OBJECTIVES: To compare the similarities and differences between Risk-Sharing-Agreements (RSA) in Korea, Australia, Taiwan.

METHODS: A survey was conducted on market access specialists. Information about RSA adoption was gathered to observe the scheme.

RESULTS: Refund and price-volume-agreement (PVA) were the major types of RSA adopted in Korea and Taiwan, Meanwhile, hybrid schemes, which are a combination of pricing-arrangements and conditional-treatment-continuation, was a major type in Australia. In Korea, RSA was only applicable for drugs satisfied all three conditions: anti-cancer or rare disease treatment, no-alternatives or equivalent therapeutic options, life-threatening disease treatment. There was no specific eligibility restriction in Australia. Drugs that have same indication regarding to first-comer RSA drug, cannot be an objective of RSA in Korea. In Australia and Taiwan, RSA contract and following reimbursement approval were not restricted to latecomers. In Korea, and Taiwan, refund amount to payer includes VAT (value-added tax) based on listed price. However, VAT laid on net price in Australia. There was also a difference in the extent of publicity, where the product name was opened in Australia, the type of scheme was added in Korea, in Taiwan, details of the scheme also were disclosed on a case-by-case basis. Indication extension of reimbursed scope was available in every country, while coverage with evidence development (CED) scheme was not allowed in Korea. Taiwanese government required PVA or price cut if the annual revenue of the new indication exceeded US$ 3.3 million. When generic entered in Korea, the contract was terminated and needed re-assessment for price cut. Although the contract could not be maintained in Australia, the price reduced by 16%. In Taiwan, there was no-case and related regulation.

CONCLUSIONS: This result shown similarities in the purposes and types, but the operational detail was adjusted to local circumstance of each country.