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Insurers trying to peg drug payments to patient outcomes


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More health-insurance plans want to pay for drugs based on patient outcomes as drug makers keep cranking up prices, with prescription medications  now accounting for perhaps over 20 percent of total healthcare costs.

STAT, a sister publication of The Boston Globe reports:

“In these arrangements, a health plan may get an extra discount from a drug maker if a medicine does not help patients as much as expected, or a drug maker may get a credit toward a rebate provided to a health plan.”

“Much of the interest  {has} centered on expensive specialty drugs. For instance, 53 percent of plans expressed high or very high interest in contracts for oncology medications, 41 percent said the same thing about rheumatoid arthritis drugs, and 35 percent pointed to multiple sclerosis treatments.”

Dan Mendelson, who runs Avalere Health, told STAT that  the interest in outcomes-based contracts is “dramatically accelerating right now because the data are available, and it’s getting much easier to track drug performance. In fact, more plans are starting to demand it.”

T0 read the STAT article, please hit this link.

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