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Should health authorities offer risk-sharing contracts to pharmaceutical firms? A theoretical approach

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  • Antonanzas, Fernando
  • Juarez-Castello, Carmelo
  • Rodriguez-Ibeas, Roberto

Abstract

In this paper, we characterise the risk-sharing contracts that health authorities can design when they face a regulatory decision on drug pricing and reimbursement in a context of uncertainty. We focus on two types of contracts. On the one hand, the health authority can reimburse the firm for each treated patient regardless of health outcomes (non risk-sharing). Alternatively, the health authority can pay for the drug only when the patient is cured (risk-sharing contract). The optimal contract depends on the trade-off between the monitoring costs, the marginal production cost and the utility derived from treatment. A non-risk-sharing agreement will be preferred by the health authority, if patients who should not be treated impose a relatively low cost to the health system. When this cost is high, the health authority would prefer a risk-sharing agreement for relatively low monitoring costs.

Suggested Citation

  • Antonanzas, Fernando & Juarez-Castello, Carmelo & Rodriguez-Ibeas, Roberto, 2011. "Should health authorities offer risk-sharing contracts to pharmaceutical firms? A theoretical approach," Health Economics, Policy and Law, Cambridge University Press, vol. 6(3), pages 391-403, July.
    • Handle: RePEc:cup:hecopl:v:6:y:2011:i:03:p:391-403_00
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    Cited by:

    1. Wettstein, Dominik J. & Boes, Stefan, 2022. "How value-based policy interventions influence price negotiations for new medicines: An experimental approach and initial evidence," Health Policy, Elsevier, vol. 126(2), pages 112-121.
    2. Jose Martinez-Raga & Francisco Gonzalez-Saiz & Julian Oñate & Itziar Oyagüez & Eliazar Sabater & Miguel Casado, 2012. "Budgetary impact analysis of buprenorphine-naloxone combination (Suboxone ® ) in Spain," Health Economics Review, Springer, vol. 2(1), pages 1-9, December.
    3. repec:bla:glopol:v:8:y:2017:i:s2:p:84-92 is not listed on IDEAS
    4. Gregory J. Critchley & Gregory S. Zaric, 2019. "The impact of pharmaceutical marketing on market access, treatment coverage, pricing, and social welfare," Health Economics, John Wiley & Sons, Ltd., vol. 28(8), pages 1035-1051, August.
    5. Panos Kanavos & Olivier Wouters & Panos Kanavos & Alessandra Ferrario & Giovanni Tafuri & Paolo Siviero, 2017. "Managing Risk and Uncertainty in Health Technology Introduction: The Role of Managed Entry Agreements," Global Policy, London School of Economics and Political Science, vol. 8, pages 84-92, March.
    6. Levaggi, Rosella, 2014. "Pricing schemes for new drugs: A welfare analysis," Social Science & Medicine, Elsevier, vol. 102(C), pages 69-73.
    7. Hui Zhang & Tao Huang & Tao Yan, 2022. "A quantitative analysis of risk-sharing agreements with patient support programs for improving medication adherence," Health Care Management Science, Springer, vol. 25(2), pages 253-274, June.
    8. Elodie Adida, 2021. "Outcome-Based Pricing for New Pharmaceuticals via Rebates," Management Science, INFORMS, vol. 67(2), pages 892-913, February.
    9. Olina Efthymiadou, 2023. "Health technology assessment criteria as drivers of coverage with managed entry agreements: a case study of cancer medicines in four countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(7), pages 1023-1031, September.
    10. Hui Zhang & Gregory Zaric, 2015. "Using price–volume agreements to manage pharmaceutical leakage and off-label promotion," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(7), pages 747-761, September.
    11. Antoñanzas, Fernando & Juárez-Castelló, Carmelo & Rodríguez-Ibeas, Roberto, 2013. "Risk-Sharing Agreements in Pharmaceutical Markets/Los acuerdos de riesgo compartido en mercados farmacéuticos," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 31, pages 359-378, Septiembr.
    12. Reza Mahjoub & Fredrik Ødegaard & Gregory S. Zaric, 2018. "Evaluation of a pharmaceutical risk‐sharing agreement when patients are screened for the probability of success," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 15-25, January.
    13. Simona Gamba & Paolo Pertile & Sabine Vogler, 2020. "The impact of managed entry agreements on pharmaceutical prices," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 47-62, October.
    14. Shuli Brammli-Greenberg & Ira Yaari & Elad Daniels & Ariella Adijes-Toren, 2021. "How Managed Entry Agreements can improve allocation in the public health system: a mechanism design approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 699-709, July.
    15. A. Carletto & A. Cicchetti & S. Coretti & V. Moramarco & M. Ruggeri, 2019. "Money back guarantee? A cost–benefit framework of performance-based agreements (PBAs) for the reimbursement of pharmaceuticals," Eurasian Business Review, Springer;Eurasia Business and Economics Society, vol. 9(1), pages 89-101, March.

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