Note: This taxonomy is based solely on the structure of the agreements. All types of agreements mentioned above may exist not only between companies and health organizations, but also between companies and other types of institutions that constitute a health system, including government agencies or national authorities responsible for making coverage or pricing decisions and/or evaluating health technologies (HTA), regional health authorities, health care providers, etc. In particular, for products used in hospitals, MEAs may be available between companies and hospitals. Source: authors of the study based on Carlson (2010), Ferrario and Kanavos (2013) and Gerkens et al. (2017). On 16 April 2020, the Belgian Parliament adopted a new law aimed at increasing the transparency of managed authorisation agreements (mea) between pharmaceutical companies and the National Institute of Health and Disability Insurance (NIHDI). The MEAS defines confidential compensation mechanisms for the Belgian government with regard to the price listed and the reimbursement base of the drugs concerned. The law provides that when the House of Representatives of the Belgian Parliament orders administrative control, the Court of Auditors has unlimited access to MEAs, including their confidential parts. There are also ongoing activities, particularly among LDCs, to improve the activities and influence of drug and therapy committees (DTCs) to improve the rational use of drugs, particularly in their hospitals, as it can vary (126, 240, 241). These activities can be reinforced by the introduction of legislation and other measures to strengthen the role of the DBA, as currently observed in South Africa (240, 242). This is based on activities carried out by Western countries to improve the rational use of medicines in general and after their introduction, including the interface (125). Research is also underway in Stockholm, Sweden, to document the effects of DBA on the influence on the use of new drugs, given the continuing pressure on resources.
Overall, Sweden, including the Stockholm Regional Council, was one of the main countries that coordinated such activities to improve controlled access to new medicines and did not guide other countries (136). It`s going to go on like this. A number of approaches were discussed to fund new drugs evaluated that would overcome current barriers.