Market access agreements for pharmaceuticals in Europe: diversity of approaches and underlying concepts

Table 1 Market Access Agreements identified on websites of European health care payers and their classification according to the typology proposed by authors.

Market Access Agreement	Analysis of health outcomes data from a cohort or on per patient basis	Provisional agreement or permanent risk-shifting	Type of MAA
Two MAA for levodopa/carbidopa and rimonabant in Sweden [6–10]	cohort	provisional	CED
12 MAA for oncology drugs in Italy [13]	cohort and per patient	provisional	P4P or CA
One MAA for three Alzeimer's Disease drugs in Italy [3, 16]	cohort and per patient	provisional	CED
Three MAA for angina pectoris and resistant type 2 diabetes drugs in Italy [14, 17–19]	cohort	provisional	CED
11 MAA developed as a part of NICE appraisal process [21–36]	per patient**	permanent**	P4P or CA; (CED**)
One MAA for Multiple Sclerosis drugs in UK [3, 37]	cohort	provisional	CED
Two MAA for type 2 diabetes drugs in France [12]	cohort	provisional	CED*
The MAA for RisperdalConsta LR in schizophrenia in France [11, 12]	cohort	provisional	CED*

For review of the schemes see [3, 7, 10, 38].
*- unfavourable CED results assumed reduction of list price of the drug and is some cases also a rebate of money for sold packages
**-one PAS assumed price reduction in case of unfavourable results of an ongoing clinical trial versus a comparator drug

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