Express Scripts Seeks "Pay For Performance" From Pharma

scott

http://www.wsj.com/articles/new-push-ties-cost-of-drugs-to-how-well-they-work-1432684755

If the above doesn't work, Google "New Push Ties Cost of Drugs to How Well They Work"

I'm not saying that people should sell healthcare by any means. I'm simply saying that the fight over prices has the potential of becoming a war, with PBM's on the other side. I mean, look at the last couple of months. Smaller PBMs Catamaran and Omnicare have been bought.

Whether one agrees with what ESRX does or not, longer-term I admit to questioning the sustainability of the kind of price increases that consumers have been faced with.

JohnChisum

Health care consumers for the most part have their expenses paid for by OPM. (Other People's Money)

I agree. These increases are not sustainable over the long term.

bumine

This is from the same company that dropped coverage for the best drug in HCV class? (that is Harvoni from Gilead; instead Express Scripts negotiated exclusive agreement with less efficacious drug compared to Harvoni).

Don't drugs work differently for people? What is best for one patient is not the best for another.....good luck with this initiative. Just another way to slow down reimbursement for Cancer patients (kill cancer patients slowly why "busy" doctors spend time to convince Express Scripts on the best drug for that patient, and at what price........)

JohnChisum

Correct @bumine. There is no best drug. The drug has to be matched to the patient.

This has been going on for decades. In the pharmacy business, inventory is the highest cost factor. That is why hospital pharmacies in particular have formularies. They negotiate for the best possible contract pricing. When there are several drugs in a particular category, they will usually select two or three to buy. The same goes for PBMs.

Disclosure: I have over 35 years work experience in hospital pharmacy.