Can Outcomes-Based Pharmaceutical Contracts Reduce Drug Prices in the US? A Mixed Methods Assessment

Author:

Seeley Elizabeth,Chimonas Susan,Kesselheim Aaron S.

Abstract

To improve the value of pharmaceutical spending, some manufacturers and payers have introduced outcomes-based contracts, where rebates are tied to specified outcomes. We reviewed the literature and interviewed key experts to assess these contracts' potential to slow pharmaceutical spending. We found that while outcomes-based contracts are increasingly common in the US, they are still limited by multiple factors — including the lack of meaningful outcomes data. Moreover, there is no evidence to date that they slow pharmaceutical spending or increase access. Experts favored having CMS test and rigorously evaluate this model to achieve a better understanding of the implications.

Publisher

Cambridge University Press (CUP)

Subject

Health Policy,General Medicine,Issues, ethics and legal aspects

Reference22 articles.

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4. 14. See above Garrison et al., supra note 7; Choe, S. , Learch, C. , “Health Plans Are Actively Exploring Outcomes-Based Contracts,” Avalere Health, May 30, 2017, available at (last visited November 9, 2018); A. Sexton Ward et al., “Regulatory, Legal Uncertainties Are Barriers to Value-Based Agreements for Drugs,” Health Affairs Blog, November 4, 2016, available at (last visited November 9, 2018); P. Keckley, “Value-Based Pricing for Pharmaceuticals: Implications of the Shift From Volume to Value,” Deloitte Issue Brief, 2012, available at (last visited November 9, 2018); P. Neuman, “Risk-Sharing Arrangements that Link Payment for Drugs to Health Outcomes Are Proving Harvard to Implement,” Health Affairs 30, no. 12 (2011): 2329–2337.

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