Value-based programs between biopharmaceutical companies and pharmacy benefit manager Express Scripts saved $4.3 billion on medicines last year. Patients in these plans with innovative contracting arrangements taking cholesterol-lowering medicines saved nearly $800,000 out of pocket.
In these arrangements, biopharmaceutical companies agree to take on more risk and be reimbursed based on how well medicines work for patients. This can lead to lower copays and coinsurance for patients, allowing them to access the right treatments the first time.
In addition to out-of-pocket savings, patients also saw the benefits of improved care coordination from these innovative contracting arrangements, which included over 100 different medicines. For example, multiple sclerosis patients, for whom adherence is critical, had an average adherence rate of nearly 85% where an innovative contract was in place, compared to an average adherence rate of 25% among all individuals with MS. All Express Scripts plans that used innovative contracting arrangements saw better care and lower spending compared to plans without innovative contracting in every participating therapeutic class.
This adds to growing evidence that innovative contracts can lower out-of-pocket costs and enable patients to access the right treatments the first time. To learn more, visit www.phrma.org/value-collaborative.
Katie Koziara is a director of public affairs at PhRMA focusing on the organization’s executive visibility work and media relations strategy. She previously ran the social media strategy for a D.C.-based non-profit working on federal management and leadership issues. Katie earned her B.A. in Public Policy from the University of Michigan’s Ford School and is currently earning her M.A. in Fiction Writing from Johns Hopkins University.