February 13, 2017 - Curant Health COO, Marc O'Connor, in Specialty Pharmacy Times - In December 2016, QuintilesIMS reported that US spending on prescription medications will reach upwards of $675 billion by 2021.
The pricing pressure on manufacturers is expected to grow along with the demand that specialty therapies, in particular, demonstrate positive outcomes in real-world conditions, as the shift from fee-for-service to value-based care accelerates, regardless of future shifts in health care policy.
To date, value-based contracts among pharmaceutical manufacturers and payers have not achieved the adoption and success levels necessary to drive significant systemic change, because many of these agreements cover only one drug, and/or rely on simple volumetric math as the arbiter of contractual conditions and payment.
The concept of contracts that base reimbursement on the broader notion of improved patient outcomes, in addition to drug efficacy, is compelling and could quickly gain traction. Manufacturers stand to benefit from pharmacy and medication therapy management partners with proven capabilities in improving adherence and patient engagement that result in positive health outcomes, such as sustained virologic response, thereby realizing the full financial potential of their specialty therapies.
Manufacturers appear open to advancing and improving value-based contracts. In a November 2016 column for Forbes, Novartis CEO Joseph Jimenez wrote, “We believe in the efficacy of our products, and by collaborating with payers on solutions for reimbursement, we hope to help start a shift toward value pricing in the health care system.
We want to be rewarded for the tangible outcomes our products provide patients, not for simply selling pills.” Specialty pharmacies and medication management providers that offer effective medication therapy management, along with support teams that deliver valuable patient care and report real-world outcomes, are best suited to serve as arbiters of the next generation of value-based contracts.
To read Marc's full article, visit Specialty Pharmacy Times.
To learn more about Curant Health, contact Kristin Lindsey, Senior Marketing Director, at firstname.lastname@example.org.