Problem Statement: Innovative contracts have long been hailed as a solution to improve patient access to medicines. However, the challenges associated with their management have prevented their widespread adoption and ability to scale.

Description: In order to enable greater access to an innovative medicine for a rare disease, a pharmaceutical company and a hospital in Ireland agreed an innovative complex pricing agreement which would enable access to the Irish patient population. However, as the patient population increased, the administrative burden of managing the contract became increasingly time-consuming and complex from a data extraction, calculation and adjudication perspective. To support the management of the contract, the pharmaceutical company and the healthcare provider agreed to explore the use of digital tools to automate the process and perform the previously manual data transformation, data validation and calculations. Through the use of a digital, cloud-based platform to automate these processes, the benefits were as follows: the hours saved across the two organisations amounted to >15 days per month, the tool reduced the delays in rebate calculations, increased data validations in order to identify and flag any potential errors and enabled the scaling of the contract to a larger patient population. The use of the platform also allowed for the transformation of data from >80 documents to a single source, whilst remaining compliant with GDPR and data privacy. The insights generated from the platform also enabled both the provider and the pharmaceutical company to understand better the product usage, patient population and identify additional trends within the patient population.

Lessons Learned: Innovative pricing arrangements can be used to support increased patient access, and with the use of digital tools challenges associated with these types of agreements can be mitigated, enabling these models to scale and ultimately benefit more patients.

Stakeholder perspective: Industry