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Performance-Based Risk-Sharing Arrangements: An Updated International Review

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  • Josh J. Carlson

    (University of Washington)

  • Shuxian Chen

    (University of Washington)

  • Louis P. Garrison

    (University of Washington)

Abstract

Enthusiasm for performance-based risk-sharing arrangements (PBRSAs) continues but at variable pace across countries. Our objective was to identify and characterize publicly available cases and related trends for these arrangements. We performed a review of PBRSAs from 1993 to 2016 using the University of Washington PBRSA Database. Arrangements were categorized according to a previously published taxonomy. Macro-level trends were identified related to the timing of adoption, countries involved, types of arrangements, and disease areas. Our search yielded 437 arrangements. Among these, 183 (41.9%) were categorized as currently active, while 58.1% have expired. Five main types of arrangements have been identified, namely coverage with evidence development (149 cases, 34.1%), performance-linked reimbursement (104 cases, 23.8%), conditional treatment continuation (78 cases, 17.8%), financial or utilization (71 cases, 16.2%), and hybrid schemes with multiple components (35 cases, 8.0%). The pace of adoption varies across countries but has renewed an upward trend after a lull in 2012/2013. Conditions in the USA may be changing toward a more favorable environment of PBRSAs. Interest in PBRSAs remains high, suggesting they are a viable coverage and reimbursement mechanism for a wide range of medical products.

Suggested Citation

  • Josh J. Carlson & Shuxian Chen & Louis P. Garrison, 2017. "Performance-Based Risk-Sharing Arrangements: An Updated International Review," PharmacoEconomics, Springer, vol. 35(10), pages 1063-1072, October.
    • Handle: RePEc:spr:pharme:v:35:y:2017:i:10:d:10.1007_s40273-017-0535-z
    DOI: 10.1007/s40273-017-0535-z
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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. Carlo Federici & Vivian Reckers-Droog & Oriana Ciani & Florian Dams & Bogdan Grigore & Zoltán Kaló & Sándor Kovács & Kosta Shatrov & Werner Brouwer & Michael Drummond, 2021. "Coverage with evidence development schemes for medical devices in Europe: characteristics and challenges," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(8), pages 1253-1273, November.
    3. Rick A Vreman & Thomas F Broekhoff & Hubert GM Leufkens & Aukje K Mantel-Teeuwisse & Wim G Goettsch, 2020. "Application of Managed Entry Agreements for Innovative Therapies in Different Settings and Combinations: A Feasibility Analysis," IJERPH, MDPI, vol. 17(22), pages 1-20, November.
    4. Jakub P. Hlávka & Jeffrey C. Yu & Dana P. Goldman & Darius N. Lakdawalla, 2021. "The economics of alternative payment models for pharmaceuticals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(4), pages 559-569, June.
    5. Biancalani, Francesco & Gnecco, Giorgio & Riccaboni, Massimo, 2022. "Price-volume agreements: A one principal/two agents model," European Journal of Operational Research, Elsevier, vol. 300(1), pages 296-309.
    6. Alessandra Ferrario & Diāna Arāja & Tomasz Bochenek & Tarik Čatić & Dávid Dankó & Maria Dimitrova & Jurij Fürst & Ieva Greičiūtė-Kuprijanov & Iris Hoxha & Arianit Jakupi & Erki Laidmäe & Olga Löblová , 2017. "The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications," PharmacoEconomics, Springer, vol. 35(12), pages 1271-1285, December.
    7. García-Collado, Carlos Gustavo & Martínez-de-la-Plata, Juan Enrique & Montoro, María del Mar Maldonado & Morales, Alberto Jiménez & Hernández, Miguel Ángel Calleja & Martínez, Fernando Martínez, 2021. "Impact of a risk-sharing agreement in rheumatoid arthritis in Spain," Health Policy, Elsevier, vol. 125(3), pages 335-340.

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