25 September 2017 - Enthusiasm for performance-based risk-sharing arrangements continues but at variable pace across countries. Our objective was to identify and characterise publicly available cases and related trends for these arrangements.

Carlson et al. performed a review of performance-based risk-sharing arrangements (PBRSAs) from 1993 to 2016 using the University of Washington PBRSA Database. Arrangements were categorised according to a previously published taxonomy. Macro-level trends were identified related to the timing of adoption, countries involved, types of arrangements, and disease areas. Our search yielded 437 arrangements. Among these, 183 (41.9%) were categorised as currently active, while 58.1% have expired. 

Five main types of arrangements have been identified, namely coverage with evidence development (149 cases, 34.1%), performance-linked reimbursement (104 cases, 23.8%), conditional treatment continuation (78 cases, 17.8%), financial or utilisation (71 cases, 16.2%), and hybrid schemes with multiple components (35 cases, 8.0%).

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