Insurers warm to deals linking drug cost, efficacy

Business 101 says you should always get what you pay for. But according a new article in the Wall Street Journal, health insurers are trying to flip the equation, paying for what they—or, more precisely, their patients—get.

Cigna Corp. has reached value-based agreements with Praluent and Repatha, the only drug manufacturers who produce PCSK9 inhibitors to lower cholesterol. If the new medications do not help patients as much as expected, Cigna will receive extra price discounts from the drugmakers.

Such deals are a part of an industry trend toward emphasizing quality over quantity, but the impact on costs may be limited. For one, tracking and measuring patients’ health are difficult prospects.

“There is a general increase in interest in exploring these kinds of contracts, but a fair amount of caution as well, largely because the administrative aspects tend to be quite daunting in the short term,” said Steven Pearson, president of the Institute for Clinical and Economic Review.

For the full report, visit the WSJ link below:

""
Nicholas Leider, Managing Editor

Nicholas joined TriMed in 2016 as the managing editor of the Chicago office. After receiving his master’s from Roosevelt University, he worked in various writing/editing roles for magazines ranging in topic from billiards to metallurgy. Currently on Chicago’s north side, Nicholas keeps busy by running, reading and talking to his two cats.

Around the web

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.

Kate Hanneman, MD, explains why many vendors and hospitals want to lower radiology's impact on the environment. "Taking steps to reduce the carbon footprint in healthcare isn’t just an opportunity," she said. "It’s also a responsibility."