Master Agreement Research Articles

The Lehman Brothers Bankruptcy G: The Special Case of Derivatives

When it filed for bankruptcy protection in September 2008, Lehman Brothers was an active participant in the derivatives market and was party to 906,000 derivative transactions of all types under 6,120 ISDA Master Agreements with an estimated notional value of $35 trillion. The majority of Lehman’s derivatives were bilateral agreements not traded on an exchange but in the over-the-counter (OTC) market. Because derivatives enjoyed an exemption from the automatic stay provisions of the U.S. Bankruptcy Code, parties to Lehman’s derivatives could seek resolution and self-protection without the guidance and restraint of the bankruptcy court. The rush of counterparties to novate Lehman’s derivative contracts, and the confusion following contracts that were terminated after its bankruptcy filing, added to the stress of the financial crisis in two ways: (1) loss of value to the Lehman estate and (2) exacerbating the contagion effects of the bankruptcy. This case explores the disposition of Lehman’s derivatives and its impacts.

The Lehman Brothers Bankruptcy F: Introduction to the ISDA Master Agreement

When Lehman Brothers Holdings, Inc. (LBHI) sought Chapter 11 protection, the more than 6,000 counterparties with which its subsidiaries had entered into over 900,000 over-the-counter (OTC) derivatives transactions faced the question of how best to respond to protect their interests. The existence of standardized documentation developed by the International Swaps and Derivatives Association (ISDA) for entering into such transactions meant that the counterparties likely thought that they were dealing with a well defined and robust set of options in answering this question. Yet, in practice, the resolution of Lehman’s OTC derivatives portfolio ended up being less orderly than the existence of standardized documentation might have suggested it would be. This case explores: (1) whether the default provisions contained in the Master Agreement played any meaningful role in Lehman Brothers’ bankruptcy and its outcome, (2) whether changes should be made to the Master Agreement to reduce the systemic risk associated with derivatives transactions, and (3) how attempts to create global certainty through the use of standardized agreements can be thwarted by the operation of local laws.

Licensing the gatekeeper? Public pathways, social significance and the ISDA Credit Derivatives Determinations Committees

Regulatory relationships in financial markets exemplify the important and changing nature of transnational business governance interactions (TBGI) which involve reciprocal forces of influence between private and public regulators. We examine one key case of private governance in financial markets: the Credit Derivatives Determinations Committees (DCs) of the International Swaps and Derivatives Association (ISDA). We find ISDA to be a particularly resilient private regulator in an environment subject both to the significant external shock of the global financial crisis and intense pressure on governmental actors to demonstrate that they are counteracting risk. Clearly, ISDA operates as a key gatekeeper in TBGI, appearing to have a form of ‘regulatory licensing’ power in the DCs. This power is derived in an immediate sense from the propagation of a web of contracts and norms established by market actors, the content of which is substantially derived from instruments such as the Master Agreement, set down by ISDA itself. Equally important, we find that this regulatory licensing capacity is ultimately backstopped by an implicit delegation from public actors, which lends additional legitimacy to the DCs.

Bridging the Gaps That Divide

T he US Constitution provides that Native American tribes are sovereign-dependent nations and their interactions with the federal government, including the cession of the tribal lands that formed America, are governed by a complex set of treaties. For decades, federal law and public policies have defined the formal, legal relationship between agencies such as the US Department of Agriculture Forest Service (USDA FS) and federally recognized Indian tribes. However, this formalized partnership has never been an easy one, long strained by misunderstanding, misgivings, missed opportunities, and political expediency. When President William J. Clinton issued Executive Order 13175 (“Consultation and Coordination with Indian Tribal Governments”; since approved and upheld by the two subsequent Administrations) in 1996, could any different outcome be expected? An opportunity to forge a new partnership arose in 2001, when during the revision of the Ouachita and Ozark St. Francis National Forests (hereafter, “Forests”) respective land and resource management plans, the Forests were asked to conduct face-to-face consultations on the Arkansas and Oklahoma homelands of the federally recognized Oklahoma Tribes (Absentee Shawnee, Caddo, Cherokee, Choctaw, Chickasaw, Citizen Potawatomie, Creek, Delaware, Eastern Shawnee, Kaw, Quapaw, Seminole, Shawnee, and Osage, among others; hereafter, “Tribes”). The management of cultural and natural resources is extremely important not only to the Forests but also to many Tribes that were removed from their homelands, making the development of a viable forum permitting both formal and informal dialogues between the USDA FS and the Tribes vital. The first of these consultative meetings, organized in 2002, was given the name “To Bridge A Gap” (TBAG) by Bobby Gonzales, Native American Graves Protection and Repatriation Act (NAGPRA) coordinator for the Caddo Nation, to signify the differences among the various people, cultures, governments, and participating agencies. The success of the first TBAG meeting led to its rapid expansion to include the entire Southern and Eastern Regions of the USDA FS, all 39 Oklahoma Tribes (and tribes from other states), other government agencies, numerous academic institutions, private industry, and archeological/ engineering consulting firms. Now entering its 14th year (Table 1), the annual TBAG meeting represents an official government-to-government interaction planned and funded by all parties and focused on mutual interests in the management of archaeological, natural, and cultural resources of the Forests. TBAG provides a venue for Tribes to develop bonds of trust and communication and establish practical ways of restoring ecosystems while seeking to benefit all participants. These interactions and opportunities are expressed in the TBAG logo (Figure 1). The ultimate goal of TBAG is to provide a permanent platform with a central setting for Tribes to meet with other stakeholders and interested parties. For Tribes, some of the benefits that immediately began to accrue involved the introduction to federal employees who are mandated to protect and preserve public resources and cultural heritage, including the location and protection of sites related to those Tribes with patrimony interests on federal lands. Other recent positive Tribal outcomes from TBAG include the achievement of National Historic Preservation Act Section 101D2 Status for Tribal Historic Preservation Offices, the granting of special use permits for collection of Forest resources for ceremonial purposes, a discussion of Traditional Cultural Properties and Rock Art studies, and NAGPRA repatriation and reburial issues. Tribal Elders can now more readily provide the Forests guidance in NAGPRA-related repatriations of human remains and funerary objects. In addition, Osage and Caddo Elders meet privately to discuss protocols on repatriation of human remains recovered from federal lands within their joint homelands. The USDA FS may be the biggest beneficiary of the TBAG meetings. USDA FS staff members develop personal relationships with sovereign dependent Nations and individuals who review and consult on specific projects and operations. Locally, the Forests have received Tribal feedback on land exchanges and developed master agreements to improve the consultation process and solicit Tribal input. Regionally, consultations have expanded to include the Daniel Boone National Forest (for the Shawnee), Alabama and Mississippi National Forests (Chickasaw and Creek), and Allegheny National Forest (Delaware). Heritage Resource Technician training programs are provided

State Procurement Law

The mark of an "academic health department" includes shared activity by academic and practice partners sustained over time. Despite a long history of productive interactivity, the Pennsylvania Department of Health and the University of Pittsburgh's Graduate School of Public Health often faced administrative hurdles in contracting for projects of mutual interest. Seeking to overcome these hurdles, the Commonwealth of Pennsylvania and the University of Pittsburgh's Graduate School of Public Health negotiated a Master Agreement on the basis of statutes designating both as "public procurement units." This provided a template for project specifications, standard financial terms, and a contracting process. Since taking effect, the Master Agreement has supported projects in policy development, capacity building, workforce development, program evaluation, data analysis, and program planning. This experience suggests an approach potentially useful for other states and localities seeking to solidify academic health department partnerships either envisioned for the future or already in place.

Effect of Power Exchange of India: An Overview and Key Issues

There stands no guarantee that if potential market participants are simply provided with the opportunity for trading electricity, there shall be an efficient wholesale electricity market. India, as well as various other developed countries, relies on voluntary agreements as far as electricity trading is concerned. Self, private initiatives to standardize and commodities contracts play an important role in increasing the trading volume to improve efficiency, in developed countries. In accordance with their experiences, this paper suggested a specific strategy to promote bilateral/OTC trading; hence, India needed to develop a master agreement for electricity contracts. This paper discusses that the creating power exchange for short-term trading in the spot market materializing the contract for the convenience of market participants stands particularly important and henceforth is a necessary factor to make sure that spot market is workable and competitive prior to developing a financial contract for electricity trading.

Observational Study of Contracts Processing at 29 CTSA Sites

We measured contracts final negotiation (FN) and full execution (FE) times using shared definitions in a prospective observational study of management of contracts for clinical trials at 29 CTSA institutions. Median FN and FE times were reached in 39 and 91 days, respectively; mean times for FN and FE were 55 and 103 days, respectively. Individual site medians ranged from 3 to 116 days for FN and 34 to 197 days for FE. The use of master agreements (MAs) and previously negotiated terms (PNTs) was associated with significant reduction of FN times by a mean of 33 days (p < 0) and 22 days (p < 0.001), respectively. PNTs, but not MAs, were associated with significantly reduced FE time (22 days, p < 0.007). Gap analysis revealed a gap of 22 days between contracts negotiation and Institutional Review Board (IRB) review and intervals of 33 days (contracts) and 48 days (IRB review) during which the process steps were being conducted alone, suggesting a potential benefit with parallel processing. These baseline data support a plan to investigate root causes of prolonged study start-up time by examining causes of variation and outliers.

Abstract 2790: Establishment and characterization of human skingraft model in immunodeficient mice.

Abstract The humanization process of mice with various tissues named Chi-mice aimed to reproduce better the human situation and to be more predictive than conventional models. In order to evaluate new targeting therapies or adverse side effects involving skin components, pre-clinical studies need to be assayed with new molecules in adequate and validated mouse models bearing human skin. The collection of skin samples was done under ethically approved master agreements and with the signed consent of each patient. The patient's clinical history, the serology results (HIV, HBV and HCV) and tissue banking were centralized in our internal approved biological resource center. To develop such models, we used skins of different origins including foreskin, breast and abdomen that were isolated by different methods (full recovery of about 1 cm depth sample or dermatomization of the 1-2 mm epidermal/dermal layer). These samples were xenografted on immune deficient NOD-SCID mice under different conditions including matrigel grafting. After one month implantation, skingrafts were collected and observed microscopically to confirm the preservation of human organization of skin by full histology. Also, the species nature of vessels was characterized by immunochemistry to evaluate the host penetration within human skingraft and both CD-31 positive mouse and human vessels were found in the skingraft. In the context of vascular leak syndrome (VLS) induction by IL2 treatment, we have used the wet/dry ratio of skingraft to measure the induced-edema and we have measured the blue evans uptake in those injured skingraft to appreciate the epidermal vasculature leaking. Anapathological comparisons were also performed to reveal the histological modifications observed during VLS. These different characterizations performed during development of the skingraft model enabled us to obtain human skin xenografted on mice that retained the human characteristics of the primary material. The co-implantation of other human tissue (tumor) with skin in same mice which refined better the humanized model will be presented. The use of fresh skin and various tissues in drug discovery and early preclinical development of new therapies aimed at corroborating results with clinical reality. Altogether, these processes from the clinical sample collection to the in vivo drug efficacy study through ex vivo assays should help the preclinical drug selection, development and clinical positioning as well as companion biomarker identification. Citation Format: Guillaume Serin, Loïc Morgand, Marie Leblanc, Francis Bichat. Establishment and characterization of human skingraft model in immunodeficient mice. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2790. doi:10.1158/1538-7445.AM2013-2790

Accountability in Transnational Contractual Governance: The International Swaps and Derivatives Association

This paper uses the Global Administrative Law (GAL) approach to develop a model of accountability in transnational contractual governance (TCG). In the transnational context contracts are increasingly governed not only by contract law but also by elaborate regimes of private ordering. Derivatives contracts, for example, are governed by the rules developed by the International Swaps and Derivatives Association (ISDA). The fact that these rules of contract governance are set, monitored, and to a certain extent enforced by a body which is not accountable to the public – at least not in a way that national legislators and judiciaries are – prima facie undermines the legitimacy of contracts used in derivatives markets. This is true in particular because of the negative externalities that these contracts are prone to generate. In an attempt to provide an alternative model of accountability this paper argues that accountability of ISDA is better understood as a combination of procedural GAL-like standards applicable to ISDA itself as well as legislative and judicial recognition of the regulatory standards contained in the documentation developed by ISDA, and in particular the ISDA master agreement (MA). This model of accountability makes TCG responsive to both cosmopolitan and national constituencies, strengthening the argument for conceptualization of GAL as a pluralist legal order.

‘Targeted Touchdown’ and ‘Partial Liftoff’: Post-Crisis Dispute Resolution in the OTC Derivatives Markets and the Challenge for ISDA*

Since the 1980s, influential participants in the niche over-the-counter (OTC) derivatives markets have sought to encourage contractual standardization in the industry to mitigate the potential for unforeseen legal interruptions and ensure the enforceability of OTC derivatives contracts. The International Swaps and Derivatives Association (ISDA), a trade association and standard-setter, has spearheaded this effort; resulting in the creation and sustenance of a highly successful transnational private regulatory regime (TPRER). Most notably, ISDA has generated a standardized boilerplate contract for OTC derivatives, known as the ‘ISDA Master Agreement’. However, the TPRER within which the ISDA Master Agreement operates displays some intriguing features and paradoxes. Chief amongst these paradoxes is that, while this TPRER appears at first glance to be highly legalistic and formal, indications are that rates of formal litigation between members of the regulatory regime have traditionally been low relative to the size of the market (the total notional amount of OTC derivatives contracts outstanding at the end of 2011 was estimated at US$648 trillion).

Strategies for collaboration agreements focusing on innovation

Collaborations focusing on innovation are often born with the conception of a technology, typically as a result of one side’s research effort. Collaborations for innovation can also be made through a deliberate process of identifying strategic synergies that should, with appropriate incentives, lead to jointly created technology in the selected area of interest. The predominant factors motivating the parties to collaborate will heavily influence the agreement structure selected to support the collaboration. If a specific technology was “born” prior to the collaboration, the parties will most likely memorialize their collaboration in an agreement specific to the joint development and commercialization for that technology. In contrast, when the parties are entering the collaboration to stimulate innovation, the agreement is often structured as a master agreement. Regardless of the agreement structure, there are two keys to a successful collaboration for innovation: (1) effective communication; and (2) balancing incentives.

The new date, new format, new goals and new sponsor of the Archon Genomics X PRIZE Competition

The Archon Genomics X PRIZE presented by MEDCO is a $10 million prize for whole human genome sequencing that will test 100 samples and establish a defined method for determining quality and cost per genome. The contest will entail a head-to-head competition starting on 3 January 2013. The $10 million grand prize will be awarded to the first team to meet all the quality standards. If there is no grand prize winner, lesser awards will be made for single achievements in the three categories of accuracy, completeness and haplotype phasing. Similar to the open comment period offered earlier this year for the validation protocol, the X PRIZE Foundation seeks commentary from the scientific community on the revised competition format and judging criteria prior to publishing final rules as part of a master agreement with competing teams next year. The official validation protocol will make the competition judging transparent and fair using multiple standard techniques and robust bioinformatics. With sponsorship from Medco Health Solutions (MEDCO), the 100 samples will be derived from genomes of appropriately consented centenarian subjects. At the conclusion of the contest, the data from the redundantly sequenced genomes will be deposited into a scientific database and provide a heretofore unrealized depth of sequence data based on multiple technologies. The sample set and the bioinformatic pipeline will also be made available to the scientific community.

Abstract 1598: Extensive use of fresh patient-derived tumor samples for drug discovery and drug positioning in oncology

Abstract Most preclinical investigations in Oncology research are performed using permanent cancer cell lines that have been kept in continuous in vitro passages since decades. These plastic-cultured cells became very different from their original tumors since accumulated genetic abnormalities and multiple selections of subclones occurred over time. The use of fresh patient-derived tumor samples for ex vivo assays and for establishment of new relevant in vivo tumor models allows investigating the anti-tumor activity of new therapies directly linked with clinical reality. In this respect, Oncodesign has developed a large and international network of clinical centers for the collection of a large number of fresh patient-derived tumor biopsies from all cancer pathologies and from healthy tissues. The collection of these samples is done under ethically approved master agreements and with the signed consent of each patient. The patient's clinical history, the serology results (HIV, HBV and HCV) and tissue banking are centralized in our internal approved biological resource center. Examples of ex vivo assays will be presented based on patient-derived acute lymphoblastic leukemia, chronic lymphocytic leukemia, acute myeloid leukemia and other hemopathologies using chromium release and Annexin V FACS assays. These studies aimed to demonstrate the CDC, ADCC and apoptosis induction of new therapeutics antibodies whereby approved antibodies such as rituximab and alemtuzumab were used as positive controls. Similarly, these fresh patient-derived models were used to study the direct dose-response effect of new chemotherapeutic agents through apoptosis induction (bortezomib used as positive control). The freshly collected tumors were also used to establish new in vivo tumor models in different strains of mice and rats. The full characterization of the genetic patterns of the xenograft derived tumors was compared with the original collected human tumors and with the clinical data of the patient. A panel of “standard of care” compounds was tested in these new tumor models for pharmacological characterization. The expansion of such tumors at early passages in mice was used to implement a reproducible ex vivo 3D assay. The assay was developed to investigate the potential anti-tumor activity of conventional and targeted therapies, and allows sufficient throughput for use during drug discovery lead optimisation. Ex vivo drug effects were then correlated with in vivo results using the same panel of tumorgrafts. The use of fresh patient-derived tumors in drug discovery and early preclinical development of new therapies aimed at corroborating results with clinical reality. Altogether, these processes from the clinical tumor collection to the in vivo drug efficacy study through ex vivo assays should help the preclinical drug selection, development and clinical positioning as well as companion biomarker identification. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1598. doi:10.1158/1538-7445.AM2011-1598

Sinyi Real Estate in China: The Challenges of Maintaining an Ethical Business Culture

Sinyi was one of the most successful real estate agent companies in Taiwan and China mainland. Sinyi's founder, Chun-chi Chou, embraced Confucian perspective in his management and successfully cultivated a "people-centered" corporate culture for both Sinyi's employees and customers. Mr. Chou proclaimed "trustworthiness and fair dealing" as the guiding principles for the company. This was in contrast to the immature environment of the real estate brokerage industry in China, where immoral real estate agents were common. Sinyi also signed a master franchise agreement with Coldwell Banker Real Estate Corporation (Coldwell Banker) as its China market entry strategy. However, large international competitors and local real estate agents were aggressively seizing market share and it became difficult for Sinyi to sustain its vision and its unique management style with high-speed expansion. The case highlights the business ethics that has been a cornerstone of Sinyi's success and outlines competitor and industry conditions in China's real estate industry, focusing on the following questions: Should Sinyi adhere to its corporate philosophy of righteousness and trustworthiness among its staff? Does Sinyi need to change its business model in countering its competitors' aggressive moves? What necessary measures must Sinyi take in the ever-changing market? What role did Chou's responsible leadership play in Taiwan and would it be working in China mainland's market?

The 2010 Tahawwut Master Agreement: Paving the Way for Shari'ah-Compliant Hedging

Modern Islamic finance remains in its infancy, having emerged only in the mid-1990s. Despite exceptional growth rates, Islamic finance is essentially devoid of derivatives products, in part due to doctrinal constraints and due in part to the infancy of the industry. In March of 2010, after years of effort, the International Swaps and Derivatives Association (ISDA) and International Islamic Financial Market (IIFM) released The 2010 Tahawwut Master Agreement for the standardized effectuation of certain swaps and derivative transactions that are compliant with the principles of Islamic Shari`ah. This paper analyzes certain provisions of The 2010 Tahawwut Master Agreement and compares those provisions with ISDA’s 2002 Master Agreement.

ISDA Valuation Cases

Following default under a given ISDA Master Agreement, outstanding derivatives contracts have to be valued in accordance with the applicable provisions for Market Quotation, Loss or Close-out Amount. The interpretation and construction of these clauses is highly complex, in some respects even more complex than the mathematical valuation of the derivatives themselves. Extremely helpful guidance is however provided by a range of ISDA valuation cases from English and other common law jurisdictions. Their judgments include: “ANZ v. Societe Generale (2000), North America Steamships Limited (2007), Enron v. Integral (2002), Enron v. Txu (2003), High Risk Opportunities HUB (2005), Peregrine v. Robinson (2000) and Yallourn v. Enron (2005)” and are summarized below. The key text from each judgment is also carefully identified and set out by topic and sub-topic in this paper and various practitioner test questions included in the Appendix.

1992 ISDA Master Agreement: Analyzing Market Quotation, Set-Off and Loss

This paper analyzes key clauses relevant to valuation in the 1992 ISDA Master Agreement. The paper focuses principally on the section 14 definitions of: Market Quotation and Loss and on ISDA’s Basic Set-off Provision which is frequently added via the Master Agreement Schedule. Additional clauses considered relate to: First and Second Method, Payments on Early Termination, Settlement Amount, Pre-Estimate, Terminated Transactions, Affected Transactions, Termination Events, One and Two Affected Parties, Reference Market-makers, Unpaid Amounts, Calculations and Settlement. The paper highlights both the richness and complexity of specific valuation-related clauses in the 1992 ISDA Master Agreement and in the structure and interpretation of the Master Agreement as a whole. The paper concludes with c.20 additional student drafting questions.

Practitioner Problems for Derivatives Lawyers- Introduction

This LLM research project analyses four topics from the work of derivatives and structured products lawyers. The first topic is the interpretation of standard industry documentation, taking the example of Market Quotation and Loss definitions in 1992 ISDA Master Agreement. The second topic is the drafting and construction of bespoke structured product documentation, specifically clauses from Structured Investment Vehicles (SIVs) and related litigation in the English courts. The third topic is the concept and regulation of derivatives mis-marking including recent FSA and SEC notices. The final topic is the interpretation of related legislation, specifically the determination of sterling exchange rates for non-GBP denominated assets under the Insolvency Rules 1986. In addition to these analyses, c.40 student test problems and drafting exercises are also included in the dissertation.

The ISDA Master Agreement - The Rise and Fall of a Major Financial Instrument

The rapid growth and complexity of the over-the-counter (OTC) derivatives market, particularly swaps, and the perceived risks to the financial system, continue to stimulate debate on regulatory controls. Too often minimized in these debates are the industry's own efforts and incentives to produce superior mechanisms for controlling risks- in terms of both effectiveness and efficiency than those imposed through regulation. While product innovation is certainly a hallmark of the derivatives industry, so too has been its ability to develop market-based solutions for addressing risk.This dissertation examines one such successful solution - the swap master agreement - that has seen significant innovations as the swaps market has grown and matured. The use and design of master agreements has evolved in response to demands for better documentation that reduces negotiating costs, addresses counterparty credit risk, and help ensure contract enforceability. Indeed, the importance of sound documentation for reducing derivatives losses has been emphasized since the 1993 report prepared by the Group of Thirty Global Derivatives Study Group.Derivatives have become an indispensable component of global financial markets, yet their ever increasing complexity, combined with the tremendous upsurge in the volume of derivatives transactions, made it essential that the risks associated with them are identified, managed and monitored. To a great extent, self-preservation and the fear of loss of reputation motivate dealers and end-users to manage derivatives risk. Moreover, dealers and end-users are in a position to appreciate the risks specific to their derivatives activities (Hu, 1993). Hence, the dealers and end-users who actually use derivatives are also best able to establish and implement a comprehensive framework of derivatives risk management and controls that are tailored to their situation. The hope is that these entities live up to that ideal, but reality often falls short of this goal.Uncertainties and legal risks complicate both trading and the management of derivative financial products in the trading book and the portfolio. Legal ambiguities associated with new vehicles can be substantial, and, though they lessen over the product cycle, they do impede the control of risk. To overcome this situation, many banks assume that the adherence to well-established market conventions provides adequate legal protection. Yet, even in respect to business involving established financial products, many players learn the hard way that 'legal surprises' may occur.

La régulation des pratiques contractuelles

The use of contractualisation has greatly developed over the last years in the field of health care, with results that are often promising, but also with failures and sometime virulent criticism. Thus it has become more and more necessary to regulate contractual practices. In the framework of its mission of general administration, that is to say, protection of the general interest, it falls to the Ministry of Health to put in place this regulation. Several tools are available. Certain, such as standard contracts and master agreements, although useful, do not remain specific and ad hoc. On the other hand, the politics of contractualisation, fitting well in the general politics of Health Care, form, without doubt, the most globalised tool, since they allow contractualisation to be replaced in the management of the total health case system, and thus to be seen as a potential contribution in the framework of performance improvement. The conditions for success are not, however, automatically united. One must ensure that the mechanisms exist which bring about regulatory tools, and which ensure that the participants use correctly the framework defined by the Ministry of Health. To cite this article: J. Perrot, C. R. Biologies 331 (2008).