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4 characteristics of a good JV arrangement

A risk-sharing arrangement provides the payer with sufficient evidence to make a decision regarding the performance uncertainty of a new product. Therefore, the question arises, what characteristics should this type of agreement have?


  1. They must propose an innovative and different way of distributing risk, compared to traditional payer-provider agreements. In this way, it can be said that it is a investment that reduces uncertainty
  2. There must be a data collection program, which is the most appropriate way to establish the efficacy, safety and cost-effectiveness of the technology of interest. The collection may be based on overall results from a population or on the follow-up of individual patients. The latter would be better because decisions would be made based on information from local patients.
  3. The collection of information, agreed in the joint risk agreement, must begin in the period after regulatory approvalThis does not mean that the data generated must be presented as post-marketing epidemiological evidence.
  4. The price, refund or rental of the product must be linked to the results of the data collection program. Remember these agreements must be focused on the health outcomes of patients.

Finally, it should be added that the decision to enter into these agreements or not is also subject to an analysis of uncertainty: The result of the studies, within the framework of joint venture agreements, is generally information that proves the suitability of the use of a technology in a cohort of patients. In this way, you can know if the patient group technology goal (which is determined based on clinical evidence) is really the group that would benefit from using this in the local context. Therefore, you must ask yourself:

Is it worth investing in the generation of local evidence to generate possible savings through a better allocation of resources?

Note that both the creator of the technology and the logistics operator and the payer have a different view of the concept of value that brings a new technology.

Therefore, it is their duty that the design of the agreement, the outcomes to be evaluated and the definitions of success or not of the intervention, satisfy the interests of all the actors involved and their different points of view.

If you want to delve into the subject, we recommend reading Garrison's publication et al from 2013: Performance-Based risk-sharing arrangements — good practices for design, implementation, and evaluation. Value in Health No. 16.


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