The simple economics of risk-sharing agreements between the NHS and the pharmaceutical industry

The Janssen-Cilag proposal for a risk-sharing agreement regarding bortezomib received a welcome signal from NICE. The Office of Fair Trading report included risk-sharing agreements as an available tool for the National Health Service. Nonetheless, recent discussions have somewhat neglected the economic fundamentals underlying risk-sharing agreements. We argue here that risk-sharing agreements, although attractive due to the principle of paying by results, also entail risks. Too many patients may be put under treatment even with a low success probability. Prices are likely to be adjusted upward, in anticipation of future risk-sharing agreements between the pharmaceutical company and the third-party payer. An available instrument is a verification cost per patient treated, which allows obtaining the first-best allocation of patients to the new treatment, under the risk sharing agreement. Overall, the welfare effects of risk-sharing agreements are ambiguous, and care must be taken with their use.

Raptos, sequestros e tomada de reféns

In this thesis we address the paradigms and inconsistencies involving crisis kidnappings and hostage-taking. This work particularly focuses on foreign hostages seized by terrorists and guerrilla movements. It highlights major global events that have contributed to the collective awareness of the phenomenon and the evolution of international agreements and protocols. We focus on the episodes involving Portugal or Portuguese abroad, particularly on the kidnapping of Portuguese in the Cabinda enclave. It also deals with the problems associated with the payment of ransoms, the increasing involvement of private agents in addressing these crises, and incongruities in the motivations of the kidnappers.