OBJECTIVES : Access to health innovation is a real headache for decision-makers. The therapeutic progress brought by these innovations is very often linked to a heavy cost, which has led payers to become more and more demanding regarding the cost-effectiveness of the products acquired. Our objective were to propose a working model that will enable Algeria to implement market access agreements (MAA) as a solution to improve access for innovation, considering the particularities of the Algerian health system and the local pharmaceutical market.

METHODS

: a descriptive analysis of the algerian health system was undertaken including an overview of the pharmaceuticals market and its progress during the last years, then a systematic review of models from authorities using MAA (USA, OK, France and Italy) was conducted. From there, a discussion with key stakeholders in Algeria regarding pharmaceuticals was carried out using a questionnaire (manufacturers, physicians, payers, health authorities, hospital staff) to identify regulatory and operational obstacles that delay the process of implementing these contracts.

RESULTS

: A low access to innovation in Algeria was observed during the last years (2017-2019) because of a lack of funding.

The information collected from the main stakeholder in Algeria showed a growing interest for this type of agreements, principle barriers mentioned were : lack of regulatory framework, weak knowledge base, and monitoring issues. Overall, interviwees recommended the implementation of a robust data collection system, and insisted on the training of involved personnel. Interviwees suggested the use of financial agreements and agreements based on performance depending on the outcomes of products. A working model was proposed defining the stakeholders involved, the process, the follow-up.

CONCLUSIONS : The adoption of the proposed scheme, with the endorsement of good implementation practices, may provide a solution to improve access to innovation.