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Among the drug industry’s least-escapable buzzphrases is “value-based contracting,” a system under which payers shell out for pricey drugs only when they work, creating a theoretical win-win that increases access and cuts costs all the while.

So why hasn’t the idea caught on?


A report out today from the Network for Excellence in Health Innovation — which counts payers and drug makers among its membership — helps explain why. Despite the both sides’ stated affinity for risk-sharing deals, a series of practical, organizational, and regulatory stumbling blocks often stand in the way. Here’s a rundown of some of the biggest barriers to payer-pharma harmony.

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