Is High Prescription Drug Spending Becoming Our New Normal?

This report concluded there was value in these therapies but also raised concerns about whether their effects will translate into lower rates of heart attack and stroke. Further, ICER concluded that a discount of 67 percent off the drugs’ list price would better represent their overall benefit. ICER’s assessment is still in draft form and it remains unclear whether the report will have any effect. Nevertheless, such work is a step in the right direction. Other entities are developing alternative methods to evaluate prescription drugs. The American Society for Clinical Oncology has sought comment on its proposed value framework, which includes factors such as clinical benefit, costs, toxicity, and palliative relief. Similarly, the National Comprehensive Cancer Network is updating its Clinical Practice Guidelines in Oncology by incorporating drug cost as a measure of the overall value of a therapy. Some insurers and pharmaceutical benefit managers are also exploring pay-for-performance deals. For example, Harvard Pilgrim recently announced it would provide exclusive formulary access to one of the PCSK9 inhibitors approved by FDA in exchange for a price discount as well as additional rebates if the drug is unable to achieve certain performance targets (e.g., the drug does not reduce cholesterol to specific target levels). While new to the US system, other countries have been entering into pay-for-performance agreements for several years. Broader change will be elusive un...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Drugs and Medical Technology Featured Payment Policy Quality Big Pharma Biosimiliar Comparative Effectiveness FDA PCSK9 inhibitors Sovaldi specialty drugs Source Type: blogs