An evaluation of managed access agreements in England based on stakeholder experience.

Autor:	Farmer C; Peninsula Technology Assessment Group (PenTAG), Department of Public Health and Sport Sciences, University of Exeter Medical School, Exeter, UK., Barnish MS; Peninsula Technology Assessment Group (PenTAG), Department of Public Health and Sport Sciences, University of Exeter Medical School, Exeter, UK., Trigg LA; Peninsula Technology Assessment Group (PenTAG), Department of Public Health and Sport Sciences, University of Exeter Medical School, Exeter, UK., Hayward S; Health and Care Public Health Team, North Somerset Council., Shaw N; Peninsula Technology Assessment Group (PenTAG), Department of Public Health and Sport Sciences, University of Exeter Medical School, Exeter, UK., Crathorne L; Peninsula Technology Assessment Group (PenTAG), Department of Public Health and Sport Sciences, University of Exeter Medical School, Exeter, UK., Strong T; Managed Access Team, National Institute for Health and Care Excellence (NICE), London, UK., Groves B; Managed Access Team, National Institute for Health and Care Excellence (NICE), London, UK., Spoors J; Medicines Value and Access Unit, NHS England, London, UK., Melendez Torres GJ; Peninsula Technology Assessment Group (PenTAG), Department of Public Health and Sport Sciences, University of Exeter Medical School, Exeter, UK.
Jazyk:	angličtina
Zdroj:	International journal of technology assessment in health care [Int J Technol Assess Health Care] 2023 Jul 27; Vol. 39 (1), pp. e55. Date of Electronic Publication: 2023 Jul 27.
DOI:	10.1017/S0266462323000478
Abstrakt:	Objectives: The objective of this research was to evaluate managed access policy in England, drawing upon the expertise of a range of stakeholders involved in its implementation. Methods: Seven focus groups were conducted with payer and health technology assessment representatives, clinicians, and representatives from industry and patient/carer organizations within England. Transcripts were analyzed using framework analysis to identify stakeholders' views on the successes and challenges of managed access policy. Results: Stakeholders discussed the many aims of managed access within the National Health Service in England, and how competing aims had affected decision making. While stakeholders highlighted a number of priorities within eligibility criteria for managed access agreements (MAAs), stakeholders agreed that strict eligibility criteria would be challenging to implement due to the highly variable nature of innovative technologies and their indications. Participants highlighted challenges faced with implementing MAAs, including evidence generation, supporting patients during and after the end of MAAs, and agreeing and reinforcing contractual agreements with industry. Conclusions: Managed access is one strategy that can be used by payers to resolve uncertainty for innovative technologies that present challenges for reimbursement and can also deliver earlier access to promising technologies for patients. However, participants cautioned that managed access is not a "silver bullet," and there is a need for greater clarity about the aims of managed access and how these should be prioritized in decision making. Discussions between key stakeholders involved in managed access identified challenges with implementing MAAs and these experiences should be used to inform future managed access policy.
Databáze:	MEDLINE
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