oa South African Family Practice - Setting the stage for risk-sharing agreements : international experiences and outcomes-based reimbursement : open forum

Volume 50, Issue 4
  • ISSN : 2078-6190
  • E-ISSN: 2078-6204



Biological medicines are clinically effective but very expensive in South Africa. The business decisions of bio-logical manufacturers and payers (medical schemes) impact the access patient's have to biological medicines. This paper presents risk-sharing agreements as a means of managing the risk of introducing biological medicines into the healthcare market.

The paper critically reviews literature of some prominent international experiences with risk-sharing agreements and the nuances associated with such agreements. The paper also critiques the outcomes-based reimbursement of biological medicine and the structural necessities for its successful implementation.
A risk-sharing agreement is a useful tool to manage the risk of introducing clinically effective and very expensive medicines into the healthcare market. It is also a tool that bridges the conflicting priorities of the manufacturer of biological medicine and the payer.
The application of risk-sharing agreements within an international context informs the local discussion. This paper is the first in a two-part series that serves to review the international experience with risk-sharing agreements and critique the outcomes-based reimbursement of biological medicines. The backdrop is set for a discussion of the application of risk-sharing agreements in South Africa, which is the purpose of the second paper in this series.

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