ABSTRACT
This chapter reviews the implementation of Managed Entry Agreements (MEAs) in a selection of markets with a wide range of experience in innovative contracting. It discusses the past and current MEA trends and illustrates those with representative examples of innovative contracts. The chapter analyses the key hurdles and success factors relative to the implementation of MEAs across these jurisdictions, to guide companies and payers interested in developing agreements that suit their needs. It discusses future trends in the field of innovative contracting. Classical price-volume agreements (PVAs), rebates, or budget caps are the most common MEAs in France. PVA are also the source of most refunds paid by manufacturers in France. The Italian Medicines Agency has been the most prolific in Europe in terms of MEAs. In the past, the National Institute for Health and Care Excellence tended to enter into complex agreements that were designed to address cost-effectiveness uncertainty.
