Top

Will value-based pricing be coming to the U.S.?

The answer may be yes.  One of the big inpediments to value-based pricing of pharmaceuticals was that any discount given to any single organization based on outcomes needed to be reflected in the Medicaid price.  Since outcomes are subject to random noise, there will inevitably be health plans that end up getting a low price due to worse than expected outcomes.  If a single discount to a single plan based on idiosyncratic factors lead to large Medicaid discounts, few life sciences companies would be interested in these value-based contracts.

However, CMS is opening up an avenue to these value-based contracts in a July 2016 guidance document.  First some background:

Read More on Healthcare Economist