Today, for many products and countries, non-tariff barriers, such as regulations and technical standards, sanitary and plant health measures, customs formalities and procurement practices, are more important than tariffs or quantitative restrictions.  The rules on non-tariff barriers are defined in a number of GATT provisions (e.g. Article VIII on import and export royalties and formalities) and in several specific WTO agreements, in particular the Technical Barriers to Trade Agreement (TBT)  and the Agreement on the Application of Health and Plant Health Measures (the SPS Agreement) . WTO law includes three broad categories of market access rules: tariff rules (tariffs), quantitative restrictions (quotas) and other non-tariff barriers, such as regulations and technical standards, health and plant health measures, customs formalities and public procurement practices. In addition, transparency and “justiciability” provisions are also included to ensure effective market access.  The OBT and SPS agreements in principle prohibit measures that distinguish between “similar” imported products and domestic products. In addition, the TBT agreement also provides that technical rules are no more restrictive than is necessary to achieve one of the legitimate political objectives set out in the agreement. The SPS agreement provides that health and plant health measures are in line with scientific principles and that there is sufficient scientific evidence to implement these measures, unless these measures are provisionally maintained. (e) obtain the content and operation of the integrated database and access to the integrated database; We conducted a comparative analysis of market access agreements in oncology in the Italian and English NHS based on the available information, in order to assess their experience almost a decade after their introduction.
Towse A: value-based pricing, research and development and patient access systems. Will the UK do it right or wrong?. Br J Clin Pharmacol. 70: 360-366. Under the WTO, Article XVI of the General Agreement on Trade in Services (GATS) provides for the concept of market access for service providers: current and minimal access opportunities are generally implemented in the form of tariff quotas. In the case of minimal access, the current tariff was low or minimal, i.e. low or low, either in absolute terms or at least in proportion to the normal duty applicable to non-tariff quota imports. These tariff quotas, including applicable tariffs and all other tariff quota conditions, are set out in the flight plans of the WTO members concerned. As part of the reform programme, members have shifted their non-tariff measures to equivalent tariffs. Some additional market access is guaranteed by tariff quotas and tariffs are reduced. Emergency protection is provided by special security measures and transparency is ensured by notifications. Some academics argue that P4P or DEC are implemented when the payer perceives a high risk associated with the payment of a drug (it is not certain that financing an expensive drug is good value), and the manufacturer is satisfied that the product is effective (value) .
For newly imported or old drugs for which there is no post-market data, the uncertainty of the payer is more pronounced.