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Options, Expertise And Risk Tolerance Needed For Successful Value-Based Contracts

 
• By Ben Comer

Biohaven Pharmaceuticals developed six different value-based contracting options to support the launch of acute migraine therapy, Nurtec ODT. Despite contract complexity and lingering regulatory risk, payers are aggressively pursuing value-based contracts, leading even small biopharmas to invest in strong health economics capabilities.

risk and reward
• Source: Shutterstock

Value-based contracts promise to make costs more predictable for payers, drugs more accessible to patients, and product value more demonstrable for biopharma companies – at least when they go according to plan. Unfortunately, most companies do not reveal the details of these risk-sharing deals, and whether they ultimately achieve those intended goals. But there is reason to believe that value-based contracts are continuing to gain traction in the US, especially for high-priced gene and cell therapies, and rare disease drugs.

Prime Therapeutics, a pharmacy benefits manager (PBM) owned by 18 Blue Cross Blue Shield plans and serving over 30 million...

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