Not surprisingly, the effectiveness and efficiency of health technologies were not considered relevant criteria for price/volume agreements (9% and 5%) respectively. However, the relevance of these criteria for efficiency-based contracts was 96% and 71%, respectively 75% and 96% for efficiency-based contracts. The participants were members of the Spanish Society of Hospital Pharmacy – Sociedad Espaéola de Farmacia Hospitalaria – (professional specialists involved in purchasing decisions regarding the acceptance of risk-sharing contracts). They were asked about their opinions and personal experience with risk-sharing contracts. The survey was web-based with closed and semi-closed questions, multiple-choice and scale. The questions related to the degree to which the different terms of risk-sharing contracts (price volume, payment effect and efficiency payment) were implemented and their perception of the inbreeding aspects (medical domains, management variables and regulatory frameworks) that influence the adoption of these contracts. The questionnaire had 32 questions. The questionnaire design process had several phases, including the revision of draft versions by four experts from the hospital`s pharmacy, who proposed changes on several issues to make them more understandable until the final version was clear enough to be sent to all potential respondents (the questionnaire is available on request). Only 12% of respondents thought that price and volume agreements would encourage genetic testing, while 85% of participants thought that the other type of agreement would be an incentive for these tests. In addition, the reverse analysis of incentives revealed that the implementation of genetic testing (80% of respondents) should lead to increased use of cost-effectiveness or efficiency risk-sharing contracts in relation to price volume contracts (17%).

Mahjoub R. Evaluation of a pharmaceutical risk-sharing agreement when patients are assessed for the likelihood of success. Health value. 2015; 18 (3): A100. This research took advantage of a web-based survey of payers` stakeholders to determine what types of innovative agreements are currently being used, future use, parameters and adoption drivers. Participants included national and regional payers (or former payers) and decision-makers at the hospital level. Keywords: Catalonia; Managed entry agreements The spending cap Reimbursement of service delivery Risk-sharing agreement. With the wider use of risk-sharing contracts, the new paradigm of personalized medicine has developed over the past decade to align treatments with patient characteristics using genetic biomarkers.

Patient stratification reduces uncertainty about the clinical and financial outcomes of medications. Risk-sharing agreements are therefore not appropriate, if not necessary, in this new context; However, this type of agreement can be used to encourage companies to provide more information about patient characteristics in order to improve clinical outcomes. From a theoretical point of view, Antonanzas et al. [12] analyzed the use of risk-sharing contracts to promote personalized medicine. However, from an empirical point of view, the link between this type of agreement and the implementation of personalized medicine requires more research, as this topic has not yet been addressed in the literature.