Implementing a Managed Entry Agreement Framework in Cyprus

ABSTRACT

Introduction

The aim of this study is to explore the current practice in Cyprus regarding the introduction and reimbursement of innovative pharmaceuticals through Managed Entry Agreements (MEA), assess its operational context, and suggest approaches toward spanning the knowledge gap consequential to these efforts, especially the barriers of a small country context.

Areas covered

The recent introduction of a National Health System (NHS), brought about fundamental reforms in Cyprus’ Healthcare sector. Among such reforms, of particular interest, has been the introduction of a Managed Entry Agreements (MEA) mechanism. The first preliminary results indicate that despite being a small and unattractive market, Cyprus can apply a substantial MEA program. Concomitantly, it annotates the need to design an operational framework which should include, the definition of important technical parameters, clear demarcation of the scope, cooperation principles ensuring the effective operation of scientific committees, and clear delineation of what ‘value’ is. Moreover, in the context of the unified healthcare market, budget transfers should be considered, which could alleviate the inordinate budget impact of new products, which nevertheless will cut down on hospital expenditures. Narrative synthesis and health policy analysis-related resources were used.

Expert opinion

The implementation of MEA in Cyprus provides an ideal testing ground for innovative reimbursement approaches. This will streamline the country’s efforts toward reimbursement of innovation, while concomitantly add to the collective MEA experience.

KEYWORDS:

• Cyprus
• cost-effectiveness
• health system transition
• HTA
• MEA implementation
• innovative pharmaceuticals
• small country
• value-based pricing

Article highlights

• The healthcare system in Cyprus is adopting a mainstream implementation of MEA

• This has highlighted the many opportunities arising from the transition as well as the threats

• A necessity exists of a robust and transparent framework to support the transition

• Cyprus as a late-comer, can draw on the experiences of other countries

• Cyprus can take advantage of its small market size while transitioning to the implementation of MEA.

Declaration of interest

O Pitsillidou and P Petrou are employees of Cyprus Health Insurance Organisation (HIO). The views and opinions expressed in this publication are those of the authors. They do not purport to reflect the opinions or views of the HIO. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

O Pitsillidou designed and drafted the article. P Petrou and M Postma provided study material and revised the initial article. All authors read and approved the final manuscript for publication.

Additional information

Funding

This paper was not funded.