Posts by viadmin

Innovative Contracting: Healthcare Reform A Key Catalyst

Posted on Tuesday, January 17, 2012

By Katya Svoboda and Alexis Matos Given the difficulty of implementing risk-sharing deals in Europe, should manufacturers in the U.S. even bother setting up these complex arrangements? After all, these innovative contracts, typically tied to a drug’s performance, are notoriously tough to put in place. In many cases the systems required to capture the relevant data are missing, and the lack of coordination between medical and pharmacy benefits means conflicting incentives could be operating within the same payer organization. Still, we believe the Affordable Care Act is the necessary catalyst for more innovative contracting. Three features of the ACA have the greatest potential for stimulating interest in developing innovative contracts:  comparative effectiveness research, private health exchanges, and a biosimilar approval pathway. Let us explain. One of the sticking points of pay-for-performance (P4P) agreements is getting payers and product makers to agree on the actual standards against which a given drug or device should be measured. Since the ACA supports comparative effectiveness research efforts, the law facilitates the creation of outcomes-based standards that all parties can agree on when establishing contracts. Enhanced data systems will then help payers and manufacturers measure and share outcomes markers. New health care exchanges, which are expected to insure more than 17 million new patients...

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