The impact of Managed Entry Agreements on pharmaceutical prices

Simona Gamba, Paolo Pertile, Sabine Vogler

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Managed entry agreements (MEA) have been used for several years, with the aim of curbing the growth of pharmaceutical expenditure and enhancing patient access to innovation. Yet, much remains to be understood about their economic implications. This paper studies the impact of MEAs on list prices, that is prices before the deduction of any discount. Using a theoretical model, we show that, under most price setting regimes, the introduction of a MEA leads to a higher list price. This is confirmed by our empirical analysis of a sample of 156 medicines in six countries, providing a conservative estimate of the increase in price due to the MEA of 5.9%. A relevant policy implication is that payers may overestimate the financial gains that can be achieved through this tool.
Original languageEnglish
Pages (from-to)47-62
Number of pages16
JournalHealth Economics
Publication statusPublished - 2020


  • Managed Entry Agreements
  • Risk-sharing agreements
  • pharmaceutical prices


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