. 29,30 Managed entry agreements can take many forms and can be incorporated into novel regulatory pathways, including adaptive licensing. For example, a new anti-diabetic medication could be "Approved for Randomisation" whereby the HTA agency asks a pharmaceutical company to gather more evidence about the long-term cardiovascular benefits and harms of its product -relative to other drugs in the same therapeutic class -in low-cost, head-to-head randomised trials.…”
Section: Raising the Bar For Market Entry By Health Technology Assessmentioning
confidence: 99%
“…At present, changing the coverage status of a previously-reimbursed drug -or withdrawing an already approved product -can pose significant political challenges for HTA agencies. 30 Such agreements may also be operationally complex, costly, and difficult to implement. However, efforts are underway to improve the data infrastructure to collect valid information on relevant outcomes.…”
Section: Raising the Bar For Market Entry By Health Technology Assessmentioning
confidence: 99%
“…(Pelchat 2012). One reason may be that clinically based agreements are difficult to implement (Neumann et al 2011). Another reason may be that because financial PLAs are confidential, private insurers, and consequently the individuals they insure, do not benefit from the discount granted by the manufacturer to the government.…”
Section: Other Provincesmentioning
confidence: 99%