Volume to value, quantity to quality: such transitions in health care today are like a rock tossed in a pond. The ripple effects are far-reaching and unstoppable. So important is this transformation that we’re dedicating a significant amount of programming to the topic at our fall conference in Dallas (Oct. 16-19). In fact, we’re calling it “AMCP Nexus 2017: Changing the Way We Pay for Health Care.”
Looking back, we’ve come a long way in just a relatively short amount of time. A decade ago, the idea of linking the cost of a therapy to how well it performed was considered revolutionary. Today, value-based contracting models increasingly are considered to manage escalating health care expenditures.
I’m pleased to say that AMCP is helping usher in this new era of value-based contracting. In the coming months, we will be fully engaged in various activities that explore the promises and challenges of paying for products based on how well they perform.
Stakeholders are looking for new models that reward and incentivize value, most notably through novel arrangements around the pricing and reimbursement of biopharmaceuticals. In one model known as outcomes-based pricing, payers and patients would receive a rebate from a manufacturer if its product failed to work. Another model known as value-based purchasing involves negotiating prices based on a clearer understanding of health care economic data behind the product.
Such value-based models require stakeholder agreement on how a drug is assessed in the real world. That is where managed care pharmacy comes into play.
AMCP’s leadership efforts in this area include the introduction last month of the "Pharmaceutical Information Exchange (PIE) Act of 2017" (HR 2026). The bill clarifies the scope of health care economic and scientific information that may be shared between biopharmaceutical manufacturers and population health decision makers in advance of product approval. The PIE Act would allow payers and manufacturers to share more data and information when negotiating contracts, a necessary condition for value-based purchasing.
AMCP’s leadership also can be seen in its plans for a June partnership forum on the nitty-gritty practicalities of implementing value-based contracting. The diverse stakeholders will seek consensus on a definition of value-based contracting to help facilitate discussions with key policy-makers and regulators. They also will develop action plans to mitigate legal and regulatory barriers to value-based contracting, and identify ways to improve operational challenges related to data validation, integration, and methodologies.
And AMCP’s leadership will continue at AMCP Nexus 2017 in October. The conference will include specific programming on new and emerging reimbursement and value-based models, as well as General Session that spotlights the nation’s leading lights in this topic. Watch for more details later this month when our meeting website launches. Registration opens June 20 at 1pm Eastern!
Changing the way we pay for health care! It’s coming, it will be based on value, and AMCP will be leading the way.
AMCP offers a wide variety of educational opportunities, from events and webinars to online training.
