Note: This taxonomy is based solely on the structure of the agreements. All types of agreements mentioned above may exist not only between companies and health organizations, but also between companies and other types of institutions that constitute a health system, including government agencies or national authorities responsible for making coverage or pricing decisions and/or evaluating health technologies (HTA), regional health authorities, health care providers, etc. In particular, for products used in hospitals, MEAs may be available between companies and hospitals. Source: authors of the study based on Carlson (2010), Ferrario and Kanavos (2013) and Gerkens et al. (2017). For Italy, England, Wales, Scotland and Sweden, specific information on the content of the schemes was consulted (N -136) (Additional information). There were financial agreements, with only one-third of the systems (40/136) having an earnings-related component. With the exception of three performance agreements in England, Wales and Scotland, all of these MEAs were applied in Italy with performance-based components. Since defined benefit agreements are rare or non-existent in most of the countries included in this study, we cannot link the typology of systems to the typology of the drugs involved. 3IMI ADAPT SMART workshop - Introduced managed in the context of adaptive trails (London, 5 July 2016) Brief workshop report. The adaptsmart.eu/wp-content/uploads/2016/02/ADAPT-SMART-Managed-entry-short-WS-report.pdf cost-sharing agreements (CSAs) provide the payer and the pharmaceutical company with ways to share the financial costs associated with the introduction of an innovative drug. CSAs can continue to be subdivided into price volume, budget and usage caps, as well as rebates. Under risk-sharing agreements (RSA), the public payer and the pharmaceutical company share the risks associated with clinical outcomes in patients treated with the innovative drug.
RSAs can be defined as "result guarantees," "guarantees of reimbursement," "payment by result" or "continuation of conditional treatment." For the latter, funding for treatment will only be continued for patients with some therapeutic efficacy. To summarize the key findings of the survey; 11 of the 21 hospital pharmacies participated in the survey and provided a reliable overview of the use of MEA in Finland. Information was provided by hospital pharmacies of all sizes, such as university hospitals, larger central hospitals and small pharmacies. Based on the survey, all hospitals participating in the survey received lump sum rebates.