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The Outcomes-Based Reimbursement Experiment

 
• By Jessica Merrill

US payers and drug companies are showing interest in outcomes-based contracts and even implementing some but whether they will become the reimbursement arrangements of the future remains highly uncertain.

Value-based reimbursement contracts between pharmaceutical manufacturers and US payers appear to be gaining momentum, with several such contracts signed in the last year. But while tying the cost of a drug to the value it delivers appeals to both payers and drug manufacturers, regulatory roadblocks and execution challenges will limit their adoption in the near term. Their viability long-term will probably depend on the savings they deliver to the US healthcare system.

The shift towards outcomes-based reimbursement is in some ways a middle ground for insurers and drug companies. The insurer is looking to save money when a drug is not working...

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