The process of introducing a new health technology into a healthcare system is characterized by uncertainty and risk for those involved—pharmaceutical companies, payers, patients and the government. In view of the accelerated introduction of new technologies in recent years, mechanisms to reduce uncertainty are of growing interest. One example is the Managed Entry Agreement (MEA), which we explore using a mechanism design approach. We make use of the Israeli experience, in which pharmaceutical companies and health plans (i.e., payers) negotiate over the introduction of new technologies into the national Health Services Basket (HSB) with the Ministry of Health acting as a mediator. We use the framework of bargaining within a mechanism design framework to show that in the process of negotiation the parties, the pharmaceutical company (PC) and the health plan (HP), have independent private valuations and that a situation of common knowledge that gains from MEA exists is rare. Adding a mediator (i.e., the MEA team) to the mechanism, as in a direct-revelation mechanism, reduces the level of uncertainty for both sides (i.e., the PC and the HP), thus making it possible to meet the budget constraint while increasing value for patients and enhancing ex-post efficiency.

将新的医疗技术引入医疗保健系统的过程中，涉及的各方（制药公司、付款人、患者和政府）面临不确定性和风险。鉴于近年来新技术的加速引入，减少不确定性的机制越来越受到关注。一个例子是管理进入协议 (MEA)，我们使用一种机制设计方法对其进行了探索。我们利用以色列的经验，其中制药公司和健康计划（即付款人）与卫生部就将新技术引入国家卫生服务篮 (HSB) 进行谈判。我们用一个机制设计框架内的讨价还价的框架来表明，在谈判各方的过程中，制药公司 (PC) 和健康计划 (HP) 具有独立的私人估值，并且存在从 MEA 中获益的公知情况很少见。在机制中添加调解人（即 MEA 团队），就像在直接披露机制中一样，降低了双方（即 PC 和 HP）的不确定性水平，从而可以在满足预算约束的同时为患者增加价值并提高事后效率。