“Managed Entry Agreements provide the opportunity to cope with uncertainties when bringing new innovative and effective pharmaceuticals to patients faster and more equally. They also make considerable resources available for other urgent healthcare needs,” says Pontus Johansson, senior economist at TLV.
In the report, TLV notes that there are major challenges in the pharmaceutical field both in Sweden and internationally. The trend is for new pharmaceuticals to be introduced at an earlier stage, which means that the uncertainties surrounding these pharmaceuticals are often high.
TLV also notes that in the coming years, it is likely that the factors that increase the cost of pharmaceuticals will be stronger than the cost-cutting effects. However, Managed Entry Agreements will become an increasingly important tool to dampen cost increases, together with generic competition and measures in the form of reassessments and price reductions for products that are older than fifteen years.
Facts about Managed Entry Agreements
Since 2014, Swedish county councils and companies have agreed, via Managed Entry Agreements for certain pharmaceuticals, that companies refund a certain amount of the pharmaceutical costs to the county councils. TLV coordinates this process in the context of three-party deliberations and continuously monitors the outcome of the agreements.
The therapeutic fields with the most agreements are hepatitis C, cancer and TNF inhibitors. It is also these fields where expenditure and treatment costs is high, and where several companies compete.
In the agreement between the Swedish government and the Swedish Association of Local Authorities and Regions (SKL) on government grant for the pharmaceutical benefits, the government and SKL share the refunds that the Manged Entry Agreements generate. In 2017, 70 percent of the refund goes to county councils and 30 percent to the government.