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This Week in Managed Care: May 19, 2017
May 19, 2017

What We're Reading: More Outcomes-Based Deals; Ebola Outbreak Small; Approving Expensive Drugs

AJMC Staff

A Better Way to Reimburse Drug Makers

The push toward value-based payments continues as UnitedHealth inks a deal with Merck to develop a better way to reimburse for a drug’s performance. According to CNBC, the 2 companies have a multiyear deal to better align value and payment for high-cost drugs. UnitedHealth is looking to sign 5 to 10 outcomes-based deals this year. Humana has more than a dozen in place, and Aetna and Cigna have also signed these agreements. It could take years for returns on the UnitedHealth-Merck agreement, but they will share their data publicly in the meantime.

 

Ebola Outbreak May Be Small

An Ebola outbreak in the Democratic Republic of Congo may still be small. While there are roughly 300 people being monitored, there are only 2 confirmed cases, reported STAT. While 14 suspected cases have already tested negative for the virus, another 40 suspected cases remain. There is a mobile laboratory operating in the area, which should help determine the actual scale of the current outbreak. As of now, the experimental Ebola vaccine, which was tested in Guinea in 2015, hasn’t been sent to the site.

 

The Challenge of Accelerated Approval and High-Cost Drugs

An editorial in New England Journal of Medicine cautions against accelerated approval for more drugs. The accelerated pathway has had many positive experiences, but with the increasing cost of drugs and a lack of strong evidence for some of these drugs, insurers may choose not to cover these drugs. Ultimately, this thwarts the “pathway’s goal of getting potentially important therapies to patients earlier,” the authors wrote. Meanwhile, government payers are forced to cover the drugs with taxpayer dollars even if the drug has not shown clinical benefit.

 
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