Funding Requests Research Articles

Research Priorities of the Oncology Nursing Society: 2024-2027.

To define the Oncology Nursing Society Research Agenda for 2024-2027. An iterative, multiple data sources consolidation through the Research Agenda Project Team. Previous research priorities, literature review, stakeholder survey, and research priorities from other cancer care organizations and funding agencies. 10 evergreen statements articulated foundational values for oncology nurse scientists, and 5 topics emerged as research priorities for the upcoming three years: Advance patient-centric, precision symptom science; provide evidence for safe and effective cancer care delivery models and support of the oncology nursing workforce; describe the impact of the environment on cancer care outcomes; integrate patient navigation into cancer care across the trajectory; and advance the use of innovative methodologies in oncology nursing research. The Oncology Nursing Society Research Agenda is an effective resource for directing the organization's research vision. This foundational document directs funding awards and requests, mentorship, and policy initiatives.

Small and medium-sized enterprises and sustainable transition: Role of FinTech in a country's banking ecosystem

During the sustainable transition, small and medium-sized enterprises (SMEs) request funding to support environmental, social, and governance (ESG) investments. In particular, these requests clash with information asymmetries typical of the bank–firm relationship, causing SMEs to experience credit crunch phenomena or increased loan costs. This aforementioned phenomenon prompted this study to examine whether FinTech increases banks’ ability to support the development of SMEs aimed at achieving ESG or, better yet, sustainable transition goals. The results suggest that FinTech in a country’s banking ecosystem improves the ESG performance of Italian and British SMEs by addressing adverse selection and moral hazard issues. This study also shows a more pronounced effect in the UK banking ecosystem, which has a higher level of FinTech development and diffusion.

Racial and ethnic composition of peer recovery community members and barriers to acquiring funding for organizations in the ecosystem of recovery

IntroductionOrganizations in the “ecosystem of recovery”—most often non-profits led and staffed by individuals with lived substance use disorder (SUD) experience—offer peer services, group counseling, and a wide variety of programs to help those struggling with SUD. The efforts of such organizations are effective in transitioning those suffering from SUD into long-term recovery. Despite well-established evidence depicting inequitable access to SUD treatment between BIPOC and non-Hispanic White Americans, there has been no empirical undertaking of whether organizations in the ecosystem of recovery face barriers to fund their operations based on the racial and ethnic composition of their community members. MethodsIn this 2022 needs assessment, “Optimizing Recovery Funding,” we combined the results of quantitative and qualitative data for a mixed methods analytic approach. The study employs bivariate descriptive statistics and inferences along with thematic analyses. From an initial list of 537 organizations across U.S. states and territories, 145 leaders of these organizations comprise our survey analytic sample. A total of 85 leaders participated in one of 16 focus groups, with 10 based on geography and 6 based on population identity. This needs assessment produced comprehensive data on the operations of organizations in the ecosystem of recovery. ResultsA lack of training and existing organizational funding, as well as non-inclusive language in funding requests for proposals contributed to some organizations' decisions not to pursue certain grants and funding mechanisms. There were no statistical differences in applying for, nor success in receiving, federal and state funding between organizations serving predominantly BIPOC community members and those serving mostly non-Hispanic White community members. However, there were key instances of—at times inexplicable—inequity in funding outcomes. ConclusionsAll leaders of organizations in the ecosystem of recovery who participated in the needs assessment made it clear that there are fundamental issues to accessing peer recovery operational and programmatic funding. Innovative strategies for developing inclusive and culturally responsive funding approaches that prioritize organizations predominantly serving historically marginalized communities are needed.

Crowd-funding to promote women entrepreneurship: a systematic literature review of the empirical studies conducted in the last decade (2012–2023)

PurposeIt aims to understand crowdfunding’s effect on women’s entrepreneurship and summarize key findings, methods, and challenges women face in using crowdfunding for financing.Design/methodology/approachThis literature review examines 36 empirical studies on crowdfunding use by women entrepreneurs. It follows the PRISMA framework, using Scopus and citation tracking to categorize studies on crowdfunding’s potential to empower women financially and address their barriers to accessing finance.FindingsThe review identified seven key themes: opportunities and challenges for women in crowdfunding, equity crowdfunding’s potential, gender differences in crowdfunding outcomes, the role of social capital and networks, investor trust and decision-making, the influence of language, communication, and platform design, and the importance of considering intersectionality and context. Crowdfunding offers women entrepreneurs access to capital and helps them overcome traditional financing barriers. Women-led campaigns achieve comparable or even higher success rates compared to their male counterparts. However, under-representation, lower funding requests, pitching difficulties, and limited access to networks remain as challenges.Research limitations/implicationsThis study has limitations inherent to systematic reviews, including potential methodological flaws or biases in the included studies and the exclusion of relevant studies due to time and resource constraints.Practical implicationsCrowdfunding can be promoted as a viable financing option for women entrepreneurs and design targeted initiatives to support them. Building social capital, enhancing financial literacy, and creating networking opportunities can contribute to their success in navigating crowdfunding platforms effectively.Originality/valueThis review offers a comprehensive analysis of empirical studies conducted between 2012 and 2023. It provides up-to-date insights, identifies key themes, and offers actionable recommendations for policymakers and organizations seeking to support women entrepreneurs in effectively accessing and utilizing crowdfunding platforms.

Geographic representation and requests for federal funds in the U.S. senate

AbstractAn essential component of a representative's job centers on deciding where to allocate scarce resources. How do legislators attempt to allocate spending across the geographic units of their constituencies, and what determines a legislator's success in securing these resources? To answer these questions, we create a new dataset of all earmark requests made by U.S. senators in the 117th Congress. This data was recently made available as part of reforms, allowing researchers to examine both requests and outcomes. We show that senators prioritize seeking earmarks for areas of their constituencies critical to their electoral success. We then match these requests to earmarks funded by the Appropriations Committee and show that a legislator's institutional standing and the behavior of their same‐state colleague—but not electoral concerns—shape whether projects are successfully funded. We provide insight into a behind‐the‐scenes aspect of representation and illuminate the strategic dynamics that shape federal spending.

Five ways to get a grip on applying a program evaluation model in health professions education academies.

The proliferation of health professions educator academies across Canada and the United States illustrates the value they hold for faculty and institutions. Yet, establishing and evaluating the efficacy of them through program evaluation can be challenging. Moreover, academy leadership often lack the time, bandwidth skillset and personnel to undertake rigorous program evaluation efforts. We outline a step-by-step guide for getting a grip on evaluating health professions educator academies. Developing a plan for program evaluation in advance of any new academy initiative helps to ensure the academy calibrates and re-calibrates to accomplish outcomes and meet stakeholder expectations. It also provides a mechanism for tracking academy impact, which strengthens requests for funding, promotes sustainability and encourages continued buy-in and support from institutional stakeholders. For all of these reasons, we present the following recommendations: apply the relevant program evaluation framework(s); identify resources for program evaluation; prepare to tell your academy's story; list desired program outcomes; establish a data collection plan; and obtain institutional review board approval.

519 Strategic Reinvestment of Sponsored Trials Residuals for Research Portfolio Development

OBJECTIVES/GOALS: Academic research is often viewed as a necessary core mission but a financial loss requiring central or clinical funds support. We present cases as evidence of sustaining academic unit research endeavors through strategic planning and reinvestment of sponsored clinical trials residuals. METHODS/STUDY POPULATION: Successful endeavors are presented that demonstrate strategic reinvestment of clinical trials residuals to develop robust academic self-sustaining research programs. A multi-year strategic plan was developed leveraging residuals from sponsored clinical trials to build an academic research infrastructure supporting extramural grant applications, pilot studies, pre- and post-award management, equipment investment, and faculty incentives. RESULTS/ANTICIPATED RESULTS: Example 1, pooling four existing department clinical trials generated yearly profits that expanded clinical trials capacity and used residuals to support a grant coordinator. Over 7 years, trial volume increased to near 50, revenue increased to $2.5 million annually, staffing increased to 20 FTEs, and extramural grant applications increased from 16 to 50. Example 2 started with a department with no infrastructure. Central support was leveraged for 6-months to support a coordinator to initiate a clinical trials program. The initial investment was offset by trials earnings by year 2, breaking even financially, while establishing a nascent yet robust infrastructure to build autonomously without additional central funding requests. DISCUSSION/SIGNIFICANCE: Utilizing sponsored clinical trials as a strategic investment fund, academic units can realize fiscally responsible expansion of research activities and national recognition through acquisition of extramural funding and investigator-initiated investigations.

Trust-and-Evaluate: A Dynamic Nonmonetary Mechanism for Internal Capital Allocation

To stay competitive, firms regularly invest in innovation by supporting internal capital projects (funded and executed in-house) that explore new products and operational improvements. Each year, in a highly competitive process, managers from different functional units of the firm submit proposals (that include estimated costs and benefits) for such projects. Managers, because of their domain knowledge and expertise, are naturally better informed about the costs and benefits of their respective projects and can use this information strategically to secure funding. An example of such behavior is the under-reporting of the cost estimate of a project and subsequently requesting additional funding during the execution phase. Such strategic behavior not only affects the firm’s ability to fund the best projects but is also costly. Motivated by this challenge of deciding the funding of such projects at a global agribusiness firm, we seek a mechanism that is both provably near-optimal for the firm and guarantees truthful reporting from managers. Our setting consists of a principal and multiple agents. In each time period, over an infinite horizon, each agent requests funding for a potential project from the principal. Before submitting his proposal, each agent privately estimates the project’s cost and its benefit. If funded, each project is executed in one period. The principal’s funding decisions are binary; that is, each project is either funded in full or not funded. The actual cost (benefit) of a funded project is realized on its completion and incurred (earned) by the principal. The agents earn utility from the experience and reputation gained in completing projects. In each period, the principal desires to keep the total spend below a budget but can borrow external money at a cost. Our main contribution is a practically appealing dynamic nonmonetary mechanism for internal capital allocation under which, for any [Formula: see text], (a) truth-telling forms an ϵ-Bayesian Nash equilibrium and (b) the principal’s expected utility is within ϵ of the expected utility in the first-best setting. This paper was accepted by Karan Girotra, operations management. Supplemental Material: The online appendices and data files are available at https://doi.org/10.1287/mnsc.2022.01121 .

Evaluating an Enterprise-Wide Initiative to enhance healthcare coordination for rural women Veterans using the RE-AIM framework.

The Veterans Health Administration (VA) Office of Rural Health (ORH) and Office of Women's Health Services (OWH) in FY21 launched a three-year Enterprise-Wide Initiative (EWI) to expand access to preventive care for rural, women Veterans. Through this program, women's health care coordinators (WHCC) were funded to coordinate mammography, cervical cancer screening and maternity care for women Veterans at selected VA facilities. We conducted a mixed-methods evaluation using the RE-AIM framework to assess the program implementation. We collected quantitative data from the 14 program facilities on reach (i.e., Veterans served by the program), effectiveness (e.g., cancer screening compliance, communication), adoption, and maintenance of women's health care coordinators (WHCC) in FY2022. Implementation of the program was examined through semi-structured interviews with the facility WHCC funding initiator (e.g., the point of contact at facility who initiated the request for WHCC funding), WHCCs, and providers. Reach. The number of women Veterans and rural women Veterans served by the WHCC program grew (by 50% and 117% respectively). The program demonstrated effectiveness as screening rates increased for cervical and breast cancer screening (+0.9% and +.01%, respectively). Also, maternity care coordination phone encounters with Veterans grew 36%. Adoption: All facilities implemented care coordinators by quarter two of FY22. Implementation. Qualitative findings revealed facilitators and barriers to successful program implementation and care coordination. Maintenance: The EWI facilitated the recruitment and retention of WHCCs at respective VA facilities over time. In rural areas, WHCCs can play a critical role in increasing Reach and effectiveness. The EWI demonstrated to be a successful care coordination model that can be feasibly Adopted, Implemented, and Maintained at rural VA facilities.

Spatial Decision Support Systems for Study Critical Freight Corridors

Efficient freight mobility plays a major role in the economy, and its performance is closely related to the quality of the transportation system. Requirements for funding transportation infrastructure projects often do not specify the analytical tools planners should use to request funding. Critical Urban and Rural Freight Corridors are sections of the National Highway Freight Network providing critical connectivity of goods and must have improved system performance. This paper offers a method for identifying these corridors using a multi-criteria spatial decision support system (MC-SDSS). The developed framework attributes a score to highway corridors (links) based on policy eligibility and prioritization. We apply the Analytic Hierarchy Process (AHP) to structure the problem and consider different stakeholder preferences and available data. The product of this study is a tool for decision-makers to optimize the selection of critical freight corridors and analyze alternatives. Using the State of Florida as a case study, this study applied different scenarios to demonstrate the applicability of the method. Results show that the GIS-based MCDM was efficient in enabling comparison and automatization of the problem, which contains a large set of feasible corridors, multiple conflicting criteria, and several stakeholders involved. In contrast with the current State’s critical freight corridor designation process, the proposed approach is based on an automated method, making the corridor selection process faster and more comprehensive.

Access to Non‐reimbursed Expensive Cancer Treatments: A Justice Perspective

ABSTRACTWhen the cost‐effectiveness of newly approved cancer treatments is insufficient or unclear, they may not (immediately) be eligible for reimbursement through basic health insurance in publicly funded healthcare systems. Patients may seek access to non‐reimbursed treatment through other channels, including individual funding requests made to hospitals, health insurers, or pharmaceutical companies. Alternatively, they may try to pay out of pocket for non‐reimbursed treatments. While currently little is known of these practices, they run counter to a deeply held egalitarian ethos that is prevalent in many publicly funded healthcare systems. In this article, we investigate to what extent this ethos can be grounded in theories of justice, notably egalitarianism and prioritarianism. We argue that allowing out‐of‐pocket payments by patients themselves, in principle, is not unjust from the perspective of either of these theories, provided that it does not raise in‐practice justice‐based concerns, for instance by displacing more cost‐effective care, to the detriment of other patients, or by failing to treat patients equally. In contrast, we conclude that the practice of making exceptions for individual patients by health insurers or healthcare providers does run counter to the justice‐based requirements of equal treatment.

Qualitative assessment of the impact of restricting number of drug treatments for rheumatoid arthritis: Experience of prescribers and patients.

In 2020, almost half of all Clinical Commissioning Groups in England were restricting the number of higher cost drugs (HCDs) that could be prescribed for Rheumatoid Arthritis (RA) before an Individual Funding Request was required. We were interested in qualitatively exploring the experiences of prescribers affected by these restrictions and the experiences of patients who required four or more of these drugs. Semi-structured interviews were conducted with five prescribers in restricted areas and six patients from our own service who had received four or more HCDs. The interviews were analysed thematically. Prescribers reported feeling distressed and frustrated by the unsatisfactory service they were constrained to provide. Some prescribers continued partially effective treatments in order not to run out of options. They did not find Individual Funding Requests or the Blueteq High Cost Drug (HCD) System helpful in the management of these patients. The Blueteq HCD System is an electronic platform that allows health managers to monitor the prescribing of high-cost medicines and manage the complexities associated with their use. Patients expressed severe distress at the prospect of running out of options and anxiety around the process of gaining approval for their next treatment. Restricting drugs for RA by the number which can be prescribed results in persistence with partially effective treatments, which is unsatisfactory for prescribers and patients, further it does not save money. Patients need to travel in their journey with RA and be able to try the next drug even though they know that it may not work.

What about Model Data? Best Practices for Preservation and Replicability

Abstract It has become common for researchers to make their data publicly available to meet the data management and accessibility requirements of funding agencies and scientific publishers. However, many researchers face the challenge of determining what data to preserve and share and where to preserve and share those data. This can be especially challenging for those who run dynamical models, which can produce complex, voluminous data outputs, and have not considered what outputs may need to be preserved and shared as part of the project design. This manuscript presents findings from the NSF EarthCube Research Coordination Network project titled “What About Model Data? Best Practices for Preservation and Replicability” (https://modeldatarcn.github.io/). These findings suggest that if the primary goal of sharing data are to communicate knowledge, most simulation-based research projects only need to preserve and share selected model outputs along with the full simulation experiment workflow. One major result of this project has been the development of a rubric, designed to provide guidance for making decisions on what simulation output needs to be preserved and shared in trusted community repositories to achieve the goal of knowledge communication. This rubric, along with use cases for selected projects, provide scientists with guidance on data accessibility requirements in the planning process of research, allowing for more thoughtful development of data management plans and funding requests. Additionally, this rubric can be referred to by publishers for what is expected in terms of data accessibility for publication.

Variation in access and prescription of vedolizumab and ustekinumab in paediatric patients with inflammatory bowel disease: a UK-wide study

BackgroundTherapeutic options for paediatric inflammatory bowel disease (IBD) are limited, especially for younger children. Unlike in adults, vedolizumab and ustekinumab are not licensed for paediatric use in the UK. We...

Recursos externos para a Administração Pública: a contribuição dos novos bancos multilaterais de desenvolvimento

Multilateral development banks are international organizations and, therefore, subjects of Public International Law, aimed at promoting financial cooperation through loans and donations to infrastructure projects, acquisition of goods and services for the Public Administration. The creation of the first banks occurred at the end of World War II, in the context of post-war reconstruction. Brazil has a constitutional and legal framework that allows the use of external resources from multilateral banks, as well as the waiver of domestic legislation for the application of external rules, subject to constitutional and procedural requirements. In the first decades of the 21st century, due to the economic growth of emerging countries and the need for greater representation of their decisions in international organizations, new multilateral banks have been created. These banks are characterized by their more flexible rules, greater possibility to make use of national procurement and contracting rules, use of local currency, and fewer conditionalities. Faced with an international context marked by the COVID-19 pandemic, the war in Ukraine, and high inflation, foreign resources qualify as an alternative to contribute to national public policies, and Brazilian institutions need to qualify themselves to be able to request funding for projects of public interest.

Implementation of Quality Management of Islamic Religious Education at the Thai Southern Bearing School

This study aims to determine how the implementation of quality management of Islamic religious education in Southern Thailand schools and to analyze the supporting and inhibiting factors for the implementation of quality management of Islamic religious education in Southern Thailand schools. This study is field research with a qualitative research approach. With data collection techniques using interviews, observation, and documentation, the data that has been obtained is then analyzed. The informants in this study were the head of the Pillowian school, the deputy head of the Pillowian school, teachers, employees, and students who were in the South Pillows school in Thailand. The results of this study are: 1. implementation of quality management of Islamic religious education in Southern Thailand schools applies four principles: a. the principle of equifinality. b. decentralization. c. self-managing; and d. human initiative. 2. Supporting factors for school-based school management. Adapted from a model from schools in Kelantan, the school organizes projects or activities by bringing in speakers from other schools to teach or give lectures and community support, such as helping to keep the school safe. 3. Factors hindering school-based management in improving the quality of Islamic religious education are problems with facilities such as inadequate technology and learning media that cause obstacles in teaching. The way to minimize inhibiting factors such as a lack of facilities and infrastructure is by submitting a proposal to request funds for school development.

P138 Inequity in Clinical Commissioning Group funding across England for high-cost biologic drugs in rheumatoid arthritis

Abstract Background/Aims Biologic, and targeted, disease-modifying antirheumatic drugs (bDMARDs/tDMARDs) are recommended for patients in England with high disease activity score rheumatoid arthritis (HDAS-RA) who do not respond to two or more conventional synthetic DMARDs. To prescribe bDMARDs/tDMARDs in England, prescribers must apply for funding via their local clinical commissioning group (CCG). The project aim was to review whether CCGs across England had defined high cost drugs pathways for bDMARDs/tDMARDs use in HDAS-RA and if so, what this pathway looked like regarding drug choice, order of availability, and ability to prescribe as monotherapy. Methods We submitted a freedom of information (FOI) request in October 2021 to all CCGs within England to obtain their high cost drug pathway for bDMARDs/tDMARDs use in HDAS-RA. We then manually reviewed the pathways to determine whether the CCG specified an order of drug prescribing. Data was also gathered on whether CCGs allowed abatacept (ABT), rituximab (RTX), and golimumab (GOL) to be prescribed as monotherapy. Results All 107 CCGs in England responded to the FOI request. 69 out of 107 CCGs (65%) had a pathway for bDMARDs/tDMARDs prescribing. 60 out of 69 CCGs (87%) specified an order for drug prescribing in RA. Within their pathways, CCGs generally fell into 3 prescribing preferences. Table 1 summarises these pathway recommendations. 39 (57%), 59 (86%), and 6 (9%) CCGs allowed ABT/RTX/GOL to be prescribed as monotherapy respectively. RTX monotherapy was specifically allowed outside of special indications such as cancer, interstitial lung disease and multiple sclerosis. Conclusion These findings show there is significant variation across England regarding which bDMARDs/tDMARDs patients can receive for HDAS-RA resulting in a postcode lottery. Several studies support the use of ABT/RTX/GOL as monotherapy and registry data shows that 30-40% of RA patients are administered ABT/RTX/GOL as monotherapy for methotrexate intolerance/contraindication. Lack of NICE appraisal, however, means some CCGs mandate individual funding requests for monotherapy prescribing. We would like to use these results to help negotiate equitable access to bDMARDs/tDMARDs nationwide. Disclosure O. Buckeldee: None. R. Khanna: None. L. Snell: None. L. Attipoe: None.

Recursos externos para a administração pública: a contribuição dos novos Bancos Multilaterais de Desenvolvimento

Multilateral development banks are international organizations and, therefore, subjects of Public International Law, aimed at promoting financial cooperation through loans and donations to infrastructure projects, acquisition of goods and services for the Public Administration. The creation of the first banks occurred at the end of World War II, in the context of post-war reconstruction. Brazil has a constitutional and legal framework that allows the use of external resources from multilateral banks, as well as the waiver of domestic legislation for the application of external rules, subject to constitutional and procedural requirements. In the first decades of the 21st century, due to the economic growth of emerging countries and the need for greater representation of their decisions in international organizations, new multilateral banks have been created. These banks are characterized by their more flexible rules, greater possibility to make use of national procurement and contracting rules, use of local currency, and fewer conditionalities. Faced with an international context marked by the COVID-19 pandemic, the war in Ukraine, and high inflation, foreign resources qualify as an alternative to contribute to national public policies, and Brazilian institutions need to qualify themselves to be able to request funding for projects of public interest.

Implementasi Model Flowchart Perancangan Sistem Informasi Akuntansi untuk Permintaan Dana/Advance

Profiting and staying away from the practices of administrative and financial manipulation is everyone's goal in trying. It is, largely determined by a decision-making process that is based on accurate, relevant, and timely information. This goal can only be met if marketing, production, and labor relations information, as well as financial data information, are properly designed and implemented in the production of an accountable document-based accounting information system. In this study, we focused on the implementation of the flowchart model in the design of the information system for accounting for requests for funds / advances as one of the company's expenditure cycles, which is focused on designing and structuring the flow of documents requesting funds or advances needed by the accounting and finance departments to finance project needs and routine company needs with mechanistic pay in advance, using observational methods, interviews and literature studies. The implementation of this model is expected to improve the efficiency and effectiveness of the company's business processes in managing the demand for funds and advances. Even though in the design process, several obstacles to the implementation of the flowchart model were found, such as limited human resources and available technology, this condition can be overcome by conducting training for employees and developing better technology. With the hope that the results of this research can contribute to the development of an accounting information system for companies.

Association of exogenous factors with the access to innovative pharmaceutical products in Hungary.

Access to innovative pharmaceuticals is thought to be associated with several exogenous factors related to the local legal or financial framework of pharmaceutical reimbursement. Our aim was to describe the association between the outcome of the reimbursement procedure on innovative pharmaceutical submissions in Hungary and several potential explanatory variables related to the legal or financial framework of reimbursement procedures, such as the submission implying a need for a legal act to conclude on a positive decision; having a risk-sharing agreement (RSA) in place at the time of submission; the aim of the submission and expenditure on individual funding requests. Publicly available administrative announcements of the Hungarian National Health Insurance Fund Manager were used to construct the analysis dataset including all concluded procedures between 1 January 2018 and 7 June 2021, complemented with information on the overall aim of the submission (new compound or new indication). Logistic regression models were used to estimate odds ratios while adjusting for potential confounding. Needing a legislative change as a proxy of involving high-level decision makers to reimburse had a lower (OR = 0.05, CI95%:0.02-0.11), whereas having an RSA had a statistically significant higher chance of a positive decision (OR = 3.49, CI95%:1.56-7.82). In contrast, neither the overall purpose of the submission (OR = 1.32, CI95%:0.65-2.69), nor the average biennial expenditure on individual funding requests exceeding 200 million HUFs (OR = 1.04, CI95%:0.92-1.19) had a statistically significant association with the decision. This study quantitatively demonstrated that the need for legal acts to conclude on a positive decision decreases, whereas having an RSA for the particular product increases the likelihood of a positive reimbursement decision in Hungary. The role of other factors remain unclear. Our findings suggest that the legal requirements and RSAs play key roles in the reimbursement of innovative pharmaceuticals and can be viewed as potential areas of policy interventions in expanding access to these products, although the feasibility of such interventions need strong commitment from decision-makers, as well as implying increased autonomy to the entities involved in reimbursement procedures. Further research is needed to assess the impact of endogenous and exogenous factors in a coherent framework.