Value-based pricing and reimbursement models are not common in the United States, but this may change after recent programs by Pfizer and Takeda. These pricing strategies are based upon the value provided to the patient and have long been held back due to insufficient outcome data infrastructures. Pfizer’s Xalkori has a patient warranty strategy, while Takeda offers a risk-sharing agreement for Alunbrig.
According to Pharmaceutical technology, “ PrecisionValue drug utilization and access expert Ryan Cox also makes the distinction that Pfizer’s arrangement is relatively novel, considering it does not involve just rebates that are commonly used in payer deals, but an insurance payment of sorts. This scheme is going in the direction of shared-risk models that can creatively avoid impacting best price, he adds. The Medicaid best price policy requires drug manufacturers to give Medicaid the best, or lowest price among nearly all purchasers.”
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(Source: Pharmaceutical Technology, November 19th, 2021)