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Klemp M, Frénsdal K, Facey K, on behalf of the HTAi Policy Forum. What principles should govern the implementation of administered access agreements? Int J Technol Review of Health Care. 2011;2011(27):77–83. Nearly 8 years after the Centers for Medicare and Medicaid Services (CMS) launched the basic purchasing hospitalization program, the transition to a value-based supply model is in full swing. So why are so many people – from health care providers to paying agencies – still worried about this reimbursement model? responsibility. Definitions and other names Risk-sharing agreements are known by several names: Managed Entry Schemes (MES), Outcomes Based Schemes, Risk-Sharing Agreements, Coverage with Evidence Development, Access with Evidence Development, Patient Access Schemes, Conditional Licensing, Pay for Performance Programs, et cetera. However, the common denominator of these agreements is that the contract addresses an explicitly perceived cost risk and that the obligation to define the risk between payers and manufacturers is accepted in a definite manner. Barros PP. The simple cost-effectiveness of risk-sharing agreements between the NHS and the pharmaceutical industry. Econ Health. 2011; 20 (4): 461-70. Neumann PJ.

Where are we in risk-sharing agreements? Health value. 2013;16:701–2. This study examined the degree of use of risk-sharing agreements in Spain and the perception of hospital pharmacists as to the relevance of several elements in their implementation. The questionnaire was distributed through the Spanish Society of Hospital Pharmacy, which has more than 3,023 members; During the investigation period, a warning was issued to encourage participation. Nevertheless, the response rate was limited and only 80 responses were valid for analysis. Respondents, whose hospitals had payment or efficiency agreements (whether they also signed volume-price agreements), estimated that the number of parcels (94.1%), the size of the target group (60.0%) and drug units per year (94.1%) the main variables to take into account when signing price and volume agreements.