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The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications
BACKGROUND: Managed entry agreements (MEAs) are a set of instruments to facilitate access to new medicines. This study surveyed the implementation of MEAs in Central and Eastern Europe (CEE) where limited comparative information is currently available. METHOD: We conducted a survey on the implementa...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684278/ https://www.ncbi.nlm.nih.gov/pubmed/28836222 http://dx.doi.org/10.1007/s40273-017-0559-4 |
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author | Ferrario, Alessandra Arāja, Diāna Bochenek, Tomasz Čatić, Tarik Dankó, Dávid Dimitrova, Maria Fürst, Jurij Greičiūtė-Kuprijanov, Ieva Hoxha, Iris Jakupi, Arianit Laidmäe, Erki Löblová, Olga Mardare, Ileana Markovic-Pekovic, Vanda Meshkov, Dmitry Novakovic, Tanja Petrova, Guenka Pomorski, Maciej Tomek, Dominik Voncina, Luka Haycox, Alan Kanavos, Panos Vella Bonanno, Patricia Godman, Brian |
author_facet | Ferrario, Alessandra Arāja, Diāna Bochenek, Tomasz Čatić, Tarik Dankó, Dávid Dimitrova, Maria Fürst, Jurij Greičiūtė-Kuprijanov, Ieva Hoxha, Iris Jakupi, Arianit Laidmäe, Erki Löblová, Olga Mardare, Ileana Markovic-Pekovic, Vanda Meshkov, Dmitry Novakovic, Tanja Petrova, Guenka Pomorski, Maciej Tomek, Dominik Voncina, Luka Haycox, Alan Kanavos, Panos Vella Bonanno, Patricia Godman, Brian |
author_sort | Ferrario, Alessandra |
collection | PubMed |
description | BACKGROUND: Managed entry agreements (MEAs) are a set of instruments to facilitate access to new medicines. This study surveyed the implementation of MEAs in Central and Eastern Europe (CEE) where limited comparative information is currently available. METHOD: We conducted a survey on the implementation of MEAs in CEE between January and March 2017. RESULTS: Sixteen countries participated in this study. Across five countries with available data on the number of different MEA instruments implemented, the most common MEAs implemented were confidential discounts (n = 495, 73%), followed by paybacks (n = 92, 14%), price-volume agreements (n = 37, 5%), free doses (n = 25, 4%), bundle and other agreements (n = 19, 3%), and payment by result (n = 10, >1%). Across seven countries with data on MEAs by therapeutic group, the highest number of brand names associated with one or more MEA instruments belonged to the Anatomical Therapeutic Chemical (ATC)-L group, antineoplastic and immunomodulating agents (n = 201, 31%). The second most frequent therapeutic group for MEA implementation was ATC-A, alimentary tract and metabolism (n = 87, 13%), followed by medicines for neurological conditions (n = 83, 13%). CONCLUSIONS: Experience in implementing MEAs varied substantially across the region and there is considerable scope for greater transparency, sharing experiences and mutual learning. European citizens, authorities and industry should ask themselves whether, within publicly funded health systems, confidential discounts can still be tolerated, particularly when it is not clear which country and party they are really benefiting. Furthermore, if MEAs are to improve access, countries should establish clear objectives for their implementation and a monitoring framework to measure their performance, as well as the burden of implementation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40273-017-0559-4) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5684278 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-56842782017-11-27 The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications Ferrario, Alessandra Arāja, Diāna Bochenek, Tomasz Čatić, Tarik Dankó, Dávid Dimitrova, Maria Fürst, Jurij Greičiūtė-Kuprijanov, Ieva Hoxha, Iris Jakupi, Arianit Laidmäe, Erki Löblová, Olga Mardare, Ileana Markovic-Pekovic, Vanda Meshkov, Dmitry Novakovic, Tanja Petrova, Guenka Pomorski, Maciej Tomek, Dominik Voncina, Luka Haycox, Alan Kanavos, Panos Vella Bonanno, Patricia Godman, Brian Pharmacoeconomics Original Research Article BACKGROUND: Managed entry agreements (MEAs) are a set of instruments to facilitate access to new medicines. This study surveyed the implementation of MEAs in Central and Eastern Europe (CEE) where limited comparative information is currently available. METHOD: We conducted a survey on the implementation of MEAs in CEE between January and March 2017. RESULTS: Sixteen countries participated in this study. Across five countries with available data on the number of different MEA instruments implemented, the most common MEAs implemented were confidential discounts (n = 495, 73%), followed by paybacks (n = 92, 14%), price-volume agreements (n = 37, 5%), free doses (n = 25, 4%), bundle and other agreements (n = 19, 3%), and payment by result (n = 10, >1%). Across seven countries with data on MEAs by therapeutic group, the highest number of brand names associated with one or more MEA instruments belonged to the Anatomical Therapeutic Chemical (ATC)-L group, antineoplastic and immunomodulating agents (n = 201, 31%). The second most frequent therapeutic group for MEA implementation was ATC-A, alimentary tract and metabolism (n = 87, 13%), followed by medicines for neurological conditions (n = 83, 13%). CONCLUSIONS: Experience in implementing MEAs varied substantially across the region and there is considerable scope for greater transparency, sharing experiences and mutual learning. European citizens, authorities and industry should ask themselves whether, within publicly funded health systems, confidential discounts can still be tolerated, particularly when it is not clear which country and party they are really benefiting. Furthermore, if MEAs are to improve access, countries should establish clear objectives for their implementation and a monitoring framework to measure their performance, as well as the burden of implementation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40273-017-0559-4) contains supplementary material, which is available to authorized users. Springer International Publishing 2017-08-23 2017 /pmc/articles/PMC5684278/ /pubmed/28836222 http://dx.doi.org/10.1007/s40273-017-0559-4 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Research Article Ferrario, Alessandra Arāja, Diāna Bochenek, Tomasz Čatić, Tarik Dankó, Dávid Dimitrova, Maria Fürst, Jurij Greičiūtė-Kuprijanov, Ieva Hoxha, Iris Jakupi, Arianit Laidmäe, Erki Löblová, Olga Mardare, Ileana Markovic-Pekovic, Vanda Meshkov, Dmitry Novakovic, Tanja Petrova, Guenka Pomorski, Maciej Tomek, Dominik Voncina, Luka Haycox, Alan Kanavos, Panos Vella Bonanno, Patricia Godman, Brian The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications |
title | The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications |
title_full | The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications |
title_fullStr | The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications |
title_full_unstemmed | The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications |
title_short | The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications |
title_sort | implementation of managed entry agreements in central and eastern europe: findings and implications |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684278/ https://www.ncbi.nlm.nih.gov/pubmed/28836222 http://dx.doi.org/10.1007/s40273-017-0559-4 |
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