1 November 2016 - U.S. commercial payers and pharmaceutical companies have rarely engaged in outcomes-based risk-sharing arrangements, at least until recently. 

Between January 1993 and December 2013, there were only 18 such deals in the United States, most of them involving Medicare (Am J Manag Care 2015;21[9]:632-40). Performance-based risk-sharing deals allow payers to hedge their bets with new drugs, according to Louis P. Garrison, Jr., PhD, an emeritus health economics professor at the University of Washington and lead author of the analysis. For pharma, they may provide access and compelling data to help grow market share.

“The core driver in risk-sharing agreements is some sort of question or uncertainty about the true clinical impact of the medicine in the real world,” Garrison says. “This uncertainty about the clinical impact leads to uncertainty about its cost-effectiveness and thus value.”

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