Highmark has entered an outcomes-based agreement with UCB, Inc. for CIMZIA® (certolizumab pegol), UCB’s tumor necrosis factor blocker prescribed for adult patients with chronic inflammatory conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, plaque psoriasis, and Crohn’s disease. The agreement for CIMZIA covers all commercially insured members in Delaware, West Virginia, in Pennsylvania, and Delaware. So far, 380 Highmark members have prescriptions for CIMZIA.
Under outcomes-based agreements between payer and manufacturer, clinical effectiveness is the key factor that determines reimbursement for a drug. If the drug is not clinically effective, the manufacturer typically refunds part of the original purchase to the payer. These types of arrangements afford patients access to effective, cost-efficient medications.
Duane Barnes, President and Head of U.S. Operations states, “UCB is committed to continuing the evolution of the U.S. healthcare system to better recognize and reward the value solutions bring to patients. We are focused on delivering patient-centered solutions and affordable access for patients to the right medicine at the right time. We believe strongly in the value of CIMZIA as a therapeutic option for people living with chronic inflammatory diseases and to help reduce overall healthcare costs in communities across the regions served by Highmark.”
This value-based contract with UCB continues Highmark’s tradition of developing value-based agreements for products that ensure members experience improved health outcomes. Find out more here.