October 2, 2015 - Curant COO, Marc O'Connor and Curant HCV Program Director, Amy Hampton in Managed Healthcare Executive - The days of biopharmaceutical manufacturers and payers operating in isolation are over. Trapped in the firestorm of prior authorizations, high-deductible plans and ultra-high-cost medications are the patients who need all the help they can get to not only access, but adhere to their therapies.
From the head-spinning blowback on PCSK9 inhibitor pricing to the ham-fisted Turing Pharmaceuticals Daraprim snafu, biopharmaceutical manufacturers can be assured that more pricing scrutiny is coming for all high-cost therapies. In the future, biopharmaceutical manufacturers will need to go “at risk” in some contracts--accepting lower prices or zero payment if high-cost therapies do not demonstrate their value where outcomes divided by costs create measurable, meaningful results.
Rather than just hammering down on drug pricing and laying out a list of programmatic demands on manufacturers, managed care executives can bring the following resources to smooth “at-risk” negotiations aligning all parties for value-based success.
Leverage or create programs that measure and improve adherence beyond MPR.
One key element manufacturers will seek in “at-risk” negotiations is programs that positively affect outcomes once the drug leaves the pharmacy. Medication possession ratio (MPR) alone is not a sufficient metric for therapy compliance. Metrics on accessibility, abandonment rates and adherence data beyond refill claims data are needed. Implementation and leveraging of programs that improve adherence, mitigate negative side effects, improve access and patient education will improve the likelihood a manufacturer will be receptive to some risk-sharing.
To read Marc and Amy's full article, visit Managed Healthcare Executive.
To learn more about Curant Health, contact Kristin Lindsey, Marketing Director, at klindsey@curanthealth.com.