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The inexhaustible pressure on health system costs, combined with growing interest in proof of value, through improved clinical outcomes and reduced hospital readmission, is fuelling demand for new types of contracts based on financial risk sharing or product performance. Consolidation of health systems has more purchasing power and value committees in hospitals are increasingly selective about the technologies they purchase. Intensive allocation of resources for the collection and analysis/monitoring of the Morel T, Arickx F, Befrits G, Siviero P, van der Meijden C, Xoxi E, et al. Compatibility of cost and outcome insecurity with the need for access to orphan medicines: a comparative study on entry agreements managed in seven European countries. Orphanet J Rare Dis. 2013;8:198. Communication and collaborative monitoring are essential elements of the value-based model. While the ultimate goal of this system is to reduce total medical effort while improving the quality of care, coordination among all members of the care team is one of the key ways to achieve this goal. Walker S, Sculpher M, Claxton K, Palmer S. Coverage with evidence, only in research, risk sharing or patient access patterns? A framework for hedging decisions. Health value.
2012;15 (3):570-9. Ferrario A, Kanavos P. Management of uncertainty and high prices for new drugs: a comparative analysis of the use of cash entry agreements in Belgium, England, the Netherlands and Sweden. Soc Sci Med. 2015;124:39-47. Given that so many groups are involved in the risk allocation of a value-based model, successful implementation of the value system is essential for common benefits and economies across the sector. Despite the implicit negative connotations, the practice of risk sharing – in the health field or in some other way – can be beneficial for the participating parties. The U.S. transition to value-based care is changing relationships. Risk-sharing agreements between service providers and healthcare companies, including pharmaceutical, medical and equipment manufacturers, are a developing phenomenon. These agreements allow both parties to share the defined risks and opportunities of a changing repayment landscape.
As an illustration, we note in Appendix 1 a number of risk-sharing agreements put in place since 2015 in two key dimensions: the effectiveness of the products and the time it takes to observe the expected results. The results are based on clinical trials of the products