ICYMI: Research shows promise of innovative payment arrangements in reducing costs, improving access

Joe Vandigo
Joe Vandigo March 15, 2018


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To address rising health care costs and help patients better access new medicines, biopharmaceutical companies are sharing financial risk with payers through new payment arrangements, like value-based contracts or results-based contracts (RBCs), which link reimbursement to patient outcomes. Research shows these innovative and flexible ways to pay for medicines can lower out-of-pocket costs and enable patients to access the right treatments the first time around. In fact, a new analysis shows results-based contracts may lower patients’ out-of-pocket costs by 28 percent.

According to two new studies published in the Journal of Managed Care & Specialty Pharmacy, shared-risk contracts, like RBCs, can help reduce the costs associated with providing new medicines to patients. The research, which included surveys of payers and biopharmaceutical companies, found:

  • Biopharmaceutical companies and payers are increasingly pursuing results-based contracts.
  • Both payers and biopharmaceutical companies see reduced costs and improved access as the biggest value drivers associated with these types of arrangements
  • Despite the promise of, and interest in these types of arrangements, risk-sharing contracts are limited by several barriers, including the complex U.S. health care system. This finding underscores the results from two surveys of payers and biopharmaceutical companies carried out last year.

Stakeholders across the health care system are working with policymakers to implement cost saving measures that improve patient outcomes, visit www.phrma.org/value-collaborative.

Topics: Out-of-Pocket Costs, Value-Driven Health Care, The Value Collaborative