Transitioning Pharma to Value-Based Payments Will Require More Than Corporate Collaboration

Posted by Paul Darling on Tue, Mar 01, 2016

Healthcare reimbursement in the U.S. is undergoing a fundamental transformation. The Center for Medicare & Medicaid Services has led this transformation, announcing that 50% of all Medicare payments will shift from fee-for-service to alternative payment models by 2018. Pharmaceuticals have been entirely omitted from these plans, as Medicare is legislatively prevented from negotiating drug prices. Hence, manufacturers and private payers are expected to play a dominant role in determining payment models that reimburse pharmaceutical manufactures for value in the form of patient outcomes, rather than the pills, themselves.


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