In 2006, Italy has implemented the Good Practices for Performance-Based Risk-Sharing Arrangements (PBRSAs) for high value drugs for critical illnesses. This policy has increased affordability and availability of drugs for critical illness and reduced the financial burden of government. At present, our country is researching the negotiation policy of high value drugs for critical illnesses. The study wants to provide our country with reference to the innovative negotiation policy of high value drugs for critical illnesses by introducing the background, main content, negotiation process and policies of PBRSAs in Italy.