Tag Archives: contracting

Turning Point Rx ‘s Network of Specialty Pharmacies Continues to Grow

The largest specialty pharmacies are owned by organizations that are increasingly integrating their product and service offerings such as CVS Health, Cigna’s Express Scripts, UnitedHealth Group’s OptumRx, and Walgreens Boots Alliance/Prime Therapeutics

Humana Joins Cigna’s Drug Buying Group Ascent Health Services

Ascent Health manages commercial rebates, the payments that drug makers make to health plans

GPO Consolidation Trend Growing

GPO consolidation is increasing under the backdrop of Amazon’s possible role in the industry

Value-Based Contracting in Commercial Insurance

Background on risk-sharing and insight into risk-sharing agreements from a payer’s and manufacturer’s perspective.

Outcome-Based Contracting Acceptance Grows in Market

Specialty Pharma Services

Outcome-Based Contracting Acceptance Grows in market with the concept of taking on financial risk on complex contracts as a result of market pressure combined with more familiarity. Outcome-based contracts between pharma companies and health insurers are becoming increasingly popular. In 2016, Novartis, Amgen, and Sanofi publicized risk-sharing, value-based, outcomes-based, or pay-for-performance deals, all of which vary […]

AetnaCare Boosted by Merck Collaboration

AetnaCare Boosted by Merck Collaboration: Aetna has announced AetnaCare℠, a new program designed to offer members an integrated care plan so they have the knowledge, motivation and confidence to manage their own health. Over 40% of Aetna’s medical spend currently runs through some form of value-based care model today and the company is developing programs like […]

Increasing Demand for Drug Based Outcomes

Specialty Pharma Services

Increasing Demand for Drug Based Outcomes – Outcome-based contracts are a relatively new and growing contracting methodology focused on shifting reimbursement from volume to value. The contracts are between a health plan and manufacturer where reimbursement is dependent on pre-defined outcome metrics focused on improving patient responses/health. Currently, the relationship between the pharmaceutical manufacturer, the […]

Contracting With Specialty Pharmacies (SPs) At Your Own Peril

How a company works with and contracts with SPs will have to be rethought as a result of the initial Department of Justice (DoJ) settlement with BioScrip and ongoing investigation of Novartis in their marketing practices. When Novartis launched Exjade, it created a limited distribution network, including BioScrip and two other specialty pharmacies selected by […]