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Current Status and Trends in Performance-Based Risk-Sharing Arrangements Between Healthcare Payers and Medical Product Manufacturers

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  • Josh Carlson
  • Katharine Gries
  • Kai Yeung
  • Sean Sullivan
  • Louis Garrison

Abstract

Our objective was to identify and characterize publicly available cases and related trends for performance-based risk-sharing arrangements (PBRSAs). We performed a review of PBRSAs over the past 20 years (1993–2013) using available databases and reports from colleagues and healthcare experts. These were categorized according to a previously published taxonomy of scheme types and assessed in terms of the underlying product and market attributes for each scheme. Macro-level trends were identified related to the timing of scheme adoption, countries involved, types of arrangements, and product and market factors. Our search yielded 148 arrangements. From this set, 65 arrangements included a coverage with an evidence development component, 20 included a conditional treatment continuation component, 54 included a performance-linked reimbursement component, and 42 included a financial utilization component. Each type of scheme addresses fundamental uncertainties that exist when products enter the market. The pace of adoption appears to be slowing, but new countries continue to implement PBRSAs. Over this 20-year period, there has been a consistent movement toward arrangements that minimize administrative burden. In conclusion, the pace of PBRSA adoption appears to be slowing but still has traction in many health systems. These remain a viable coverage and reimbursement mechanism for a wide range of medical products. The long-term viability and growth of these arrangements will rest in the ability of the parties to develop mutually beneficial arrangements that entail minimal administrative burden in their development and implementation. Copyright Springer International Publishing Switzerland 2014

Suggested Citation

  • Josh Carlson & Katharine Gries & Kai Yeung & Sean Sullivan & Louis Garrison, 2014. "Current Status and Trends in Performance-Based Risk-Sharing Arrangements Between Healthcare Payers and Medical Product Manufacturers," Applied Health Economics and Health Policy, Springer, vol. 12(3), pages 231-238, June.
  • Handle: RePEc:spr:aphecp:v:12:y:2014:i:3:p:231-238
    DOI: 10.1007/s40258-014-0093-x
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    Citations

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    Cited by:

    1. Trevor Jozef Piatkiewicz & Janine Marie Traulsen & Tove Holm-Larsen, 2018. "Risk-Sharing Agreements in the EU: A Systematic Review of Major Trends," PharmacoEconomics - Open, Springer, vol. 2(2), pages 109-123, June.
    2. Hinterhuber, Andreas, 2017. "Value quantification capabilities in industrial markets," Journal of Business Research, Elsevier, vol. 76(C), pages 163-178.
    3. Dunlop, William C.N. & Staufer, Alexandra & Levy, Pierre & Edwards, Guy J., 2018. "Innovative pharmaceutical pricing agreements in five European markets: A survey of stakeholder attitudes and experience," Health Policy, Elsevier, vol. 122(5), pages 528-532.
    4. Ulf Persson & J. M. Norlin, 2018. "Multi-indication and Combination Pricing and Reimbursement of Pharmaceuticals: Opportunities for Improved Health Care through Faster Uptake of New Innovations," Applied Health Economics and Health Policy, Springer, vol. 16(2), pages 157-165, April.
    5. Makady, A. & van Veelen, A. & de Boer, A. & Hillege, H. & Klungel, O.H. & Goettsch, W., 2019. "Implementing managed entry agreements in practice: The Dutch reality check," Health Policy, Elsevier, vol. 123(3), pages 267-274.
    6. Josh Carlson & Katie Gries & Kai Yeung & Sean Sullivan & Louis Garrison, 2014. "Authors’ Reply to Curto and Garattini: “Current Status and Trends in Performance-Based Risk-Sharing Arrangements Between Healthcare Payers and Medical Product Manufacturers”," Applied Health Economics and Health Policy, Springer, vol. 12(5), pages 567-568, October.
    7. 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.
    8. Fernando Antonanzas & Carmelo Juárez-Castelló & Reyes Lorente & Roberto Rodríguez-Ibeas, 2019. "The Use of Risk-Sharing Contracts in Healthcare: Theoretical and Empirical Assessments," PharmacoEconomics, Springer, vol. 37(12), pages 1469-1483, December.

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