April 24, 2018
On Monday, RxAnte President and CEO Josh Benner took the stage at the AMCP Annual Meeting in Boston to speak on how leveraging real-world evidence is critical to move the market forward in value-based contracting (VBC). The talk featured a case study on RxAnte’s work with UPMC Health Plan, where RxAnte facilitated the collection and analysis of real-world evidence in order to inform how VBCs should be designed and executed. Below are key takeaways coming out of the session.
Real-world evidence can (and should) inform utilization and outcomes metrics that health plans and drug manufacturers can agree to.
Leveraging real-world evidence is critical to move the market forward in value-based contracting. In today’s value-focused healthcare environment, health plans and pharmaceutical manufacturers have a shared interest in getting more value from medicines. Having a partner to generate evidence allows both the pharmaceutical company and health plan to understand all of the data sets in their own population. In this setting, both parties can participate in the design of a randomly controlled trial to demonstrate the efficacy of a drug, and then put mutually agreed upon utilization and outcome metrics in place to measure quality improvement.
Creating timely, symmetrical access to real-time performance information is key to successful value-based contracting execution.
While industry-wide cost pressures and value-based models of care are encouraging changes in healthcare delivery, the path forward for value-based prescription drug contracting is challenging. A transparent analytics platform and consultative services are needed to design a value-based contract containing performance measures amenable to both pharmaceutical manufacturers and health plans, minimizing the financial and execution risk that accompanies value-based contracts today.
All key performance indicators should be tracked and reported in near real-time.
Setting and tracking key performance indicators (KPIs) can contribute to a well-informed and manageable value-based contract. By tracking against these KPIs in real-time, performance monitoring analytics are available to both pharmaceutical manufacturers and health plans.
During the contract period, incorporate provider- and patient-level intervention programs to improve prescribing and adherence.
By monitoring and evaluating performance in near-real time, both parties can identify actionable opportunities to manage to the performance metrics in the contract, such as adherence rates, medical utilization, and health outcomes.