Over the past couple of years, drug makers have increasingly explored outcomes-based contracting as a way to convince payers to cover their medicines. Basically, this notion revolves around the idea that an insurer will get a drug at a lower cost if a patient does not benefit as planned. But not all deals are likely to deliver, and a new analysis argued that an agreement offered by Amgen (AMGN) is a notable example.
To wit, Amgen sells Repatha, a new type of cholesterol medicine approved in 2015 to treat patients who struggle to control cholesterol using statins, particularly those with an inherited disorder known as familial hypercholesterolemia. Around the same time, Sanofi (SNY) and Regeneron Pharmaceuticals (REGN) won regulatory approval to market a competing treatment.
Initially, the drug makers priced their drugs at around $14,500, substantially more than older pills called statins. Sales never took off because payers balked at the prices and many physicians wanted to see more clinical data about the extent to which the medicines could reduce the risk of heart attacks, strokes and deaths. Meanwhile, Amgen, in particular, pursued outcomes-based contracting.
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