Patient Access Scheme Patient access schemes (PASs) are confidential pricing agreements proposed by pharmaceutical companies to enable patients to gain access to drugs or other treatments that may not be considered to be cost-effective under normal circumstances. In some forms, they are known as ‘risk sharing’ or ‘rebate’ schemes.
What is a Patient Access Scheme (PAS)?
Patient access schemes are pricing agreements proposed by pharmaceutical companies to enable patients to gain access to these high costs drugs. The Patient Access Scheme Liaison Unit (PASLU) has been set up by NICE to work with companies who are considering a patient access scheme for their drug or treatment.
What is the patient access schemes Liaison Unit?
The Patient Access Schemes Liaison Unit is part of our Centre for Health Technology Evaluation. It was set up when the Department of Health asked NICE to advise on the feasibility of patient access scheme proposals from companies.
When should a patient access scheme be submitted to Nice?
As a general rule, companies should include a patient access scheme when making their initial evidence submission to NICE. This means that any patient access scheme proposal should be sent to NHS England long before the evidence submission for the NICE appraisal.
How long does it take to review patient access schemes?
4.21 Patient access schemes are designed to maximise the opportunity for cost-effective access to a new technology. Therefore, within 12 weeks of publication of the final guidance, companies can request a rapid review to consider new patient access scheme proposals.
Is the Patient Access app free?
The Patient Access app is available on the iOS and Android app stores for free. You can also access the website at www.patientaccess.com. You will need to register for Patient Access either online, if your practice allow this, or by asking for a registration letter from your practice.
What is Patient Access Pharma?
Patient access is controlled by complex interactions between governmental and third-party payers, pharmacy benefit managers (PBMs), distributors, pharmaceutical manufacturers, health systems, and pharmacies that together control the receipt of goods by patients after prescription by clinicians.
Who is incharge of patient access?
A patient access supervisor is a professional who is responsible for supervising a health facility's patient registration, inpatient and outpatient, the financial counseling division, central scheduling, and the PBX department.
What is the difference between patient access and market access?
Patient access focuses on actual product usage. Market access is oftentimes tasked with obtaining strong pricing and favorable reimbursement status, but this mindset ignores real product uptake.
What does a patient access representative do?
Patient Access Representative responsibilities include collecting patient information, preparing various medical documents, and explaining policies to our patients as needed. Ultimately, you will work directly with patients to help them understand the process and steps to obtain medical attention at our organization.
Why is patient Access important in healthcare?
Patient Access often sets the tone for the patient's perception of the organization and their overall care journey. Consumers of health care are looking for the same conveniences, access to information and customer service that they are used to from other industries, such as retail and travel.
What is patient Access Week?
Established in 1982, Patient Access Week is a celebration of the people in Patient Access profession. The date marks the anniversary of the founding of the National Association of Healthcare Access Management (NAHAM), the only national professional organization dedicated to promoting excellence within the field.
What is the difference between patient experience and patient satisfaction?
In brief, patient experience is associated with a patient's perception of care, while patient satisfaction is about the patient's expectations for care.
What is a PAS scheme?
They are sometimes referred to as risk share schemes or market access schemes. PAS have been available via NICE since 2002 and also more recently via the CDF. Although PAS unequivocally aim to improve access to new medicines for NHS patients, it is essential that the costs of operating them and the financial benefits actually realised locally are assessed as carefully as the clinical benefits of the medicines themselves to ensure that they offer the NHS genuine value for money. If PAS are not implemented the NHS may incur unnecessary costs. Implementation of NICE-approved PAS also ensures local compliance with NICE technology appraisal guidance.
What is PAS in healthcare?
Patient Access Scheme (s) (PAS) are one way in which pharmaceutical companies can lower the acquisition cost of a medicine to the NHS, enabling patients to gain access to high cost medicine treatments.
How to sign up for Operational PAS Update?
To sign up for the NICE-maintained Operational PAS Update e-mail list, send an e-mail to [email protected] with 'Operational PAS Update' in the subject line.
Is LPP a PAS?
LPP is continuing the PAS project initiated in 2013, which has now been expanded to encompass all non-cancer and cancer PAS, both NICE-approved and those in the CDF.
What is a patient access scheme?
4.3 A patient access scheme is a scheme proposed by a company that is a member of the 2014 PPRS. Up to January 2018, these were approved by the Department of Health and Social Care, but from January 2018 onwards they are approved by NHS England. Patient access schemes allow patients to have a technology when NICE's assessment of value, on the current evidence base, is unlikely to support the list price.
When can an appraisal committee consider a patient access scheme?
4.15 The appraisal committee can consider a patient access scheme or commercial access agreement proposal before formal approval from NHS England when the risk of non-approval is considered low (for example when the PASLU advice to NHS England supports the proposal). NICE must not release an ACD or FAD until approval of the patient access scheme is received from NHS England.
How long does it take to submit a simple discount proposal to NHS England?
The simple discount proposal must be submitted to NHS England in sufficient time for it to complete its consideration of the proposed scheme and notify NICE at least 14 calendar days before the next committee meeting, to allow sufficient time for ERG or NICE review.
When should a company include a patient access scheme in the context of a NICE appraisal?
When companies wish to propose a patient access scheme in the context of a NICE technology appraisal, they should follow these rules: As a general rule, companies should include a patient access scheme when making their initial evidence submission to NICE.
Does Nice consider patient access schemes?
4.6 NICE can only consider patient access scheme proposals, flexible pricing proposals and commercial access agreements after NHS England has formally approved them (see figure 6 ).
Can a simple discount patient access scheme be accepted at other times in the NICE process?
In exceptional circumstances, a simple discount patient access scheme may be accepted at other times in the NICE process. A simple discount scheme can be proposed:
When was PAS updated?
The PAS Standard Terms were updated in January 2020. All PAS submissions from 1 March 2020 will be governed under these terms. A high proportion of existing PAS in operation is governed by the previous version of the Standard Terms (revised in May 2013), this version has been maintained on the webpage for reference.
Why do companies need to submit PAS?
Companies can submit Patient Access Schemes (PAS) to improve the cost effectiveness of a medicine.
When did PAS start?
Patient Access Schemes (PAS) have been a formal part of the pricing and reimbursement environment in the UK since they were added into the Pharmaceutical Price Regulation Scheme (PPRS) in 2009. They’re defined in the 2014 PPRS as: ‘facilitat [ing] patient access to a medicine where the National Institute for Health and Care Excellence’s (NICE) assessment of value, on the current evidence base, is unlikely to support the list price’. (They’re called lots of other names too, such as risk-sharing schemes).
Is PAS a simple scheme?
Over time, though, PAS have been divided into those that are ‘simple discount schemes’ and those that are ‘complex schemes’ as recognised by the dropping of the taxonomy in the 2014 PPRS. And indeed it does follow practice in the market; analysis of schemes approved by NICE shows the dominance of simple schemes in recent years (Figure 1).
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Details
Guidance for companies considering a Patient Access Scheme (PAS) proposal in England, has been published.
What is PAS in medical?
What are Patient Access Schemes (PAS)? As Andrew explains, “these are schemes that help moderate the price of a new technology for a given disease as considered in the NICE Technology Appraisal process. In these arrangements the list price of the drug remains unchanged, while the actual price of the drug is discounted in order to facilitate patient access.” Their rationale is in the context of the UK list price being used as a reference price in a range of countries.
What is PPRS in healthcare?
A voluntary agreement between the Pharma industry body, the Association of the British Pharmaceutical Industry (ABPI) and the Department of Health, the Pharmaceutical Price Regulation Scheme (PPRS) included agreed principles for Patient Access Schemes in 2009. The PPRS defines the main types of schemes: which range from the simplest type ...
Can a Pharma company use outcomes based PAS?
Although the PPRS does allow the use of outcomes-based PASs there are relatively few such proposals in England and Wales as such schemes often generate new activity for NHS and the manufacturer. However, it does offer clear evidence of the success of a medicine. In this way a Pharma company can provide a direct demonstration of the value of its medicines. This might also be facilitated through the use of other activities such as a register or another existing ways of monitoring patient outcomes and tie the scheme into that. Using such approaches can allow schemes to operate with adding additional burden to the NHS. These are the approaches the more imaginative manufacturers are using in their schemes proposals. A manufacturer thinking of sponsoring a patient register or monitoring scheme should follow best practice to ensure it is operated in an open-access and transparent way, such that the relevant and anonymised information is open to those with legitimate interests, including the pharma companies themselves. This may be a route by which a company might use to develop an outcomes-based PAS for use in the NHS.”
What is patient access?
Patient access (or risk-sharing) schemes are alternative market access agreements between healthcare payers and medical product manufacturers for conditional coverage of promising health technologies. This study aims to identify and characterize patient access schemes to date in the Asia-Pacific region.
Which country has the most patient access schemes?
Australia has the most experience with patient access schemes and its experience may provide useful insights for other Asia-Pacific countries. The main targets are pharmaceuticals likely to have high budget impact (due to high per-patient costs and/or large volumes of use), and pharmaceuticals that may be adopted more widely than indicated. With the proliferation of high-cost medicines, the use of schemes may increase to address rising cost pressures, consumer demands, and uncertainties, while attempting to provide patient access to innovative care within finite budgets. Future research is warranted to evaluate the performance of patient access schemes.
How many schemes were there in South Korea?
We identified 3 schemes in South Korea, 5 in New Zealand, and 98 in Australia. Most (97.2%; n = 103) schemes focused on pharmaceuticals, few on medical technologies. More than half of the schemes related to treatments for cancer and inflammatory diseases such as rheumatoid arthritis. The majority (77.4%; n =82) involved pricing arrangements. Evidence generation schemes were rarely used. About half (41.8%; n = 41) of schemes in Australia were hybrid by nature, consisting of pricing arrangements with a conditional treatment continuation component.
What is price volume agreement?
Price volume agreements; manufacturer committed to pay for the drug if the sales exceed a fixed threshold
