As the cost of prescription drugs remains vexing, a new survey finds that more health plans are increasingly interested in paying for the highest-priced medicines based on patient outcomes. And the findings suggest that insurers are eager to exploit drug makers that are willing to strike such deals in order to win favorable insurance coverage.
In these arrangements, a health plan may get an extra discount from a drug maker if a medicine does not help patients as much as expected, or a drug maker may get a credit toward a rebate provided to a health plan. The survey, released last week, found interest was particularly strong for hepatitis C and oncology drugs, although plans have started to use these arrangements for other types of drugs, as well.
Specifically, the survey found that 70 percent of health plans view outcomes-based contracts favorably and 24 percent already have one such deal in place. Another 30 percent reported they are currently negotiating for at least one contract, according to Avalere Health, a consulting firm that queried 45 different health plans representing 183 million insured people.
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