PBM Seeks to Tie Drug Price With Outcomes

Steve Miller, MD, chief medical officer of Express Scripts, explained indication-specific pricing as an alternate pricing model for high cost specialty medications like oncology drugs.

The pharmacy benefit manager Express Scripts, the largest such operation in the United States for employers and payers, has initiated conversation with drug manufacturers on setting drug prices based on their performance, a model that can possibly reign-in the .high cost of specialty medications that are a big concern for our healthcare system.

In an interview early this month, Steve Miller, MD, the chief medical officer of the company, talked about ongoing efforts to seek deals with drug makers for differentiated pricing for certain cancer drugs based on how well they work against different types of tumors. Citing an example of Tarceva, indicated for lung cancer and pancreatic cancer, Dr Miller explained the indication-specific model: the per-pill cost of Tarceva would be lower for pancreatic-cancer patients than for lung-cancer patients, based on the survival benefit observed in pancreatic cancer, he said.

Read the complete article on The Wall Street Journal:

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