The review showed that the intensification of reports on pricing and reimbursement practices across the EU has led to a better understanding of RSAs and that RSAs have evolved dramatically since their initial conception and implementation. The report concludes that SSAs can play an increasingly important role in the availability of drugs in the future, particularly when it comes to high-priced personalized drug options. However, the authors point out that pharmaceutical companies could deny the need for SRAs if they improved to produce and collect the data needed to enable them to develop stronger market authorization arguments for their new drugs. Such data is needed to reduce the risk of being rejected by HTA agencies. If successful, the design, reception and development of the RSA will have played an important role in reducing the financial burden on EU health systems and providing patients with access to new, innovative and effective medicines. Towse A, Garrison LP Jr. Can`t you have satisfaction? Will the payment of the benefit help? Towards an economic framework for understanding performance-based risk-sharing agreements for innovative medical devices. Pharmacoeconomics. 2010;28(2):93–102.

The aging of the population, life expectancy and the increase in drug costs are expected to significantly increase the burden on health systems in the coming years. In order to reduce this burden and increase access to new innovative and effective medicines in the European Union (EU), risk-sharing agreements have been concluded between national health cost beneficiaries, health technology assessment agencies (HTA) and the pharmaceutical industry. A recent study published in PharmacoEconomics – Open [1] looked at SSA in the EU from 2000 to 2015. It shows that during this period, interest in aces and the acquisition of RSAs increased and that the reasons for this increase were discussed. De Pouvourville G. Risk-Sharing Agreement for Innovative Medicines: A New Solution to Old Problems? Eur J Health Econ. 2006;7 (3):155-7. doi:10.1007/s10198-006-0386-6. All authors (TJP, JMT and THL) contributed to the design of the study, the revision of the research protocol, the analysis and interpretation of the results, and the writing and verification of the manuscript. TJP established the research protocol, conducted database searches and all screenings, analyzed the data and prepared the drafting of the manuscript.

For each article reviewed by experts, which passed both levels of the first screening, two levels of data extraction were carried out by an author (TJP). First, the summary information (authors, title, summary and classification of articles) was extracted from a table of evidence for all articles. Second, keywords, data (i.e. numerical values) and summaries of the results presented for all articles were extracted, which form the basis of the final table of evidence. Information obtained from quantitative articles focused on the number and/or type of RSA studied or tracked, as well as the country and specific years in which the RSA took place.