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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2017
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.
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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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