Under the deal, UPMC Health plan will pay for AstraZeneca’s blood thinner Brilinta based on how well patients respond. If Brilinta, used in patients who have suffered a heart attack, fails to prevent another attack within 12 months, UMPC will pay less for the drug. If Brilinta prevents a heart attack in the 12-month period, the health plan will pay more for the drug.
The deal also reduces patient copay to $10 per month, down from about $45 for a one-month supply, bringing the cost closer to generic versions of blood-thinning medications.
The agreement marks the first time an outcomes-based contract has been coupled with a mechanism that also lowers out-of-pocket costs for consumers.
“There are many patients today who are not taking their [blood thinners] because they say their out-of-pocket costs are too high,” Rick Suarez, senior vice president of market access at AstraZeneca, told STAT. “This is a way to move the conversation away from list price, and, in turn, for the government to see there can be cost savings in the overall health care system.”
Stacie Dusetzina, associate professor of health policy at Vanderbilt University Medical Center, who studies drug pricing, told STAT that the contract also may boost patient medication adherence.
“The novel aspect is that they are creating incentives for patients for these value-based contracts. They’re allowing them to pay less up front for using the product, which is an important advance over other contracts that have been made public,” she said.
Read the full report here.
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