New Deals Tie Drug Prices to Outcomes

May 11, 2016 – “Value-backed” deals are becoming more common as Cigna announces contracts that tie the cost of two new cholesterol drugs to how well they work.

Following the announcement by Cigna Corp., Peter Loftus and Anna Wilde Mathews, writing for the Wall Street Journal identified a new trend as insurers react to consumer pressure. With drug prices skyrocketing—up12% to nearly $425 billion in 2015 (following a 13% increase in 2014), customers have become far more vocal, demanding assurances that they are getting what they pay for.

The drugs in question—Praluent and Repatha—are the only two PCSK9 inhibitors on the U.S. market. Both were introduced in 2015 to reduce levels of LDL “bad” cholesterol beyond what can be achieved by statins, a much more well-known class of drugs. Both Praluent and Repatha cost at least $14,000 a year, and Cigna has negotiated an undisclosed discount off the list prices.

That discount could increase if the drugs aren’t able to reduce LDL cholesterol at least as well as it had in clinical trials. Similar deals between AstraZeneca and Express Scripts and between Eli Lilly and Humana reflect increased interest in contracts that allow redress if something “doesn’t work as expected,” especially for medicines that now cost thousands or tens of thousands of dollars a year.

As Paul Hudson, president of AstraZeneca’s U.S. unit said, “More and more in the U.S., people are making choices between a bag of groceries and a medicine, a copay. The long-term sustainability of the industry and our ability to deliver breakthrough medicines requires us to demonstrate value.” Whether or not this amounts to anything more than a “fancy way of rebating” remains to be seen.

Read the full article here:

“Health Insurers Push to Tie Drug Prices to Outcomes.”


40 Grove St, Suite 270 Wellesley, MA 02482

  • LinkedIn - White Circle
  • Facebook - White Circle
  • Twitter - White Circle
  • YouTube - White Circle


© Copyright 2020 Scripta Insights, Inc. 

Scripta™ is neither a pharmacy nor a doctor. The benefit service does not tell you what drug to take and does not participate in the drug selection process. Only your physician can determine the medications that are right for you. These alternative medications are options for less costly drugs that physicians may prescribe in place of the medications you are taking now. Scripta has reviewed your current medications only for the purpose of identifying potential cost savings for you to consider with your physician. Scripta has not analyzed the effectiveness or other therapeutic aspects of these medication alternatives. Accordingly, this report and any other forms of communication received from Scripta are not, nor should they be interpreted as, any form of treatment, drug regimen review, or provision of counseling or consultation by a prescriber, pharmacist or pharmacy. Do not stop taking your medication, change your medication, or start taking a new medication without being directed to do so by your physician and filling the prescription under the oversight of a licensed pharmacist. The alternatives set forth above may not be equivalent to your current medication, may interact adversely with your other medications, may not be indicated in light of your other conditions, may cause different or severe side effects, or may be less effective at treating your condition. Medication prices are approximate based on information provided by your pharmacy benefits manager, insurance plans, and/or employer, and may vary from pharmacy to pharmacy. Check with your insurance plan to obtain a full list of pharmacies where your prescriptions can be filled. All information herein is HIPAA protected, treated as highly confidential, and never shared with your employer.

Scripta™, Scripta Insights™ and The Best Meds at the Best Price® are registered trademarks of Scripta Insights, Inc. The contents of the site are for informational purposes only and not intended as a substitute for professional medical advice, diagnosis, or treatment. We do not recommend or endorse any specific prescription drug or pharmacy that may be mentioned herein. Reliance on any information provided by us, our affiliates, employees or others is solely at your own risk.