Reconciling uncertainty of costs and outcomes with the need for access to orphan medicinal products: a comparative study of managed entry agreements across seven European countries

Table 1 Overview of MEAs identified across five European countries, described by country and design

Types of MEAs	Countries					Number of MEAs
	B	E	I	NL	S
Performance-based arrangements						23
Performance-linked reimbursement schemes						8
Money-back guarantees			x			8
Coverage with evidence development (CED)						15
CED ‘only with research’				x	x	15
Financial-based arrangements						19
Patient-level financial schemes						10
Discounted treatment initiation			x			6
Patient utilisation cap		x				2
Patient cost cap	x	x				2
Population-level financial schemes						9
Discount	x	x	x			7
Price-volume agreement with budget cap	x					2
Grand total	4	8	15	10	5	42

ISSN: 1750-1172