Thursday, February 11, 2016

Lilly and Anthem: New Drugs, New Ways to Pay for Them

We hear much about a brave new world where providers and payers will have to collaborate toward common goals.  Lilly and Anthem have released two white papers, and a Health Affairs blog, talking about exactly that.

The blog, "Discovering new medicines and new ways to pay for them," is at Health Affairs, here.  It explains two recent white papers that have been jointly released by the companies.  In the first, they ask for improved permissions to allow communications before drugs are lost.  For example, the manufacturer would be able to say, "This drug improves cancer survival by 25%, and pharmacoeconomic studies support [this] price" without concerns that it is engaged in off label marketing and claims (25%) for an unapproved drug.   Second, they ask that "regulatory barriers to value based payment arrangements" be reconsidered.   CMS and the OIG have already faced this with arrangements like ACOs and bundled payment demonstration projects; the white paper talks about remaining barriers.

See Anthem's website, here.  The "open communication" white paper, here.  Value based contracting, here.  Coverage at Bloomberg, here.  Subscription coverage at RPM Report, here.  Since both Lilly and Anthem are based in Indianapolis, an acronym for the project is "ProjectIndy."

Separately, an announcement about value based, outcome based contracting between Cigna and Novartis, here.