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Risk sharing schemes on both sides of the pond
Proving value to national health technology assessment (HTA) agencies and gaining national reimbursement listing may no longer assure nationwide market access of a product. For countries such as Italy, Spain, Portugal, and to some extent France, negotiations also take place at local payer level, which may mean specific schemes will be needed in certain regions to ensure patients can gain equitable access to medicines. However, so far risk sharing schemes at a national level, have proven complex, expensive to run and difficult to implement, yet as austerity continues to bite, these may become more commonplace.
Across the pond in the US, risk sharing schemes have rarely been used; however, health reforms are resulting in a shift of risk from payers to providers. The fragmentation in the US payer landscape may be a deterrent to enter such schemes, but according to some, it could be possible if Medicare entered these arrangements, as about 50% of oncology patients are covered by Medicare. As the environment evolves towards specialty medicines, people are crying out for these kinds of solutions to cope with the associated growing cost, and therefore a serious change may be expected within three years.
U.S. government eyes risk-sharing in housing bonds
Fannie Mae and Freddie Mac buy mortgages from lenders to free up cash for banks to make more loans. The two companies then repackage the loans for sale to investors as securities and charge fees to guarantee the debt.Under the private-sector risk-sharing idea, they would begin to issue some bonds without a federal guarantee.Investors in those securities would receive a higher return to compensate them for the greater risk of losses, according to the people familiar with the matter. The Wall Street Journal first reported on the possibility on Friday.The idea is just in the concept stage. The administration could consider a variety of ways to get investors to take on more credit risk, one source said.The administration and housing regulators are eyeing the possibility of using derivatives or relying on greater mortgage insurance coverage for the loans underlying the bonds to spur private-sector interest, according to the sources.Any final plan on investor risk sharing would require the approval of the Federal Housing Finance Agency, which oversees Fannie Mae and Freddie Mac.The Obama administration would like to begin testing ideas to bring in greater private-sector involvement as early as next year, the sources said.The approach under consideration would reduce the long-term risk exposure of Fannie and Freddie. Together with the Federal Housing Administration, the companies now fund roughly 90 percent of all new U.S. mortgages.FHFA's acting director, Edward DeMarco, said in a speech last month that his agency is considering various alternatives to attract private investors to the market through different types of risk-sharing structures.
U.S. government eyes risk-sharing in housing bonds
Fannie Mae and Freddie Mac buy mortgages from lenders to free up cash for banks to make more loans. The two companies then repackage the loans for sale to investors as securities and charge fees to guarantee the debt.Under the private-sector risk-sharing idea, they would begin to issue some bonds without a federal guarantee.Investors in those securities would receive a higher return to compensate them for the greater risk of losses, according to the people familiar with the matter. The Wall Street Journal first reported on the possibility on Friday.The idea is just in the concept stage. The administration could consider a variety of ways to get investors to take on more credit risk, one source said.The administration and housing regulators are eyeing the possibility of using derivatives or relying on greater mortgage insurance coverage for the loans underlying the bonds to spur private-sector interest, according to the sources.Any final plan on investor risk sharing would require the approval of the Federal Housing Finance Agency, which oversees Fannie Mae and Freddie Mac.The Obama administration would like to begin testing ideas to bring in greater private-sector involvement as early as next year, the sources said.The approach under consideration would reduce the long-term risk exposure of Fannie and Freddie. Together with the Federal Housing Administration, the companies now fund roughly 90 percent of all new U.S. mortgages.FHFA's acting director, Edward DeMarco, said in a speech last month that his agency is considering various alternatives to attract private investors to the market through different types of risk-sharing structures.