Payer Agreements: Splitting the Risk
Budgets are tight. Payer funding for new products is dwindling. And for pharmaceutical companies, market access is more and more difficult to attain.
Across the UK, the US, Canada, Australia and parts of Europe, payer schemes are increasingly de rigueur. Schemes advanced by pharmaceutical companies either aim to grapple financial issues such as price volume agreements, or they tackle uncertainty by addressing increased data collection.
Report Overview
In Payer Agreements: Splitting the Risk, FirstWord Dossier offers a complete and concise overview of payer schemes by definition and category. Based on an array of expert interviews, the report discusses the key drivers behind the evolution of payer schemes from financial imperatives to market uncertainty. Most importantly, the report defines—country by country—emerging trends based on current case studies and tackles the big question: What are the key features that will ensure success?
Key features
Key Benefits
Key Questions Asked
Who Should Read This Report
Across the UK, the US, Canada, Australia and parts of Europe, payer schemes are increasingly de rigueur. Schemes advanced by pharmaceutical companies either aim to grapple financial issues such as price volume agreements, or they tackle uncertainty by addressing increased data collection.
Report Overview
In Payer Agreements: Splitting the Risk, FirstWord Dossier offers a complete and concise overview of payer schemes by definition and category. Based on an array of expert interviews, the report discusses the key drivers behind the evolution of payer schemes from financial imperatives to market uncertainty. Most importantly, the report defines—country by country—emerging trends based on current case studies and tackles the big question: What are the key features that will ensure success?
Key features
- Detailed examination of the role of agreements in global pricing, reimbursement and market access
- Discussion of the drivers for schemes, including HTA and financial challenges
- Country-by-country trends illustrated with case studies
- Expert insight into the role of schemes and their evolution
- Analysis of the pros and cons of agreements
Key Benefits
- Definitions and categories of schemes
- Expert insight from key regulatory bodies
- Comprehensive references to key literature
Key Questions Asked
- What principles should be used in designing schemes?
- When should companies offer risk-sharing agreements?
- How can European risk-sharing be implemented in the US?
- What is the current state of play with schemes globally?
- What changes are likely in the future?
Who Should Read This Report
- Market access directors and managers
- Health economics professionals
- Pharmacoeconomics professionals
- Health Outcomes / Outcomes Research professionals
- Pricing and Reimbursement teams
- Government and regulatory affairs analysts
- Marketing research/business intelligence managers
- Government and regulatory affairs analysts
EXECUTIVE SUMMARY
CURRENT AGREEMENTS WITH PAYERS ACROSS AUSTRALIA, EUROPE, CANADA AND THE US
Introduction
Defining and categorizing schemes
Definitions from the literature
UK definition and categorization
Drivers for schemes
Financial challenges
HTA and saying no
Dealing with uncertainty
COUNTRY TRENDS IN SCHEMES AND SELECTED CASE STUDIES
Australia
Bosentan patient registry
Canada
Clozaril money-back guarantee
Denmark
No cure, no pay for Diovan
France
Risperdal refund
Germany
Aclasta refund scheme
Italy
Tarceva discount scheme
Sutent discount scheme
Serbia
Avastin, Erbitux and MabCampath rebate schemes
Sweden
Crestor and ezetimibe coverage with evidence development
UK
Multiple Sclerosis Risk Sharing Scheme
Velcade money back guarantee
Lucentis dose capping scheme
US
Proscar refund scheme
Zocor refund scheme
Januvia guarantee scheme
Sanofi and Proctor & Gamble pay for fractures scheme
POTENTIALS AND PITFALLS OF AGREEMENTS
Fit with pricing and reimbursement environments
Pros and cons
Reality check
CONCLUSIONS
Too early to say
Maybe necessary, but not sufficient
Exploring uncertainty, not discounting in the future
ACKNOWLEDGEMENTS
CURRENT AGREEMENTS WITH PAYERS ACROSS AUSTRALIA, EUROPE, CANADA AND THE US
Introduction
Defining and categorizing schemes
Definitions from the literature
UK definition and categorization
Drivers for schemes
Financial challenges
HTA and saying no
Dealing with uncertainty
COUNTRY TRENDS IN SCHEMES AND SELECTED CASE STUDIES
Australia
Bosentan patient registry
Canada
Clozaril money-back guarantee
Denmark
No cure, no pay for Diovan
France
Risperdal refund
Germany
Aclasta refund scheme
Italy
Tarceva discount scheme
Sutent discount scheme
Serbia
Avastin, Erbitux and MabCampath rebate schemes
Sweden
Crestor and ezetimibe coverage with evidence development
UK
Multiple Sclerosis Risk Sharing Scheme
Velcade money back guarantee
Lucentis dose capping scheme
US
Proscar refund scheme
Zocor refund scheme
Januvia guarantee scheme
Sanofi and Proctor & Gamble pay for fractures scheme
POTENTIALS AND PITFALLS OF AGREEMENTS
Fit with pricing and reimbursement environments
Pros and cons
Reality check
CONCLUSIONS
Too early to say
Maybe necessary, but not sufficient
Exploring uncertainty, not discounting in the future
ACKNOWLEDGEMENTS
