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The implementation of managed entry agreements in Central and Eastern Europe: findings and implications

Ferrario, Alessandra and Arāja, Diāna and Bochenek, Tomasz and Čatić, Tarik and Dankó, Dávid and Dimitrova, Maria and Fürst, Jurij and Greičiūtė-Kuprijanov, Ieva and Hoxha, Iris and Jakupi, Arianit and Laidmäe, Erki and Löblová, Olga and Mardare, Ileana and Markovic-Pekovic, Vanda and Meshkov, Dmitry and Novakovic, Tanja and Petrova, Guenka and Pomorski, Maciej and Tomek, Dominik and Voncina, Luka and Haycox, Alan and Kanavos, Panos and Vella Bonanno, Patricia and Godman, Brian (2017) The implementation of managed entry agreements in Central and Eastern Europe: findings and implications. PharmacoEconomics. ISSN 1170-7690

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Identification Number: 10.1007/s40273-017-0559-4

Abstract

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. Alessandra Ferrario was a Research Officer at the LSE Health at the time this research was conducted. She is now a postdoctoral Research Fellow at the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA. Email: Alessandra_Ferrario@harvardpilgrim.org

Item Type: Article
Official URL: https://link.springer.com/journal/40273
Additional Information: © 2017 The Authors © CC BY-NC
Subjects: R Medicine > RZ Other systems of medicine
Sets: Research centres and groups > LSE Health
Date Deposited: 13 Sep 2017 13:38
Last Modified: 13 Sep 2017 16:37
URI: http://eprints.lse.ac.uk/id/eprint/84214

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