ANALYSIS AND CLASSIFICATION OF RISK-SHARING SCHEMES PROPOSED IN REIMBURSEMENT APPLICATION RECEIVED BY AHTAPOL IN 2012

Author(s)

Zawodnik S*1;Iwanczuk T1;Hermanowski T2, Matusewicz W3 1Agency for Health Technology Assessment in Poland, Warsaw, Poland, 2Department of Pharmacoeconomics, Medical University of Warsaw, Warsaw, Poland, 3Agency for Health Technology Assessment in Poland (AOTM), Warsaw, Poland

OBJECTIVES: The aim of the study was to analyze and classify the Risk-Sharing Schemes (RSSs) proposed in reimbursement applications received by Agency for Health Technology Assessment in Poland (AHTAPol) in 2012. METHODS: Risk-Sharing Schemes proposed in reimbursement applications received by AHTAPol in 2012 were quantitatively and qualitatively analyzed. The classification of the RSSs was also conducted based on both Carlson’s approach and the Polish Act on Reimbursement of medicinal products. RESULTS: In the studied period, 52 reimbursement applications with 26 proposed RSSs were received by AHTAPol. They were classified into 5 categories according to the Act on Reimbursement. The most common category was making the official sales price dependent on the applicant providing supplies at a reduced price, as specified in the negotiations on the price of the medicine (34.61%). Further categories were: making the official sales price dependent ona pay-back of a part of the reimbursement obtained to the entity which is obliged to finance benefits with public funds (23.08%), making the official sales price dependent on the level of turnover of the medicine (11.54%) and making the level of the applicant’s revenues dependent on the health effects achieved (3.85%). RSSs classified as others constituted 26.92% of all. Among 26 proposed RSSs only 8 of them could be classified according to the Carlson’s approach (1 proposition included more than one category). As a results, 4 Price Volume Agreements, 4 Manufacturer Funded Treatment Initiation and 1 Conditional Treatment Continuation were identified. CONCLUSIONS: Most of the propositions should not be considered as RSS according to the Carlson’s approach. The most common propositions were related to medicinal product’s price reduction and did not include any risk sharing. There is a strong need for further research.

Conference/Value in Health Info

2013-11, ISPOR Europe 2013, The Convention Centre Dublin

Value in Health, Vol. 16, No. 7 (November 2013)

Code

PHP208

Topic

Health Policy & Regulatory

Topic Subcategory

Risk-sharing Approaches

Disease

Multiple Diseases

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