Module 6

03/10/2024

Increasing use of risk sharing agreements

Particularly in oncology

• Avastin (in NSCLC, CRC, BC, RCC): 50% reimbursed for the first three cycles; 100% reimbursed forcycles 4 – 14; cost of subsequent cycles borne bymanufacturer • Sutent (in mRCC): first courseof treatment is free • Torisel (in mRCC): total reimbursement limited to 8 packs (~2 months of therapy); additional cost is paid back by themanufacturer if the patient discontinues treatment during thisperiod

• Different types ofrisk-sharing agreement areused: • Risk sharing (rebate) –

reimbursement of drug costfor non-responders • Cost sharing (discount) – discounted drugprice • Payment by results (rebate) – reimbursement of first cycles for non-responders

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Focus of HTAcritiques

Across HTAs the areas of consistent criticism were the survival data, utility data, and choice of active comparators.

Key areas of HTA critique across countries:

Comparators Survival data Eligible population

PRO/Utility data

SMC

NICE

TC

IQWiG

Source: HAS – TC Opinion on Yervoy, Dec. 2011

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