Misaligned Pharmacy Incentives in Value-Based Care

Author:

Jain Nina12,Rome Benjamin N.32,Mendu Mallika L.12

Affiliation:

1. Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

2. Harvard Medical School, Boston, Massachusetts

3. Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

Abstract

This Viewpoint explains some ways in which the alignment of incentives between payers and clinicians in value-based care (VBC) arrangements can be interrupted and proposes a multifaceted approach to realigning incentives for drug spending within VBC contracts to better provide value-based care and improve patient outcomes.

Publisher

American Medical Association (AMA)

Reference7 articles.

1. Estimating rebates and other discounts received by Medicare Part D.;Feldman;JAMA Health Forum,2021

2. Cost-effectiveness of canagliflozin added to standard of care for treating diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM) in England: estimates using the CREDEM-DKD model.;Willis;Diabetes Ther,2021

3. Acute diabetes complications after transition to a value-based medication benefit.;Wharam;JAMA Health Forum,2024

4. Assistant Secretary for Planning and Evaluation, Office of Science and Data Policy. Trends in Prescription Drug Spending, 2016-2021. US Department of Health and Human Services. Published September 2022. Accessed August 27, 2023. https://aspe.hhs.gov/sites/default/files/documents/88c547c976e915fc31fe2c6903ac0bc9/sdp-trends-prescription-drug-spending.pdf

5. Congressional Budget Office. Prescription drugs: spending, use, and price. Published January 19, 2022. Accessed January 7, 2024. https://www.cbo.gov/publication/57772

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