I highly recommend the article by Ellen Licking and Susan Garfield, "A Road Map to Strategic Drug Pricing," which appeared in the trade journal IN VIVO in 2015. A copy is available open-access at her current company, EY (here). They write:
- Products come to market with clinical trial data and not real-world evidence. Stakeholders may see them as "having potential" but "not proven value" at the time of launch...many products enter the market with a "value gap."
- To accelerate the shift to proven value and bridge the value gap, biopharma should consider multi-stakeholder collaborations aimed at co-creating data to support innovative pricing models.
That's the teaser; see the full article.
The EY website also features an interesting two-pager, "The myth of the 'payer,' " by Roger Longman of Real Endpoints (company website here.) Real Endpoints helps pharmas implement some of the ideas discussed by Licking & Garfield; its logo is "Preparing health care companies for today's value based economy." Longman points out that there is no monolithic "payer" but different payers have different interests. At the extremes, a consolidated payer/entity like the VA would view savings on drug costs and hospitalization equally. On the other hand, a Medicare Part D plan and some other carved-out PBMs are only incented to save costs on drugs, regardless of the spillover on health or on hospital costs.
