Ultimately, a better match between prices and the value of health technologies, such as drugs, biologics and medical services, is an important goal of any health system. This can be achieved in a number of ways, including awarding value-based contracts and providing evidence-based coverage. In drugs, value-based contracts often reflect performance agreements that reimburse the predetermined results of a drug or biologic drug. Here, the value is measured in the form of patient outcomes per dollar spent. These two instruments provide a constructive management of the inevitable uncertainty of a newly licensed drug or the safety and efficacy profile of Biologic when it is put on the market. They also allow patients to access treatments during the evidence-gathering period. And payment based on the actual performance of a product allows value-based contracts and evidence-based coverage to reduce the risk of excessive cost. For industry to master them, the barriers of life sciences and biopharmaceutical value contracts must be openly and seriously debated. This series will help to put into context the context of patient access, the views of health stakeholders and the therapeutic areas that are the subject of the charge. There are compelling arguments for manufacturers and payers to consider value-based contracts: but there are still significant logistical hurdles to achieving a consensus definition of value, ways to pay for post-market data collection and analysis, and overcome regulatory barriers such as Medicaid`s “best price” policy. Medicaid`s best price states that Medicaid drug manufacturers must provide the best price for a drug or product organic among almost all buyers. This may be an obstacle to signing value-based contracts when a refund is triggered, if a drug or biologist does not achieve a predetermined goal. At this point, regardless of the net fact price, will be the best price for the entire Medicaid program.
Unbearable health care costs and variable patient outcomes are accelerating health care change. Interest in value-based contracts (VBCs) between pharmaceutical manufacturers and payers/providers is growing as an approach that contributes to this shift to value-based care. Despite this growing interest, adoption has been slower for many reasons, including misdirected incentives, difficulties in tracking patient outcomes and a lack of consensus on industry standards. The lack of technology to effectively manage and decide agreements is also a common concern.