January 3, 2017 - Curant Health COO, Marc O'Connor, in Managed Healthcare Executive - Every year, the business of healthcare gathers en masse at the annual J.P. Morgan Healthcare Conference. This year’s conference will be held January 9 to January 12 in San Francisco. What will we learn? What will we hear? What will be missing?
Because of the nature of the forum, companies are a bit light in presenting substance when it comes to patient care. This conference is about the healthcare business, not necessarily the patient care business. The conference is an opportunity to highlight value to the entire continuum by putting the focus on the patient from which positive outcomes in personal health, population health and economic health emanate.
Here are three things to watch at this year’s conference:
1. At-risk contracts 2.0: Will real value make an appearance?
Every year we hear about new therapies that have completed phase three trials and are about to be commercially launched, along with the manufacturers speaking to their drugs’ pricing. The CEOs of pharma manufacturers will, of course, be messaging directly to analysts.
From the payers and PBMs, we will hear pushback on the cost of specialty medications and that manufacturers may be cut out of payers’ formularies if pricing, value and efficacy are not proven for new specialty therapies.
The movement toward value-based pharma arrived in late 2015 with Amgen’s pay for performance agreement with Harvard Pilgrim for the PCSK9 inhibitor Repatha. Yet the first generation of at-risk contracts between manufacturers and payers appeared to be little more than value-based window dressing.
From an article I wrote earlier this year in Managed Healthcare Executive, “As the only drug on formulary within these agreements, manufacturers are still banking on a simple volumetric percentage of efficacy to meet payment and profit goals. Real improvements in outcomes and value-based contracts require more lifestyle factor measurement and corresponding agreement on their evaluation.”
Curant Health President and CEO, Patrick Dunham, along with Javier Mendez, VP Pharmacy Operations for Virginia Premier Health Plan, discussed four key components for successful outcomes-based contracts at the Asembia 2016 conference. They include engagement of pharmacy partners with medication management protocols shown to improve adherence and outcomes, agreed upon up-front data sharing and outcomes measurement, and neutral arbiters of that data in order to achieve their value-based potential.
What can we learn about the latest at-risk contracts between manufacturers and payers at J.P. Morgan 2017? Is either party improving value, where value is defined as outcomes divided by cost? We are eager to find out.
To read Marc's full article, visit Managed Healthcare Executive.
To learn more about Curant Health, contact Kristin Lindsey, Senior Marketing Director, at klindsey@curanthealth.com.