EVALUATING A CONCEPTUAL PLATFORM FOR FACILITATING AND SCALING PHARMACEUTICAL RISK SHARING ARRANGEMENTS
Author(s)
Dean BW1, Hinkel JM2, McGivney W2
1Medullan, Arlington, VA, USA, 2McGivney Global Advisors, Wayne, PA, USA
Presentation Documents
Value-based or risk sharing arrangements between biopharmaceutical manufacturers and payers, particularly for higher cost drugs, are of wide interest but as of yet have seen limited implementation in the US and other markets. According to the literature, potential benefits of such arrangements include the ability to link payment to outcomes. However, the literature also acknowledges the many hurdles of implementing such arrangements. One hurdle is the expense of developing such agreements, including the costs associated with data collection, maintenance, and analysis. In some cases, payers have reported that the cost to implement these types of arrangements may exceed the potential savings associated with paying on a performance basis. Another hurdle is the lack of data and technological infrastructure that could facilitate and potentially automate the analytic requirements needed for these arrangements. We theorize a model for developing and implementing risk-sharing arrangements on a common platform that could include elements of automation, economies of scale, and shared administration costs across stakeholders. We have built a data-driven financial simulation and analysis that demonstrates the possibility of constructing multiple arrangements, focused on specialty biopharmaceutical products with an average sales price of above $100,000/year, and reducing administrative expenses associated with such contracts to facilitate the potential existence and scalability of these arrangements. Furthermore, we model potential savings for various clinical scenarios and populations based on implementation of risk-sharing arrangements, and demonstrate cost and savings differentials dependent on estimated setup, maintenance, and transaction fees.
Conference/Value in Health Info
2018-05, ISPOR 2018, Baltimore, MD, USA
Value in Health, Vol. 21, S1 (May 2018)
Code
PCP1
Topic
Health Policy & Regulatory
Disease
Multiple Diseases, Neurological Disorders, Oncology, Systemic Disorders/Conditions