Innovative payment models helping provide patient access to new medicines in USA

As we continue to make remarkable strides to treat our most costly and challenging diseases, there is a renewed focus on ensuring patients have access to the most innovative medicines, wrote Holly Campbell on the Pharmaceutical Research and Manufacturers of America (PhRMA) Catalyst on May 5.

Increasingly, biopharmaceutical companies are entering into value-based contracts with payers – such as payment models that link reimbursement to patient outcomes. By doing so, payers and biopharmaceutical companies are working together to control costs and provide patients access to new, life-saving treatments.

A recent AP story highlights a few examples that demonstrate how value-based arrangements can improve patient access by reducing payer risks. These innovative payment models are structured to provide a win-win for patients and health plans. Under these arrangements, health plans often provide better access to the newest treatments in exchange for better deals if the medicines fail to meet expectations. This focus on value and outcomes over volume offers significant benefits for both patients and the healthcare system alike. As the story notes, some stakeholders are optimistic that these innovative payment models are part of the solution to cost concerns.