Posted by Michael Wonder on 13 Sep 2017
Drug companies tie costs to outcomes
12 September 2017 - But early signs show little evidence that the plans lower prices.
For decades, health insurers and patients have paid for prescription drugs based on the volume of pills or vials purchased—whether or not the medicines helped individual patients as intended.
Now the outcry over high drug prices has raised the profile of a different approach to paying for prescription drugs. Pharmaceutical companies increasingly are offering to tie a portion of their reimbursements from insurers to how well drugs work in patients.
In effect, such agreements say that if for some patients certain drugs don’t meet preset targets for performance, the drug companies will accept less reimbursement, thus lowering the cost for consumers. In some cases such rebates are applied on an individual basis; in others they are applied more broadly—for example, to all patients taking a medicine that average test results show is underperforming.
