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\nOutcomes-based contracting (OBC) is a growing value-based purchasing strategy used by U.S. healthcare payers to hold pharmaceutical companies responsible for ensuring that their drugs perform according to expectations in a real-world patient setting.<\/p>\n
Key finding: <\/strong>OBCs are increasingly embraced by payers, with 71% of surveyed pharmacy and medical directors from managed care organizations (MCOs) reporting that they either have such contracts now (22% of those surveyed) or plan to have them in the next year (49%). Our results show that for commercial plans, chronic heart failure and other cardiology indications are among the most common indications covered by OBCs, as well as Hepatitis C and oncology.<\/p>\n Interest in OBCs in CHF was generated in 2016 when Cigna and Aetna confirmed contracts with Novartis for Entresto, one of the first branded drugs to be publicly associated with the risk-based contracting strategy.<\/p>\n The \u201cso what\u201d for decision makers: <\/strong>A positive showing in an outcomes-based contract can be a stepping stone to good formulary access, but falling short of expectations often means higher discounts from the drug marketer.<\/p>\n Pharmaceutical companies need to understand the implications of this contracting strategy as part of an overall commercialization strategy, particularly at a time when more payers are demanding proof that expensive new therapies will work as promised.<\/p>\n
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<\/a>Chris Lewis serves as primary research manager, Access and Reimbursement. During her tenure at DRG, Lewis has specialized in tracking and analyzing U.S. market access trends for clients, including reimbursement landscape, managed care, pharmacy benefits, accountable care organizations, Medicare Advantage and Medicaid in each state. She is also a seasoned journalist with a degree in communications from California State University, Sacramento.<\/p>\n","protected":false},"excerpt":{"rendered":"