Qualitative Analysis of Value-Based Contract Experience, Perception, and Future Adoption across Geographies

OBJECTIVES: Value-based healthcare have gained significant attention as a promising approach to improve patient outcomes and overcome reimbursement barriers while managing costs. This study aimed to explore the current state of VBCs, assess payer experiences and perceptions, and analyze future adoption.

METHODS: Insights gathered from in-depth interviews (N=20) conducted with payers (public, private, national, regional) from Europe (Germany, Italy, The Netherlands, Sweden, and Spain), Latin America (Argentina, Brazil, Colombia, and Mexico), Asia-Pacific (APAC) (Australia, China, South Korea, and Taiwan), and the US were qualitatively analyzed.

RESULTS: The findings highlight diverse experiences with VBCs across geographies. In Europe, payers expressed familiarity with VBCs and highlighted positive outcomes, such as improved patient outcomes and enhanced collaborations. However, they also emphasized the administrative burden, impeding broader adoption and leading to negotiations focused on simple price discounts. In Latin America and APAC, the experience varies with the maturity and the capacities of the healthcare system. Less mature markets are more familiar with financial-based agreements (FBAs) allowing for access equity and costs containment. Due to constrained data infrastructures, the adoption of outcome-based agreements (OBAs) remains limited despite acknowledged benefits. Whereas, in Australia, there is a trend to move away from OBAs due to the associated implementation burden and costs. The US payers showed a mixed interest in VBCs, with reservations about the need and the financial benefit. Overall, challenges such as data sharing, outcomes measures, trust, and complex financial flows, were identified as critical factors influencing future adoption of VBCs. While there is more interest in FBAs, there is still an opportunity for OBAs in specific disease areas with expensive drugs i.e., rare diseases

CONCLUSIONS: VBC use is influenced mainly by financial and data capabilities. Stakeholders should address challenges while focusing on standardizing performance measures and promoting collaboration to foster wider adoption of VBCs.