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The simple economics of risk-sharing agreements between the NHS and the pharmaceutical industry
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Resumo(s)
The Janssen-Cilag proposal for a risk-sharing agreement regarding bortezomib
received a welcome signal from NICE. The Office of Fair Trading report
included risk-sharing agreements as an available tool for the National
Health Service. Nonetheless, 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 even with a low success probability. 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 risk
sharing agreement. Overall, the welfare effects of risk-sharing agreements
are ambiguous, and care must be taken with their use.
Descrição
Palavras-chave
risk sharing agreements, pharmaceutical prices