García Martí Sebastián, Pichon-Riviere Andrés, Augustovski Federico, Espinoza Manuel
Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina.
Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Int J Technol Assess Health Care. 2024 Dec 2;40(1):e65. doi: 10.1017/S0266462324000527.
Healthcare stakeholders in Latin America, including payers, manufacturers, and patients, seek to expedite access to technologies. However, uncertainty sometimes surrounds their true benefits and budgetary implications. Managed entry agreements (MEAs) are proposed to address this uncertainty by redistributing risks among key actors.
The objective of Health Technology Assessment International's 2023 Latin American Policy Forum was to examine the potential utility of MEA in technology reimbursement and decision-making processes in the region.
This article is based on a background document, a survey, and the deliberative work of the country representatives and others who participated in the Policy Forum.
Interest in MEA in Latin America is increasing, with financial agreements being more prevalent than those based on clinical outcomes. During the Policy Forum, potential barriers to MEA implementation were identified, such as the lack of legal frameworks, insufficient reliable data, and, in some cases, distrust among stakeholders. Some potential solutions were also identified, including early stakeholder involvement to enhance dialogue and understanding, and piloting shorter-duration MEA to facilitate the revision of agreement terms, especially in situations of epidemiological uncertainty.
The Policy Forum served as a valuable platform for discussing the importance of flexible MEA implementation that acknowledges data uncertainty, promotes transparent dialogue to incorporate opinions and values from all stakeholders, and develops legal frameworks to support effective technology access schemes in Latin America.
拉丁美洲的医疗保健利益相关者,包括支付方、制造商和患者,都希望加快技术的获取。然而,这些技术的真正益处和预算影响有时存在不确定性。有人提议采用管理式进入协议(MEA),通过在关键行为者之间重新分配风险来解决这种不确定性。
国际卫生技术评估组织2023年拉丁美洲政策论坛的目标是研究MEA在该地区技术报销和决策过程中的潜在效用。
本文基于一份背景文件、一项调查以及参与政策论坛的国家代表和其他人的审议工作。
拉丁美洲对MEA的兴趣在增加,财务协议比基于临床结果的协议更为普遍。在政策论坛期间,确定了MEA实施的潜在障碍,如缺乏法律框架、可靠数据不足,以及在某些情况下利益相关者之间的不信任。还确定了一些潜在的解决方案,包括让利益相关者尽早参与以加强对话和理解,以及试行较短期限的MEA以促进协议条款的修订,特别是在流行病学存在不确定性的情况下。
政策论坛是一个宝贵的平台,用于讨论灵活实施MEA的重要性,MEA要承认数据的不确定性,促进透明对话以纳入所有利益相关者的意见和价值观,并制定法律框架以支持拉丁美洲有效的技术获取方案。