Over the past decade, compliance programs at life sciences companies have grown in scope and complexity. Now, executives and boards of directors are questioning whether these larger programs are effectively reducing their risks, or have they become too onerous to deliver real business value?
In the face of stagnant healthcare budgets, and ever-growing demand for care, pharmaceutical companies are under severe pressure to demonstrate the value of their products. Often it is no longer enough to show that drugs are efficacious; they now need to show improved outcomes that justify the price.
The industry is under the public and political microscope, with demands for an alternative to the traditional, sales-led approach to marketing. One payment model receiving increasing attention is value-based pricing (VBP).
Within a VBP arrangement, risk is shared between pharmaceutical companies and payers, which should focus all parties on appropriateness of use and on outcomes.
In this article, we outline the challenges facing VBP implementation, notably the need to define and measure outcomes, and overcome any regulatory and legal barriers. We discuss how to overcome these challenges, and feature a case study based on Novartis’ experience to date with the heart drug Entresto.
We believe that, with certain products, under certain conditions, VBP can add the value that healthcare systems and patients are looking for. This is the first in a series of discussions on VBP by KPMG professionals.
Most healthcare organizations are only halfway up the data and analytics maturity ladder. Heeding Affordable Care Act (ACA) mandates, they are instituting electronic health records (EHRs) and using analytics derived insights to improve short-term outcomes, such as decreased hospital admissions and complications.
Moving up the D&A maturity ladder in this new era of payment reform requires organizations to become data driven cultures and use data to gain a holistic picture of patients’ healthcare touch points.