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Linking Payment to Health Outcomes

November 29, 2010

Over the past decade, there has been growing enthusiasm in many countries for linking access to new medical products with a requirement for collection of additional evidence on “real world” and comparative benefits and risk.

In the United States, the approach has been called “coverage with evidence development”, in the UK it is “only in research” and “risk-sharing”, and more recently the terms “access with evidence development” and “managed entry” have been more widely used. It is our hope that this new website will provide a forum for information sharing, dialogue and conceptual development for all of these initiatives that share the common objective of balanced access to new technology with the desire to have better information on how well they work.

To begin this conversation, we are posting an article by Dr. Carlson and his colleagues that was recently published in Health Policy, which provides a taxonomy of performance-based health outcomes reimbursement schemes. The paper defines this term as “…schemes between healthcare payers and medical product manufacturers in which the price, level, or nature of reimbursement are tied to future measures of clinical or intermediate endpoints ultimately related to patient quality or quantity of life”.

A systematic review was conducted to “…identify, categorize, and evaluate performance-based health outcomes reimbursement schemes between medical product manufacturers and payers…”, which identified 34 examples of coverage with evidence development, 10 examples of conditional treatment continuation, and 14 examples of performance-linked reimbursement.

We invite you to comment on Carlson et al.’s taxonomy of performance-based reimbursement schemes. Please feel free to cite other related papers and reports, work in progress, etc. In addition, feel free to raise any other topics in this broad field that you believe would be of interest to the other members of this group.

The article may be accessed through the link below.

Linking payment to health outcomes: A taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers

8 Comments leave one →
  1. Sean Tunis permalink
    November 29, 2010 1:23 PM

    We are looking forward to your feedback on this article – in part to test the functionality of the new ISG website. We are working on getting permission to post a PDF of the Carlson article from the publisher, but for now can only provide a link to the article. Hopefully many of you have access to full text retrieval, and will be able to view the entire article.

    If you wish to send any comments or suggestions directly to the website moderator, please click on the “contact” link in the upper right corner and you can send a message.

    • antonio brazil permalink
      November 29, 2010 1:45 PM

      Sean, congratulations! I do expect consistent discussions here to support the expansion of HE indicators as an access tool worldwide.


  2. Louis Jacques permalink
    November 29, 2010 1:59 PM

    This site seems more user friendly. If possible you might post the 2010 MedPAC Report on CED as well.

  3. Catherine Voutier permalink
    November 29, 2010 5:23 PM

    This is great – I’m glad to see HTAi getting involved in blogging. You can also read posts in your email or via an RSS reader. Just go to the main blog URL by clicking on the header and type in /feed at the end. This will bring up the RSS page – use this link when subscribing to RSS.

    You might want to create some categories however. This post has been categorised as ‘uncategorised’ (automatic if no categories created/chosen). Please get in touch with me if you would like some help or tips. I’ll be in Brazil in 2011.

  4. Sean Sullivan permalink
    November 29, 2010 7:26 PM

    Sean and HTAi ISG – My colleagues and I at the University of Washington welcome comments on our paper in Health Policy as well as comments on a follow-on paper by Lou Garrison and Adrian Towse in PharmacoEconomics that describes the economic motivations to engage in innovative contracting. We are most particularly interested in comments on the proposed taxonomy and whether or not we have missed any relevant, publicly available cases. As a further point, our group have recently created a searchable database of all cases we identified in our systematic review and intend to periodically update the database and conduct additional research on these contracting schemes. We hope to make this database available to researchers at some point in the future.

  5. Laura Sampietro-Colom permalink
    December 2, 2010 4:10 AM

    Congratulations for the first HTAi blog! Hope this will be the seed for a fruitfull developments in this area. Although in the past we had some exemples on CED with medical devices (that was in Catalonia 1990!), there is no any formal initiative by any of the Spanish governement Regions. Happy to contribute when initiaties come out.

  6. December 10, 2010 4:33 PM

    We are pleased to announce that we were able to post the Carlson et al. article discussed in the first blog post! You may access the article by clicking on the link at the bottom of the post.

  7. Bergemann permalink
    December 15, 2010 8:59 AM

    That is a good initiative and I look forward to have fruitful discussions about CED.
    This is a since long needed blog!

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