Implementing outcomes-based risk-sharing agreements: an integrative review of applications in blood cancer in the UK and beyond

Bayani, Diana Beatriz; Wee, Hwee Lin

doi:10.1080/14737167.2023.2240515

Cited by 2 publications

(1 citation statement)

References 32 publications

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“…A discussion guide was developed based on findings from a systematic review(19) and was reviewed by two additional researchers (see ). Semistructured, one-on-one, in-depth interviews were conducted via teleconference, recorded, and transcribed by the lead researcher, who possesses experience and training in qualitative data collection and analysis.…”

Section: Methodsmentioning

confidence: 99%

Value-based payment for high-cost treatments in Singapore: a qualitative study of stakeholders’ perspectives

Bayani,

Wee

2024

Int J Technol Assess Health Care

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Objectives: The rising costs of drugs have necessitated the exploration of innovative payment methods in healthcare systems. Risk-sharing agreements (RSAs) have been implemented in many countries as a value-based payment mechanism to manage the uncertainty associated with expensive technologies. This study aimed to investigate stakeholder perspectives on value-based payment in the Singaporean context, providing insights for future directions in health technology assessment and financing. Methods: This descriptive qualitative inquiry involved participant interviews conducted between October 2021 and April 2022. Thematic analysis was conducted in two phases to analyze the interview transcripts. Results: Seventeen respondents participated in the study, and five key themes emerged from the analysis. Stakeholders viewed RSAs as moderately positive, despite limited experience with them. They emphasized the importance of clearly defining objectives and establishing transparent criteria for implementing these schemes. The current data infrastructure was identified as both a barrier and facilitator, as RSAs impose administrative burdens. To successfully implement these payment mechanisms, capacity building, and effective stakeholder engagement that fosters mutual trust and cocreation are crucial. Conclusion: This study confirms previously identified barriers and facilitators to successful RSA implementation while contextualizing them within the Singaporean setting. The findings suggest that value-based payment has the potential to address uncertainty and improve access to healthcare technologies, but these barriers must be addressed for the schemes to be effective.

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Section: Methodsmentioning

confidence: 99%

Value-based payment for high-cost treatments in Singapore: a qualitative study of stakeholders’ perspectives

Bayani,

Wee

2024

Int J Technol Assess Health Care

Self Cite

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Evaluation of a risk-sharing agreement for atezolizumab treatment in patients with non-small cell lung cancer: a strategy to improve access in low-income countries

Arrieta,

Ramos-Ramírez,

Garcés-Flores

et al. 2024

The Oncologist

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Background Using immune checkpoint inhibitors (IO) is a promising approach to maximize clinical benefits for patients with non-small cell lung cancer (NSCLC). PD-L1 expression serves as a predictive factor for treatment outcomes with IO. However, the high cost of this treatment creates significant barriers to access. Substantial evidence demonstrates the sustained clinical benefits experienced by patients who respond to immunotherapy. While IOs show promise in NSCLC treatment, their high cost poses access barriers. Aim This study focused on a prospective cost analysis conducted at a high-specialty health facility to assess the economic implications of implementing a risk-sharing agreement (RSA) for atezolizumab in NSCLC. Methods The study included 30 patients with advanced NSCLC, with the pharmaceutical company funding the initial cycles. If patients responded, a government program covered costs until disease progression. Results A median progression-free survival of 4.67 months across populations, rising to 9.4 months for responders. The 2-year overall survival rate for the response group was 64%, significantly higher than for non-response. Without an RSA, a total treatment cost of $881 859.36 ($29 395.31/patient) was reported, compared to $530 467.12 ($17 682.24/patient) with an RSA, representing a 40% cost reduction. In responders, the average cost per year of life per patient dropped by 22%. Risk-sharing, assessed through non-parametric tests, showed a statistically significant difference in pharmacological costs (P < .001). Conclusion Implementing RSAs can optimize resource allocation, making IO treatment more accessible, especially in low-income countries.

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Implementing outcomes-based risk-sharing agreements: an integrative review of applications in blood cancer in the UK and beyond

Cited by 2 publications

References 32 publications

Value-based payment for high-cost treatments in Singapore: a qualitative study of stakeholders’ perspectives

Value-based payment for high-cost treatments in Singapore: a qualitative study of stakeholders’ perspectives

Evaluation of a risk-sharing agreement for atezolizumab treatment in patients with non-small cell lung cancer: a strategy to improve access in low-income countries

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