Prescription Drugs
| Feb 17 2016

Outcomes Based Programs for Prescription Drugs

Emily Ferreira
Associate, Health & Benefits Survey Research, Mercer

Outcomes based incentive programs are typically associated with employer health and well-being programs (where employees earn incentives by achieving or showing progress towards certain health status targets), but a recent arrangement could speak to a similar trend for prescription drugs. Cigna has entered into a performance based contract with Novartis, specific to their drug Entresto (used to treat chronic heart failure) in which Cigna would pay the pharmaceutical organization based on the reduction of Cigna customers who are hospitalized for heart failure. A similar arrangement for the same medication was made between Novartis and Aetna, though Aetna’s measures are on the drug replicating the results of clinical trials. As the value-based care trend is driving health care market focus away from traditional fee-for-service models and towards pay-for-performance and prescription drug prices continue to climb (as our research shows), we may see similar deals arise for between carriers and pharmaceuticals for other prescription medications. 

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