The Organisation for Economic Co-operation and Development (OECD) has published a report on managed entry arrangements (MEAs), exploring this approach and making recommendations for improvement.
The report, Performance-based managed entry agreements for new medicines:
“explored the experience countries have had thus far with performance-based MEAs to identify good practices and possible ways to improve the use of these agreements in the future.”
The key findings of the project were in the form of good practices that could be implemented by payers around the world:
- “Defining a strategy to guide the use of performance-based MEAs and ensuring that they are used only where the benefit of additional evidence on product performance outweighs the cost of negotiating and executing MEAs;
- Clearly identifying uncertainties in each coverage decision and designing performance-based MEAs to ensure that data sources and research designs are appropriate to address the uncertainties at hand;
- Implementing a governance framework that ensures transparency of process and allows payers to act upon the additional evidence generated as a result of MEAs in accordance with that evidence, including exit from MEAs and potential withdrawal of temporary coverage; and
- Ensuring a minimum level of transparency of content, limiting confidentiality to those parts of MEAs that may be commercially sensitive (in particular prices)”
International data sharing is flagged as having potential for global benefit, informing colleagues in other countries on when these sorts of MEAs have been used effectively.
The authors highlight current limitations of the study, such as lack of existing analyses of data, as well as the widespread use of confidentiality around the agreements.