The first objective is to describe the current activities of the Managed Membership Agreement (MEA) in the Middle East and North Africa (MENA), as well as the perception and use of these agreements by pharmaceutical decision-makers; The second objective is to describe the issues and reflect on the uncertainty associated with the implementation of AEDs and the future prospects of AED activities in the region. In recent months, a number of key players in the German health system have spoken out about the possibility of increasingly using managed entry agreements (MEAs) for new high-priced drugs, such as innovative therapy drugs. Josef Hecken, Chairman of the Joint Federal Committee (JCC); The federal joint committee speculated that performance payment contracts could replace discount negotiations for drugs that, at the time of marketing authorization, have an immature evidence base. Due in part to the lack of vaccines in 2018, the federal government wanted to reopen the market to all vaccine manufacturers and accept selective contracts. To this end, The Legislature has incorporated such provisions into the Law on Prior Medical Appointments and Improvement of Medical Care (TSVG), which came into force in May 2019. Although this is not a new regulation for the most part, the statues have since had a specific additional mandate that vaccine rebate agreements under the SHI regulation, which must be concluded between SSIs and pharmaceutical companies, are no longer permitted. In addition, the TSVG limits shi reimbursements for pharmacists to the actual purchase price paid by pharmacists when the vaccines are issued to the manufacturer concerned. In this way, pharmacists were encouraged to reduce individual price negotiations with vaccine manufacturers. Opinions differ as to whether the agreements should be local or regional/national. While these rebates are mandatory, ISS and pharmaceutical companies may also enter into individually negotiated discount agreements on a voluntary basis. The contracting parties have broad discretion over the extent and content of these rebate agreements.
The legal provisions provide only examples of discounts such as. B prices differentiated according to quantity or quantity rebate and also allow (other) differentiated schemes for the organization of discounts. Discount agreements with SSIs can help pharmaceutical companies increase their sales volumes, as pharmacists are generally required to replace discount products with non-discount products. This mechanism can lead to a position in which the drug somehow becomes an exclusive supplier of the reduction product for the reduction product for the shi product concerned. Payers expect the use of innovative price agreements to multiply in Europe.