Presentation (CTI)

OBJECTIVES: The US healthcare system is experiencing a shift in how pharmaceutical innovations are paid for by the healthcare system. Traditional fee-for-service models are increasingly being challenged by more dynamic, outcomes-focused (or value-based) approaches that align financial incentives with patient health outcomes. Value-based agreements (VBAs) are gaining attention as a potential solution to improve access to innovative yet costly therapies.
This poster examines the evolving VBA landscape in the US, focusing on current implementation, barriers, and future potential. It also aims to identify key learnings from Europe’s experience with VBAs to inform US implementation.
METHODS: We conducted a targeted literature review assessed the current VBA landscape and analysed influencing factors. A case study review of VBAs across the EU and US was conducted to compare differences in implementation and impact on access. A survey of US pharmaceutical companies was conducted to gauge insights into current and future VBA use, including perceived opportunities and barriers.
RESULTS: VBA implementation remains limited, with one study reporting approximately one-third of respondents successfully implementing a VBA since 2020. Key barriers to VBA implementation in the US include uncertainty as to the long-term therapeutic benefits, regulatory challenges and administrative burden. Survey results indicate gene therapies followed by oncology are viewed as areas with the most potential for future VBA use. Furthermore, case study analysis indicates successful VBA use in the EU has been contingent on strong data infrastructure, stakeholder engagement and legal support frameworks.
CONCLUSIONS: VBAs show promise in improving patient access to innovative therapies in the US, particularly in gene therapy and oncology. Overcoming barriers and learning from EU experiences could accelerate VBA adoption, potentially enhancing patient outcomes and aligning financial incentives with therapeutic value.