High-Priced Drugs For Rare Disease: Leading US Payers Discuss Cost Concerns, Value-Based Contracts And ICER

There are as many rare disease patients as there are diabetics, Cigna’s Steve Miller notes, arguing that exorbitant prices for each treatment could drive counterproductive categorical exclusions by payers.

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OptumRx Inc. chief formulary and procurement officer Kent Rogers, Cigna Corp. chief clinical officer Steve Miller and Harvard-Pilgrim Health Care chief medical officer Michael Sherman offered their perspectives on reimbursement for high-cost therapies, both chronic and curative, at the Biotechnology Innovation Organization virtual international convention. They were joined by Jason Tardio, chief commercial officer for Ovid Therapeutics Inc., which is developing treatments for rare disease.

The panel discussion, moderated by Real Endpoints CEO Jeff Berkowitz, focused on pharmacy benefit manager and payer concerns with affordability,...

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