Drug Prescription Population Health Management

At the 2018 AMCP Annual Conference, there was a lot of discussion about important trends in healthcare. Here are two particularly noteworthy examples:

The Rise of Value-Based Agreements

There are many individual components that determine the pieces of information that can feed into the value of a drug. However, value-based agreements break down those silos by providing a comprehensive picture of a patient’s health, thus creating a cohesive care continuum, and empowering the parties involved to make evidence-based health decisions.

Value-based agreements are gaining interest in the industry because, among other reasons, they offer the potential for a win-win-win for manufacturers, payers and, most importantly, patients. Generally, these contracts are based on whether a drug works as promised.  If it doesn’t, then the drug maker refunds all or part of the cost of treatment.

There was quite a lot of buzz about value-based agreements at AMCP, and while some companies are thinking about these approaches, at Abarca, we are all in. Recently, we announced agreements with Amgen and Biogen for value-based programs, and we expect to be announcing others soon.

The Impact of the Health Transformation Alliance (HTA)

Formed by more than three dozen companies, the HTA seeks to transform the corporate healthcare benefit marketplace by focusing on four areas: marketplace efficiency, learning from data, employee education, and breaking bad habits.

Though still in its early stages, this group is poised to be a major force for change in healthcare with the potential to significantly impact health plans, PBMs, and providers. One of the HTA initiatives we anticipate seeing come to fruition is direct contracts with drug manufacturers–which, if done successfully, could create a healthcare model that makes people healthy while saving money.

At Abarca, we believe change and innovation in healthcare is important, and we applaud HTA participants for outside the box thinking and bold action. Does the HTA have the potential to be disruptive to a large swath of the healthcare industry? It sure does. Cause if the goal is to lower costs and improve outcomes for patients, we say it’s worth exploring.

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This blog was written by David Capó.

David Capó, MD, MPH, is a Clinical Epidemiologist for Abarca Health providing value-based medicine counsel and population health management intelligence to address risk patterns and support health economics & outcomes research (HEOR). Before joining Abarca, Dr. Capó worked for the Center for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), as a Preventive Medicine and Public Health Fellow. He received his medical degree in 2007 and a master’s in public health with a concentration in epidemiology, in 2009, from the University of Puerto Rico (UPR). As part of a postdoctoral research fellowship in the Division of Cancer Epidemiology Genetics, National Cancer Institute, National Institutes of Health (NIH), he worked on the etiology and progression of lung cancer.

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