The issue of high drug prices has raised a number of concerns with insurers and employers searching for strategies to provide patients with the most cost-effective payment plans.
Express Scripts, the country’s largest pharmacy benefits manager, is testing out a value-based pricing plan for inflammatory and diabetes drugs.
The organization will partner with another company “to help educate patients and keep them on track taking their meds but then refund up to $6,000 if a patient discontinues any preferred anti-inflammatory medication within the first 90 days,” reported FiercePharma.
Inflammatory disease treatments like Humira were lumped together in coverage plans despite targeting different ailments so Express Scripts’s new plan would allow it to treat these conditions differently based on each approved drug.
Diabetes drugs were added to this value-based program last week too. This particular initiative, though, focuses on guaranteeing per-patient spending caps for clients in an effort to drive down costs and help increase adherence. Patients taking part in participating plans will be able to receive 90-day supplies of their diabetes medication while being able to access clinical counseling from pharmacists participating in Express Scripts network.
The intent of these programs is to hopefully force drug companies to lower their prices giving institutions like pharmacy benefits managers more flexibility in managing drugs for these expensive diseases, wrote The New York Times.
Other pharmacy benefits managers are trying different tactics. CVS changed its coverage plan for 2017 by favoring biosimilars, drugs that could save the healthcare system over $110 billion in four years.
Express Scripts inflammatory drug program goes into effect January 2017 while the diabetes one will activate in March of that year.
Filed Under: Drug Discovery