In order to make the pharmaceutical budget predictable, an internationally accepted approach of health insurance providers is to shift more and more financial risks to pharmaceutical companies. The major paradox of financial risk-sharing schemes is that increased mortality, poor therapeutic compliance, reduced access to healthcare services, decreasing quality of health care and lack of treatment reduce pharmaceutical spending. Consequently, payers have started to employ reimbursement schemes that enable them to guarantee health gain and quality of service. Introduction of a risk-sharing scheme based on outcome and compliance can be a major advancement in the strategy of the Hungarian National Health Insurance Fund (NHIF). Funding schemes that guarantee therapeutic benefit can help reduce the uncertainty in coverage decisions regarding high-value, innovative healthcare technologies. However, justification of the parallel use of financial and outcomebased risk-sharing on the micro level is questionable. Even if the primary objective of the NHIF is to ensure the sustainbility of the public pharmaceutical budget, financial risks should be managed on the macro level.
|Translated title of the contribution||The role of risk sharing in drug funding|
|Number of pages||5|
|Journal||Lege Artis Medicinae|
|Publication status||Published - Apr 1 2010|
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