PHP192 Recent Global Insights Into Risk Sharing Agreements: A Comparative Analysis

Abstract

To evaluate whether risk sharing agreements (RSA) are utlilised by health technology assessment (HTA) agencies over the world. Similarities and differences between appraisals where an RSA is applied will be assessed across the different agencies. Nine select HTA agencies across the globe (MOHTLC, NICE, PBAC, SMC, TLV, INESSS, CADTH, NCPE, and AWMSG) were scanned to determine what type of RSAs were adopted for drug appraisals. Only single technology appraisals published between 2010 and April 2012 were included in the search. Comparisons were made between the agencies to determine whether any common trends were present, particularly for appraisals on the same drug. In total 100 HTAs (74 treatments) were identified that included an RSA across the 9 agencies. The number of RSAs identified per agency was as follows: MOHTLC (24 HTAs), NICE (23), PBAC (15), SMC (14), TLV (10), INESSS (7), CADTH (6), NCPE (4), and AWMSG (2). Overall there was very little consistency between agencies as to which treatments included an RSA. For the very few treatments with an RSA fwith more than one agency, the type of agreement applied between these agencies varied. RSAs identified in NICE submissions were often elaborate whilst the remaining agencies usually applied simple discounts, price reductions or cost agreements. Interestingly, all recently submitted oncology therapies to INESSS were required to have a shared financial risk agreement for recommendation. RSAs are applied by several HTA agencies from around the world. There does not seem to be consistency in RSAs amongst the different agencies. If an RSA is made for a particular treatment for one agency, this does not mean an RSA will be applied by another agency for the same treatment.