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Performance-Based Risk-Sharing Arrangements: An Updated International Review
Josh J Carlson1, Shuxian Chen2, Louis P Garrison2
1Pharmaceutical Outcomes Research and Policy Program, University of Washington, 1959 NE Pacific St., Box 357630, Seattle, WA, 98195-7630, USA. carlsojj@u.washington.edu.
Pharmacoeconomics
|July 12, 2017
Summary
Performance-based risk-sharing arrangements (PBRSAs) are increasingly adopted globally. Analysis of 437 cases reveals diverse types and an upward trend, indicating their viability for medical product coverage and reimbursement.
Area of Science:
- Health economics
- Healthcare policy
- Medical device and pharmaceutical markets
Background:
- Performance-based risk-sharing arrangements (PBRSAs) are gaining traction globally.
- Adoption rates and types of PBRSAs vary significantly across different countries.
- Understanding trends in PBRSAs is crucial for healthcare payers and manufacturers.
Purpose of the Study:
- To identify and characterize publicly available PBRSAs from 1993 to 2016.
- To analyze macro-level trends in PBRSA adoption, including timing, geography, types, and disease areas.
- To assess the current landscape and future viability of PBRSAs.
Main Methods:
- A comprehensive review of PBRSAs was conducted using the University of Washington PBRSA Database.
- Arrangements were categorized using a previously established taxonomy.
- Data analysis focused on identifying trends in adoption, types, and active status.
Main Results:
- A total of 437 PBRSAs were identified between 1993 and 2016.
- Over half (58.1%) of the identified arrangements have expired, with 41.9% remaining active.
- The most common types included coverage with evidence development (34.1%) and performance-linked reimbursement (23.8%).
- A renewed upward trend in PBRSA adoption was observed after a dip in 2012/2013.
Conclusions:
- Interest in PBRSAs remains high, highlighting their role as a flexible coverage and reimbursement tool.
- The evolving landscape, particularly in the USA, suggests a potentially more favorable environment for PBRSAs.
- PBRSAs represent a viable mechanism for managing risk and ensuring value in healthcare markets.
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