Picture of Payer Agreements: Splitting the Risk

Payer Agreements: Splitting the Risk

October 2011


Published: October 2011 | 41 pgs 

Budgets are tight. Payer funding for new products is dwindling. And for pharmaceutical companies, market access is more and more difficult to attain.  

Across the UK, the US, Canada, Australia and parts of Europe, payer schemes are increasingly de rigueur. Schemes advanced by pharmaceutical companies either aim to grapple financial issues such as price volume agreements, or they tackle uncertainty by addressing increased data collection.  

Report Overview: 

In Payer Agreements: Splitting the Risk, FirstWord Dossier offers a complete and concise overview of payer schemes by definition and category. Based on an array of expert interviews, the report discusses the key drivers behind the evolution of payer schemes from financial imperatives to market uncertainty. Most importantly, the report defines—country by country—emerging trends based on current case studies and tackles the big question: What are the key features that will ensure success?  

Key Features: 

Detailed examination of the role of agreements in global pricing, reimbursement and market access 
Discussion of the drivers for schemes, including HTA and financial challenges 
Country-by-country trends illustrated with case studies 
Expert insight into the role of schemes and their evolution 
Analysis of the pros and cons of agreements  

Key Benefits: 

Definitions and categories of schemes 
Expert insight from key regulatory bodies 
Comprehensive references to key literature  

Key Questions Asked: 

What principles should be used in designing schemes? 
When should companies offer risk-sharing agreements? 
How can European risk-sharing be implemented in the US? 
What is the current state of play with schemes globally? 
What changes are likely in the future?  

Who Should Read This Report: 

Market access directors and managers 
Health economics professionals 
Pharmacoeconomics professionals 
Health Outcomes / Outcomes Research professionals 
Pricing and Reimbursement teams 
Government and regulatory affairs analysts 
Marketing research/business intelligence managers  

Expert Views: 

Alicia Granados: MD. Senior Director Global HTA Strategy, GMA Genzyme 
Andrea Rappagliosi: Vice President European Government Affairs & Head of Brussels Office, GlaxoSmithKline 
Andrew Hobbs: Managing Director, Pope Woodhead and Associates Limited 
Ansgar Hebborn: Global Head, Payer and HTA Programme Policy, Roche 
Clare McGrath: Senior Director HTA Policy, Pfizer 
David Grainger: Global Public Policy Director, Lilly 
Günter Harms: Market Access & Public Affairs Director, Shire Human Genetic Therapies 
Kalipso Chalkidou: Director of International Division, National Institute for Health and Clinical Excellence 
Karen Facey: Evidence based health policy consultant and non-executive Director at NHS Forth Valley, and Chair of the HTAi Interest Group for Patient/Citizen Involvement in HTA 
Larry Gorkin: President, Gorkin and Cheddar Consulting 
Mel Walker: Senior Director Value Expert Engagement & Collaborations, GlaxoSmithKline 
Robert Nauman: Principal, BioPharma Advisors 
Ulf Staginnus: Head of Pricing & Health Economics Europe, Novartis and author of www.healtheconomicsblog.com   

Key Quotes: 

"The current international pharmaceutical pricing framework is far too rigid. Manufacturers willing to openly differentiate the price for a given product in line with the different ability of various payers to afford a product will be punished by the consequences of international price referencing. At the same time, price systems are barely capable of differentiating the price for a single product that is used in multiple indications according to its different value propositions."
–Ansgar Hebborn, Global Head, Payer and HTA Programme Policy, Roche  

"Imagine in a time where those schemes could be really connected to one server. Like right at the patient's bed people would enter the data and so you would constantly be able to adjust and see performance and see small performance even in changes of dosing or changes or things. I know it's very difficult but I think eventually we might get there."
– Ulf Staginnus, Head of Pricing & Health Economics Europe, Novartis and author ofwww.healtheconomicsblog.com   

"There is a lot of difference in the governance across Europe, which ultimately leads to quality of HTA. An important aspect is of course the independence of the assessment from the appraisal and ultimately the decision on a certain price. That's very, very different country by country and region by region."
– Ansgar Hebborn, Global Head, Payer and HTA Programme Policy, Roche