New Publication: Risk-Sharing Agreements Between Pharmaceutical Manufacturers and Payers

Recently published in the American Journal of Managed Care is a study which examines prospects for Risk-Sharing Agreements (RSAs) between Pharmaceutical manufacturers and payers in the US private sector. OHE’s Professor Adrian Towse was involved in the study, alongside colleagues from the US National Pharmaceutical Council, the University of Washington, and Tufts University. The study was led by Professor Lou Garrison

RSAs between drug manufacturers and payers link coverage and reimbursement to real-world performance (or effectiveness) or utilisation of the product. 

RSAs are also known as: performance-based risk-sharing arrangements (PBRSAs), managed entry agreements, patient access schemes, and coverage with evidence development (CED).

The study involved a review of RSAs, alongside interviews and a survey, to explore key stakeholders’ experiences and expectations for RSAs in the US private sector. The aim was to understand current trends, success factors, and challenges in the use of RSAs.

The study finds that whilst manufacturers and payers see the value in RSAs, use of these arrangements has been limited in the US private sector. This is partly due to the additional effort (and potentially cost) required to set up and monitor RSAs as compared to traditional arrangements. Interviewees demonstrated greater interest in financial-based RSAs (based on utilisation or financial capitation), and lesser interest in clinical and health outcomes-based RSAs.

The authors explain that utilisation of RSAs could increase as data systems improve and incentives evolve as a result of health reform and accountable care organisations. 

Access the full study here.

Reference: Garrison, L., Carlson, J., Bajaj, P., Towse, A., Neumann, P., Sullivan, S., Westrich, K. and Dubois, R., 2015. Private Sector Risk-Sharing Agreements in the United States: Trends, Barriers, and Prospects. American Journal of Managed Care, 21(9), pp.632-640.

Posted in Risk-sharing Arrangements | Tagged External publications