America’s biopharmaceutical companies are committed to working with policymakers and stakeholders to further the move toward a value-driven health care system and advance solutions that enhance the private competitive market. We support reforms that will enable private companies to negotiate better deals for prescription medicines and protect patients from unaffordable out-of-pocket costs.
Biopharmaceutical Companies Need Flexibility to Communicate Broadly with Payers and Health Decision Makers
In order for biopharmaceutical companies to become partners—rather than simply vendors—we need flexibility to communicate about the value of our medicines with payers. Recently the U.S. Food and Drug Administration (FDA) released guidance on biopharmaceutical companies’ ability to share certain information about the potential benefits of a treatment with insurers and health systems. This guidance may help facilitate value-based contracting, which, in turn, may result in costs savings and increased access.
Regulatory and Legal Barriers That Limit Value-Based Payment Arrangements Must Be Addressed
Private payers and biopharmaceutical companies have made clear their interest in pursuing innovative contracting approaches to more directly link prescription medicine pricing to value. As an industry, we are exploring new approaches in the private market, such as being reimbursed depending on how well our medicines work for patients. To spur more of these value-based arrangements, we need to reform outdated, unclear regulations that discourage companies from offering discounts that are tied to outcomes, rather than volume. And we need to modify existing Medicaid best price requirements that inhibit companies from taking on more risk in new payment arrangements.