Catalan Health Service (CatSalut), Barcelona, Spain.
Catalan Health Service (CatSalut), Barcelona, Spain; Digitalization for the Sustainability of the Healthcare System (DS3), Sistema de Salut de Catalunya, Barcelona, Spain.
Value Health. 2022 May;25(5):803-809. doi: 10.1016/j.jval.2021.10.010. Epub 2021 Dec 1.
Publications assessing health and economic outcomes of risk-sharing arrangements (RSAs) are limited. Better knowledge of these outcomes would shed light on the pertinence of such arrangements, informing design improvements for the future. The aim of the study is to describe the different types of RSAs implemented in Catalonia and their health and economic outcomes.
Retrospective descriptive analysis of RSAs implemented from January 2016 to December 2019 in the Catalan Health Service, CatSalut. Individual RSAs were reviewed and categorized according to standard RSA guidelines. Relevant health and economic outcomes pertaining to the RSAs were analyzed using aggregate data recorded in Catalan central registries.
A total of 15 RSAs were implemented over the study period (10 of which are still ongoing). A total of 8 consisted of performance-linked reimbursements (PLRs) and 7 of cost-sharing arrangements (CSAs). The arrangements were implemented in the oncohematology (n = 11), rare disease (n = 3), and neurology (n = 1) areas. A total of 951 patients were included in PLR and 73% achieved the target health outcomes. Total medication costs were €9 295 755 of which 11% were refunded to CatSalut. CSAs involved 2066 patients and resulted in overall refunds of €1 349 564 (2.61%) for CatSalut.
Both PLRs and CSAs were used to manage the different uncertainties related to accessing innovative medicines in Catalonia. The data generated provide relevant information to inform decision-making, allowing an adaptation of the initial recommendation for use and access. Additional efforts are required to increase the RSA assessments and their publication.
评估风险分担安排（RSA）对健康和经济结果的影响的出版物有限。更好地了解这些结果将有助于了解此类安排的相关性，为未来的设计改进提供信息。本研究旨在描述加泰罗尼亚实施的不同类型的 RSA 及其对健康和经济的影响。
对 2016 年 1 月至 2019 年 12 月期间在加泰罗尼亚卫生服务中心（CatSalut）实施的 RSA 进行回顾性描述性分析。根据标准 RSA 指南对个体 RSA 进行审查和分类。使用加泰罗尼亚中央登记处记录的汇总数据分析与 RSA 相关的健康和经济结果。
在研究期间共实施了 15 项 RSA（其中 10 项仍在进行中）。其中 8 项为基于绩效的报销（PLR），7 项为成本分担安排（CSA）。这些安排分别在肿瘤血液病学（n=11）、罕见病（n=3）和神经病学（n=1）领域实施。PLR 共纳入 951 例患者，其中 73%达到了目标健康结果。总药物费用为 9295755 欧元，其中 11%退还给 CatSalut。CSA 涉及 2066 例患者，导致 CatSalut 的总退款为 1349564 欧元（2.61%）。
PLR 和 CSA 均用于管理与在加泰罗尼亚获得创新药物相关的不同不确定性。所产生的数据提供了相关信息，为决策提供了依据，允许对初始推荐的使用和获得进行调整。需要进一步努力增加 RSA 评估及其发布。
