## Abstract Many public and private healthcare payers use formularies as a tool for controlling drug costs and quality. Although the price per dose is often negotiated as part of the formulary listing, payers may still face unlimited financial risk if demand is much greater than expected at the tim
The simple economics of risk-sharing agreements between the NHS and the pharmaceutical industry
✍ Scribed by Pedro Pita Barros
- Publisher
- John Wiley and Sons
- Year
- 2011
- Tongue
- English
- Weight
- 122 KB
- Volume
- 20
- Category
- Article
- ISSN
- 1057-9230
- DOI
- 10.1002/hec.1603
No coin nor oath required. For personal study only.
✦ Synopsis
The introduction of new (and expensive) pharmaceutical products is one of the major challenges for health systems. The search for new institutional arrangements is natural. The use of the so-called risk-sharing agreements is one example. Recent discussions have somewhat neglected the economic fundamentals underlying risk-sharing agreements.
We argue here that risk-sharing agreements, although attractive due to the principle of paying by results, also entail risks. Too many patients may be put under treatment. Prices are likely to be adjusted upward, in anticipation of future risk-sharing agreements between the pharmaceutical company and the third-party payer. An available instrument is a verification cost per patient treated, which allows obtaining the first-best allocation of patients to the new treatment, under the agreement. Overall, the welfare effects of risk-sharing agreements are ambiguous, and caution is urged regarding their use.
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