BackgroundThere has been an increase in 'risk sharing' schemes for pharmaceuticals between healthcare institutions and pharmaceutical companies in Europe in recent years as an additional approach to provide continued comprehensive and equitable healthcare. There is though confusion surrounding the terminology as well as concerns with existing schemes.MethodsAliterature review was undertaken to identify existing schemes supplemented with additional internal documents or web-based references known to the authors. This was combined with the extensive knowledge of health authority personnel from 14 different countries and locations involved with these schemes.Results and discussionA large number of 'risk sharing' schemes with pharmaceuticals are in existence incorporating both financial-based models and performance-based/outcomes-based models. In view of this, a new logical definition is proposed. This is "risk sharing' schemes should be considered as agreements concluded by payers and pharmaceutical companies to diminish the impact on payers' budgets for new and existing schemes brought about by uncertainty and/or the need to work within finite budgets". There are a number of concerns with existing schemes. These include potentially high administration costs, lack of transparency, conflicts of interest, and whether health authorities will end up funding an appreciable proportion of a new drug's development costs. In addition, there is a paucity of published evaluations of existing schemes with pharmaceuticals.ConclusionWe believe there are only a limited number of situations where 'risk sharing' schemes should be considered as well as factors that should be considered by payers in advance of implementation. This includes their objective, appropriateness, the availability of competent staff to fully evaluate proposed schemes as well as access to IT support. This also includes whether systematic evaluations have been built into proposed schemes.

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Background Over the last few years, increased international attention has been paid to bridging the gap between health research and policy-making. The situation analysis on evidence-informed policy-making (EIP) in Poland aims to increase understanding of interactions among a country’s research and policy-making communities, to determine where and how to best establish a knowledge translation platform (KTP), i.e. an organization or network that through its structure and functioning brings the worlds of research and policy together. Methods The methods were guided by the EVIPNet Europe Situation Analysis Manual and included a literature review, key-informant interviews and survey data analysis. Results In Poland, the existence of incentives or requirements stipulating the use of research evidence in health policy varies, depending on the type of policy. The use of evidence is a standard practice in drug policy, and in decisions related to the inclusion of services in the health benefit package. In other areas, some good practice examples of using evidence in policy can be identified. Yet these are rather individual, isolated and bottom-up initiatives, which neither occur systematically, nor routinely. Key challenges in view of strengthening a systemic approach to EIP relate to: overlapping mandates of key health system and research institutions, generally low research capacity and lack of knowledge translation skills. Conclusions Establishing and operationalizing a KTP can be an effective means of supporting sustainable EIP. Building such infrastructure, however, is a longer-term and complex process that needs to be based on the current characteristics of the country’s EIP landscape. The proposed model of a future KTP in Poland is a network with a joint secretariat within the Ministry of Health. Such form can take advantage of existing organizations’ competencies via information exchange and cooperation. Key messages Although systemic mechanisms for evidence-informed health policy are missing in Poland, its importance is recognized among major health system stakeholders. The proposed model of a future knowledge translation platform in Poland is a network with a joint secretariat within the Ministry of Health.