On December 17, 2019 Prime Therapeutics LLC (Prime), a leading pharmacy benefit manager (PBM) serving more than 28 million members nationally, reported that it has entered into a value-based agreement with Pfizer Inc., a global biopharmaceutical company, intended to help improve outcomes for patients being treated for cancer (Press release, Prime Therapeutics, DEC 17, 2019, View Source [SID1234552452]).
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"An essential part of Prime’s total drug management strategy is identifying drug therapies that, with the right measures and monitoring, can lead to enhanced member outcomes and yield the best value for patients and insurers," said Kelly Pokuta, vice president, pharmaceutical trade relations for Prime. "Intentionally teaming up with biopharmaceutical companies is one of the many ways we control health plan costs and deliver customer-centered value. Prime’s next-generation analytics and rich drug value assessment experience, combined with Pfizer’s deep expertise in oncology and research, make this agreement a win for patients."
Prime will utilize real-world patient pharmacy data to support a value-based agreement related to patients’ adherence to their cancer treatment. Interruptions in oncology therapy can not only have a negative impact on patient outcomes but can also drive up associated health care costs.
"We are pleased to work with Prime on this agreement using real-world data with the aim to improve patient outcomes and ultimately lower health care costs," said Justin McCarthy, senior vice president, patient and health impact group, Pfizer. "As we move from a volume- to a value-based health care system, this collaboration is a great example of the partnerships we are creating across the health care sector to help patients access innovative medicines."
As a pioneer in value-based contracting since 2010, Prime’s manufacturer contracts analyze the value of a selected medicine when taken appropriately, with the goal of improving outcomes and lowering total cost of care. As an integral part of its value and health outcomes strategy, Prime is transforming value-based contracting through analysis of integrated pharmacy and medical data, showing members’ total health picture and providing actionable information to design high-touch interventions. Prime continues to leverage value-based contracts to help ensure emerging and high-cost therapies are priced according to the member value they deliver.