As they take on more risk for patient outcomes under the rubric of accountable care, the pharmaceutical industry’s customers — physicians, payers, and patients — are demanding evidence of better patient outcomes in return for their pharma dollars. To justify their pricing, pharmaceutical companies must either offer more value without charging more, or they must back up premium pricing with solid scientific evidence.
Accountable care models have given providers and payers strong incentives to deliver the most cost-effective, efficacious patient care — and they are subsequently considering their spending on and coverage of prescribed therapies more carefully than ever. Payers want new therapies that are clinically and economically better than existing alternatives and that are backed by hard, real-world data that proves claims about a drug’s superiority. In fact, our report, 10Minutes: Drug value in the new health system, found that four-fifths of the US health insurers we polled in a recent survey now require pharma manufacturers to provide evidence of cost savings or a clear clinical benefit to include new products in payer formularies.
Drug value is the sum of many dynamic forces, determining the success of any one product.
Health organizations have access to more data than ever before to manage populations and target promising drug therapies.