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.  In effect, they are usually forms of simple price discounting, which enable companies to retain control of (undiscounted) list prices across countries but also, in principle, facilitate renegotiations of the discount should the need arise.  Principles and terms for these schemes were set out in the 2014 Pharmaceutical Price Regulation Scheme (PPRS).  More complex schemes include outcomes-based dose caps, rebates and upfront free stock.  Proposed schemes in England are presented to NICE (PAS Liaison Unit) which provides initial guidance, assesses them for feasibility, and then advices NHS England.  Similar arrangements for Scotland are co-ordinated by the Scottish Medicines Consortium.  If a medicine subject to a PAS becomes a comparator in a technology appraisal for a new intervention, it is the discounted (post-PAS) price that will need to be considered in that appraisal.


How to cite: Patient Access Scheme [online]. (2016). York; York Health Economics Consortium; 2016.