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2017;23(10):1018-26. As of October 2012, 29 MEAs were in force for 25 drugs . Three types of agreements can be concluded with pharmaceutical companies: (1) cost-sharing (CS, No. 11), (2) risk sharing (RS, No. 2) and (3) payment method (PbR, n -16). CS only involves a remission, usually limited to the first 2-3 months or treatment cycles. These discounts are usually monaceous and producers are expected to refund. The other two contracts are based on « non-respondent » rates. The manufacturer should refund a portion of (RS) or the total price (PbR) for each patient who does not react. If a patient meets the non-response criteria, the hospital pharmacist should ask the manufacturer for a refund by the end of the year; the manufacturer may accept or reject the proposal (arbitration requires an arbitration procedure) . Adamski J, Godman B, Ofierska-Sujkowska G, Osinska B, Herholz H, Wendykowska K, et al.
Risk-sharing regimes for medicines: potential reflections and recommendations for European payers. BMC Health Serv Res. 2010;10:153. Soini E, Asseburg C, Taiha M, Puolakka K, Purcaru O, Luosujarvi R. Economic health effects of a hypothetical risk-sharing system certolizumab pegol for patients with moderate to severe rheumatoid arthritis in Finland. Adv Ther. 2017;34 (10):2316-32. Kanavos P, Ferrario A, Tafuri G, Siviero P. Managing risks and uncertainty in the introduction of health technologies: the role of managed entry agreements. The Glob Directive. 2017;8( S2):84-92.
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