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Published: August 18, 2016

Cost versus Cure: Achieving a Value-Based Care Algorithm We Can Live With

August 16, 2016 - Curant Health COO, Marc O'Connor, in Specialty Pharmacy Times - When Specialty Pharmacy Times editorial team proffered the topic of cost versus cure, and the responsibility of the payer (including the employer and patient), prescriber, patient or pharmacy, I hesitated.

Answering the question by making one party more responsible than another reinforces the legacy silos that must be razed if we wish to transform health care into a value-based care system. Arriving at one responsible party would necessitate a single-payer system, which is far from likely in the United States. Since that is the case, every party shares an equal burden of responsibility on decision points relating to cost versus cure.

Cure is the key word. We have cured hepatitis C. But we have yet to cure cancer. In fact, cancer is going to trend toward being a hugely expensive chronic condition in the near future. According to an article by Alice Park in the April 4, 2016 edition of Time, there are currently 3400 immunotherapy trials ongoing in the United States.

The better questions for the editorial team to ask are how long is it going to take the needed parties to engage in non-threatening, meaningful dialogue to create solutions, and who leads that conversation? The short answer to the second question is all of the above and more.

Real alignment among all stakeholders, inclusive of the aforementioned, is arguably the most urgently needed new practice in health care. There must be immediate meaningful discussions about value-based care (including pharmaceutical therapies) and the value of life, led by plan sponsors, commercial and government payers, manufacturers, pharmacy benefit managers, policy makers, patients, and patient advocates.

As with any industry, health care decisions are all about the allocation of scarce resources. Those allocations are based on the value placed on every element that serves or receives service from the industrial players. Perhaps the most difficult assignment of value involves that of the extension of life, a figure that US health care policy makers have yet to quantify.

To read Marc’s full article, visit Specialty Pharmacy Times.

To learn more about Curant Health, contact Kristin Lindsey, Senior Marketing Director, at klindsey@curanthealth.com.

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