La Organizaci\u00f3n para la Cooperaci\u00f3n y el Desarrollo Econ\u00f3micos\u200b (OCDE, por sus siglas en ingl\u00e9s), acoge la definici\u00f3n de algunos autores indicando que los MEAs son acuerdos entre compa\u00f1\u00edas y pagadores del sistema de salud, que permiten garantizar la cobertura de nuevos medicamentos mientras se gestiona la incertidumbre sobre su desempe\u00f1o e impacto presupuestal (1). En palabras generales, consisten en un conjunto de instrumentos para reducir la incertidumbre y el impacto presupuestario de nuevos medicamentos de alto precio(2).
\n <\/p>\n
Estos acuerdos son usados en, al menos, dos tercios de los pa\u00edses de la OCDE y miembros de la Uni\u00f3n Europea, aunque entre las diversas herramientas para garantizar el acceso de medicamentos en esos pa\u00edses, los MEAs suelen ser menos frecuentes. Estos acuerdos han sido caracterizados de acuerdo con su estructura en financieros y por desempe\u00f1o, y a su vez, cada tipo tiene unos niveles y dise\u00f1os (1).
\n <\/p>\n
Figura 1. Taxonom\u00eda de los Managed Entry Agreements (MEAs)<\/em><\/h5>\n![\"Managed](\"https:\/\/neuroeconomix.com\/wp-content\/uploads\/2022\/05\/Managed-Entry-Agreements1.png\")
<\/a><\/p>\nFuente:<\/strong> Figura adaptada y traducida del documento \u201cPerformance-based managed entry agreements for new medicines\u201d<\/em> p\u00e1g.14 (1).<\/h6>\n <\/p>\n
Los MEAs de tipo financiero est\u00e1n relacionados con la generaci\u00f3n de ahorro o una reducci\u00f3n del gasto en salud y son los m\u00e1s com\u00fanmente usados; mientras que los MEAs por desempe\u00f1o\/resultado est\u00e1n enfocados en el logro de mayores resultados cl\u00ednicos y se presentan de forma menos frecuente. Esto se debe a que, aunque los acuerdos por desempe\u00f1o\/resultado son una herramienta importante para mejorar el acceso a nuevos medicamentos innovadores, existen cuestiones cr\u00edticas que abordar sobre los desenlaces a considerar, la medici\u00f3n de estos, las externalidades que pueden afectar el \u00e9xito de los tratamientos, entre otros.
\n <\/p>\n
Tabla 1. Definici\u00f3n de algunos dise\u00f1os de MEAs usados<\/h5>\n
![\"Managed](\"https:\/\/neuroeconomix.com\/wp-content\/uploads\/2022\/05\/Managed-Entry-Agreements2.png\")
<\/a>
\n <\/p>\n![\"Managed](\"https:\/\/neuroeconomix.com\/wp-content\/uploads\/2022\/05\/Managed-Entry-Agreements4-.png\")
<\/a>![\"Managed](\"https:\/\/neuroeconomix.com\/wp-content\/uploads\/2022\/05\/Managed-Entry-Agreements3-1.png\")
<\/a>
\n <\/p>\nFuente: Tabla adaptada y traducida del documento \u201cPerformance-based managed entry agreements for new medicines\u201d<\/em> p\u00e1g.15-26 (1)<\/h6>\n <\/p>\n
Adicionalmente, existen unos acuerdos por desempe\u00f1o a nivel de paciente donde la cobertura del tratamiento contin\u00faa solo para los pacientes que logran una respuesta preespecificada al tratamiento; las empresas ofrecen productos sin cargo o con descuento para los pacientes que no logran resultados. Un ejemplo de esto son algunos medicamentos para el Alzheimer en Italia en 2007. En este caso el laboratorio proporciona productos sin cargo durante los primeros 3 meses de tratamiento y se eval\u00faa la efectividad a corto plazo. Si los objetivos del tratamiento se cumplen despu\u00e9s de 3 meses, el tratamiento se contin\u00faa durante un m\u00e1ximo de 2 a\u00f1os y la empresa paga por el sistema de salud (1).
\n <\/p>\n
Finalmente, es probable que los MEAs sea m\u00e1s frecuentes e incluso m\u00e1s diversos en los pr\u00f3ximos a\u00f1os, con el lanzamiento continuo de nuevos tratamientos m\u00e1s costosos e innovadores, de la mano con el aumento de la cobertura en salud y la disminuci\u00f3n de las barreras de acceso por parte de los gobiernos (2). Por esta raz\u00f3n, es importante profundizar en su utilizaci\u00f3n como herramienta de negociaci\u00f3n que permita, a trav\u00e9s del dise\u00f1o m\u00e1s adecuado, garantizar a los pacientes la mejor alternativa terap\u00e9utica disponible.
\n <\/p>\n
\n<\/h4>\n\n\n
Referencias <\/span><\/strong><\/p>\n1. <\/span><\/strong>Wenzl M, Chapman S. Performance-based managed entry agreements for new medicines in OECD countries and EU member states: How they work and possible improvements going forward. OECD Health Working Papers [Internet]. 2019;(115). Available from: https:\/\/dx.doi.org\/10.1787\/6e5e4c0f-en<\/p>\n2.<\/strong><\/span> Zampirolli Dias C, Godman B, Gargano LP, Azevedo PS, Garcia MM, Souza Cazarim M, et al. Integrative Review of Managed Entry Agreements: Chances and Limitations. Vol. 38, PharmacoEconomics. Adis; 2020. p. 1165\u201385.<\/p>\n\u00a0<\/span><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":" Los Managed Entry Agreements (MEAs) han sido traducidos de diversas formas como Acuerdos de Entrada Gestionada, Esquemas de Acuerdo Administrativo, o en el caso…<\/p>\n","protected":false},"author":19,"featured_media":14074,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","_kadence_starter_templates_imported_post":false,"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"categories":[4,8],"tags":[87,227,228,576,36,89,90,53,230,577,13,179],"ppma_author":[740],"class_list":["post-12312","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-sistema-de-salud","tag-articulo-72","tag-decreto-433-2018","tag-decreto-710-2018","tag-decretos-433-2-y-710-de-2018-3","tag-iets","tag-invima","tag-ley-1753-de-2015","tag-medicamentos","tag-plan-nacional-de-desarrollo","tag-plan-nacional-de-desarrollo-2014-2018","tag-pnd","tag-puerta-de-entrada"],"taxonomy_info":{"category":[{"value":4,"label":"Blogs 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<\/a><\/p>\nFuente:<\/strong> Figura adaptada y traducida del documento \u201cPerformance-based managed entry agreements for new medicines\u201d<\/em> p\u00e1g.14 (1).<\/h6>\n <\/p>\n
Los MEAs de tipo financiero est\u00e1n relacionados con la generaci\u00f3n de ahorro o una reducci\u00f3n del gasto en salud y son los m\u00e1s com\u00fanmente usados; mientras que los MEAs por desempe\u00f1o\/resultado est\u00e1n enfocados en el logro de mayores resultados cl\u00ednicos y se presentan de forma menos frecuente. Esto se debe a que, aunque los acuerdos por desempe\u00f1o\/resultado son una herramienta importante para mejorar el acceso a nuevos medicamentos innovadores, existen cuestiones cr\u00edticas que abordar sobre los desenlaces a considerar, la medici\u00f3n de estos, las externalidades que pueden afectar el \u00e9xito de los tratamientos, entre otros.
\n <\/p>\n
Tabla 1. Definici\u00f3n de algunos dise\u00f1os de MEAs usados<\/h5>\n
<\/a>
\n <\/p>\n<\/a><\/a>
\n <\/p>\nFuente: Tabla adaptada y traducida del documento \u201cPerformance-based managed entry agreements for new medicines\u201d<\/em> p\u00e1g.15-26 (1)<\/h6>\n <\/p>\n
Adicionalmente, existen unos acuerdos por desempe\u00f1o a nivel de paciente donde la cobertura del tratamiento contin\u00faa solo para los pacientes que logran una respuesta preespecificada al tratamiento; las empresas ofrecen productos sin cargo o con descuento para los pacientes que no logran resultados. Un ejemplo de esto son algunos medicamentos para el Alzheimer en Italia en 2007. En este caso el laboratorio proporciona productos sin cargo durante los primeros 3 meses de tratamiento y se eval\u00faa la efectividad a corto plazo. Si los objetivos del tratamiento se cumplen despu\u00e9s de 3 meses, el tratamiento se contin\u00faa durante un m\u00e1ximo de 2 a\u00f1os y la empresa paga por el sistema de salud (1).
\n <\/p>\n
Finalmente, es probable que los MEAs sea m\u00e1s frecuentes e incluso m\u00e1s diversos en los pr\u00f3ximos a\u00f1os, con el lanzamiento continuo de nuevos tratamientos m\u00e1s costosos e innovadores, de la mano con el aumento de la cobertura en salud y la disminuci\u00f3n de las barreras de acceso por parte de los gobiernos (2). Por esta raz\u00f3n, es importante profundizar en su utilizaci\u00f3n como herramienta de negociaci\u00f3n que permita, a trav\u00e9s del dise\u00f1o m\u00e1s adecuado, garantizar a los pacientes la mejor alternativa terap\u00e9utica disponible.
\n <\/p>\n
\n<\/h4>\n\n\n
Referencias <\/span><\/strong><\/p>\n1. <\/span><\/strong>Wenzl M, Chapman S. Performance-based managed entry agreements for new medicines in OECD countries and EU member states: How they work and possible improvements going forward. OECD Health Working Papers [Internet]. 2019;(115). Available from: https:\/\/dx.doi.org\/10.1787\/6e5e4c0f-en<\/p>\n2.<\/strong><\/span> Zampirolli Dias C, Godman B, Gargano LP, Azevedo PS, Garcia MM, Souza Cazarim M, et al. Integrative Review of Managed Entry Agreements: Chances and Limitations. Vol. 38, PharmacoEconomics. Adis; 2020. p. 1165\u201385.<\/p>\n\u00a0<\/span><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":" Los Managed Entry Agreements (MEAs) han sido traducidos de diversas formas como Acuerdos de Entrada Gestionada, Esquemas de Acuerdo Administrativo, o en el caso…<\/p>\n","protected":false},"author":19,"featured_media":14074,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","_kadence_starter_templates_imported_post":false,"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"categories":[4,8],"tags":[87,227,228,576,36,89,90,53,230,577,13,179],"ppma_author":[740],"class_list":["post-12312","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-sistema-de-salud","tag-articulo-72","tag-decreto-433-2018","tag-decreto-710-2018","tag-decretos-433-2-y-710-de-2018-3","tag-iets","tag-invima","tag-ley-1753-de-2015","tag-medicamentos","tag-plan-nacional-de-desarrollo","tag-plan-nacional-de-desarrollo-2014-2018","tag-pnd","tag-puerta-de-entrada"],"taxonomy_info":{"category":[{"value":4,"label":"Blogs 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\n <\/p>\n
<\/a>\n <\/p>\n
<\/p>\n Adicionalmente, existen unos acuerdos por desempe\u00f1o a nivel de paciente donde la cobertura del tratamiento contin\u00faa solo para los pacientes que logran una respuesta preespecificada al tratamiento; las empresas ofrecen productos sin cargo o con descuento para los pacientes que no logran resultados. Un ejemplo de esto son algunos medicamentos para el Alzheimer en Italia en 2007. En este caso el laboratorio proporciona productos sin cargo durante los primeros 3 meses de tratamiento y se eval\u00faa la efectividad a corto plazo. Si los objetivos del tratamiento se cumplen despu\u00e9s de 3 meses, el tratamiento se contin\u00faa durante un m\u00e1ximo de 2 a\u00f1os y la empresa paga por el sistema de salud (1). Finalmente, es probable que los MEAs sea m\u00e1s frecuentes e incluso m\u00e1s diversos en los pr\u00f3ximos a\u00f1os, con el lanzamiento continuo de nuevos tratamientos m\u00e1s costosos e innovadores, de la mano con el aumento de la cobertura en salud y la disminuci\u00f3n de las barreras de acceso por parte de los gobiernos (2). Por esta raz\u00f3n, es importante profundizar en su utilizaci\u00f3n como herramienta de negociaci\u00f3n que permita, a trav\u00e9s del dise\u00f1o m\u00e1s adecuado, garantizar a los pacientes la mejor alternativa terap\u00e9utica disponible. Referencias <\/span><\/strong><\/p>\n 1. <\/span><\/strong>Wenzl M, Chapman S. Performance-based managed entry agreements for new medicines in OECD countries and EU member states: How they work and possible improvements going forward. OECD Health Working Papers [Internet]. 2019;(115). Available from: https:\/\/dx.doi.org\/10.1787\/6e5e4c0f-en<\/p>\n 2.<\/strong><\/span> Zampirolli Dias C, Godman B, Gargano LP, Azevedo PS, Garcia MM, Souza Cazarim M, et al. Integrative Review of Managed Entry Agreements: Chances and Limitations. Vol. 38, PharmacoEconomics. Adis; 2020. p. 1165\u201385.<\/p>\n \u00a0<\/span><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":" Los Managed Entry Agreements (MEAs) han sido traducidos de diversas formas como Acuerdos de Entrada Gestionada, Esquemas de Acuerdo Administrativo, o en el caso…<\/p>\n","protected":false},"author":19,"featured_media":14074,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","_kadence_starter_templates_imported_post":false,"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"categories":[4,8],"tags":[87,227,228,576,36,89,90,53,230,577,13,179],"ppma_author":[740],"class_list":["post-12312","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-sistema-de-salud","tag-articulo-72","tag-decreto-433-2018","tag-decreto-710-2018","tag-decretos-433-2-y-710-de-2018-3","tag-iets","tag-invima","tag-ley-1753-de-2015","tag-medicamentos","tag-plan-nacional-de-desarrollo","tag-plan-nacional-de-desarrollo-2014-2018","tag-pnd","tag-puerta-de-entrada"],"taxonomy_info":{"category":[{"value":4,"label":"Blogs 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\n <\/p>\nFuente: Tabla adaptada y traducida del documento \u201cPerformance-based managed entry agreements for new medicines\u201d<\/em> p\u00e1g.15-26 (1)<\/h6>\n
\n <\/p>\n
\n <\/p>\n
\n<\/h4>\n\n\n