Pharmaceutical Outcomes Research and Policy Program, University of Washington, 1959 NE Pacific St., Box 357630, Seattle, WA, 98195-7630, USA.
Pharmacoeconomics. 2017 Oct;35(10):1063-1072. doi: 10.1007/s40273-017-0535-z.
Enthusiasm for performance-based risk-sharing arrangements (PBRSAs) continues but at variable pace across countries. Our objective was to identify and characterize publicly available cases and related trends for these arrangements. We performed a review of PBRSAs from 1993 to 2016 using the University of Washington PBRSA Database. Arrangements were categorized according to a previously published taxonomy. Macro-level trends were identified related to the timing of adoption, countries involved, types of arrangements, and disease areas. Our search yielded 437 arrangements. Among these, 183 (41.9%) were categorized as currently active, while 58.1% have expired. Five main types of arrangements have been identified, namely coverage with evidence development (149 cases, 34.1%), performance-linked reimbursement (104 cases, 23.8%), conditional treatment continuation (78 cases, 17.8%), financial or utilization (71 cases, 16.2%), and hybrid schemes with multiple components (35 cases, 8.0%). The pace of adoption varies across countries but has renewed an upward trend after a lull in 2012/2013. Conditions in the USA may be changing toward a more favorable environment of PBRSAs. Interest in PBRSAs remains high, suggesting they are a viable coverage and reimbursement mechanism for a wide range of medical products.
对基于绩效的风险分担安排（PBRSAs）的热情在各国之间持续存在，但速度不一。我们的目的是确定和描述这些安排的公开案例和相关趋势。我们使用华盛顿大学 PBRSAs 数据库，对 1993 年至 2016 年的 PBRSAs 进行了回顾。根据之前发表的分类法对安排进行了分类。确定了与采用时间、涉及国家、安排类型和疾病领域相关的宏观趋势。我们的搜索结果为 437 个安排。其中，183 个（41.9%）被归类为当前活跃，而 58.1%已经过期。已经确定了五种主要类型的安排，即有证据开发的覆盖范围（149 例，34.1%）、与绩效挂钩的报销（104 例，23.8%）、有条件的治疗延续（78 例，17.8%）、财务或利用（71 例，16.2%）和具有多个组件的混合方案（35 例，8.0%）。采用的步伐在各国之间有所不同，但在 2012/2013 年的停顿之后，又重新呈现上升趋势。美国的情况可能正在朝着有利于 PBRSAs 的环境转变。对 PBRSAs 的兴趣仍然很高，这表明它们是广泛的医疗产品的可行的覆盖范围和报销机制。
