Category: Value-based Contracts

Health insurer Cigna Corp. has announced it has negotiated a value-based contract for Praluent, a new cholesterol-lowering drug belonging to a the class of PCSK9 inhibitors. Praluent, is co-marketed by Sanofi SA and Regeneron Pharmaceuticals Inc.

The drug costs at least $14,000 a year, and Cigna negotiated an undisclosed discount off the list price.

If Cigna-insured patients who take the drugs aren’t able to reduce LDL cholesterol at least as well as what was shown in clinical trials, the manufacturers will further discount the costs of the drugs—and not just for patients who didn’t meet the cholesterol goals. If the drugs meet or exceed expectations, the original negotiated price stays, according to Cigna.

This is viewed as a significant step in a broader push to tie the cost of drugs to how well they work.

Get the full story @ WSJ 

downloadBeginning as early as January 2017, the agency will be seeking “risk-sharing” deals with pharmaceutical manufacturers to link drug payments with patient outcomes. @ CMS.gov

CMS’s surprise announcement was soon followed by a report from the Department of Health and Human Services, “Observations on Trends in Prescription Drug Spending”. The report turns the spotlight on the shift toward more expensive prescriptions—rather than changes in the total quantity of prescriptions. @ HHS.

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novartis

Novartis has entered a performance-based pricing pact with U.S. health insurance majors Cigna and Aetna for Entresto, its new congestive heart failure drug.

The novel deal crafts payment schemes based on patient outcomes and comes as drug companies are under pressure to lower prices. Cigna says the deal ties the price of Entresto to how well it improves the health of patients relative to its performance in clinical trials. @ Drug Discovery & Development

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