There is considerable international experience regarding the use
of RSAs to draw upon
„X RSAs are not mandatory in any market. Use of RSAs should be selective
and based on negotiation between the manufacturer and the payers.
„X Simple agreements are generally preferred
- Interest from payers tends to focus on financial agreements with mixed
interest in outcomes-based deals
- Outcomes-based agreements are more difficult to execute but can add value
„X RSAs can improve access but when RSAs are used as a cost containment
process on top of other cost containment processes, they can increase
delays with little benefit
„X It is important to use RSAs that address the challenges in the market but
an appropriate process is also required
- Predictability, defined timelines and confidentiality are key components
„X Countries should assess the impact of RSAs periodically to ensure that
they are working as intended (i.e. overcoming the key challenges faced)