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

Alessandra Ferrario, Diāna Arāja, Tomasz Bochenek , Tarik Catic, Dávid Dankó, Maria Dimitrova, Jurij Fürst, Leva Greičiūtė-Kuprijanov, Iris Hoxha, Arianit Jakupi, Erki Laidmäe, Olga Löblová, Ileana Mardare, Vanda Markovic-Pekovic, Dmitry Meshkov, Tanja Novakovic, Guenka Petrova, Maciej Pomorski, Dominik Tomek, Luka Voncina & 4 others Alan Haycox, Panos Kanavos, Patricia Vella Bonanno, Brian Godman

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25 Citations (Scopus)

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-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 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%). Conclusion: 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 public health systems confidential discounts can still be tolerated, particularly when it is not clear which country and party they are really benefiting. Further, 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.
LanguageEnglish
Pages1271-1285
Number of pages15
JournalPharmacoEconomics
Volume35
Issue number12
Early online date23 Aug 2017
DOIs
Publication statusPublished - 31 Dec 2017

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Keywords

  • managed entry agreements
  • public health
  • medicine prices

Cite this

Ferrario, Alessandra ; Arāja, Diāna ; Bochenek , Tomasz ; Catic, Tarik ; Dankó, Dávid ; Dimitrova, Maria ; Fürst, Jurij ; Greičiūtė-Kuprijanov, Leva ; Hoxha, Iris ; Jakupi, Arianit ; Laidmäe, Erki ; Löblová, Olga ; Mardare, Ileana ; Markovic-Pekovic, Vanda ; Meshkov, Dmitry ; Novakovic, Tanja ; Petrova, Guenka ; Pomorski, Maciej ; Tomek, Dominik ; Voncina, Luka ; Haycox, Alan ; Kanavos, Panos ; Vella Bonanno, Patricia ; Godman, Brian. / The implementation of managed entry agreements in Central and Eastern Europe : findings and implications. In: PharmacoEconomics. 2017 ; Vol. 35, No. 12. pp. 1271-1285.
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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-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 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{\%}). Conclusion: 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 public health systems confidential discounts can still be tolerated, particularly when it is not clear which country and party they are really benefiting. Further, 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.",
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Ferrario, A, Arāja, D, Bochenek , T, Catic, T, Dankó, D, Dimitrova, M, Fürst, J, Greičiūtė-Kuprijanov, L, Hoxha, I, Jakupi, A, Laidmäe, E, Löblová, O, Mardare, I, Markovic-Pekovic, V, Meshkov, D, Novakovic, T, Petrova, G, Pomorski, M, Tomek, D, Voncina, L, Haycox, A, Kanavos, P, Vella Bonanno, P & Godman, B 2017, 'The implementation of managed entry agreements in Central and Eastern Europe: findings and implications' PharmacoEconomics, vol. 35, no. 12, pp. 1271-1285. https://doi.org/10.1007/s40273-017-0559-4

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

In: PharmacoEconomics, Vol. 35, No. 12, 31.12.2017, p. 1271-1285.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The implementation of managed entry agreements in Central and Eastern Europe

T2 - PharmacoEconomics

AU - Ferrario, Alessandra

AU - Arāja, Diāna

AU - Bochenek , Tomasz

AU - Catic, Tarik

AU - Dankó, Dávid

AU - Dimitrova, Maria

AU - Fürst, Jurij

AU - Greičiūtė-Kuprijanov, Leva

AU - Hoxha, Iris

AU - Jakupi, Arianit

AU - Laidmäe, Erki

AU - Löblová, Olga

AU - Mardare, Ileana

AU - Markovic-Pekovic, Vanda

AU - Meshkov, Dmitry

AU - Novakovic, Tanja

AU - Petrova, Guenka

AU - Pomorski, Maciej

AU - Tomek, Dominik

AU - Voncina, Luka

AU - Haycox, Alan

AU - Kanavos, Panos

AU - Vella Bonanno, Patricia

AU - Godman, Brian

PY - 2017/12/31

Y1 - 2017/12/31

N2 - 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-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 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%). Conclusion: 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 public health systems confidential discounts can still be tolerated, particularly when it is not clear which country and party they are really benefiting. Further, 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.

AB - 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-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 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%). Conclusion: 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 public health systems confidential discounts can still be tolerated, particularly when it is not clear which country and party they are really benefiting. Further, 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.

KW - managed entry agreements

KW - public health

KW - medicine prices

UR - https://link.springer.com/journal/volumesAndIssues/40273

U2 - 10.1007/s40273-017-0559-4

DO - 10.1007/s40273-017-0559-4

M3 - Article

VL - 35

SP - 1271

EP - 1285

JO - PharmacoEconomics

JF - PharmacoEconomics

SN - 1170-7690

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ER -