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Trends That Matter for New Multiple Sclerosis Value-Based Contract

Posted by Sharon Bender on Jan 16, 2020


Under a value-based contracting agreement believed to be the first of its kind, UPMC Health Plan will receive discounts for two Biogen Inc. multiple sclerosis (MS) drugs — Tecfidera (dimethyl fumarate) and Avonex (interferon beta-1a) — based on patient-reported measures of disability progression. The agreement is also based on research with a panel of key MS stakeholders who identified the most meaningful outcomes in relapsing forms of MS, AIS Health reported.

UPMC's Center for Value-Based Pharmacy Initiatives led the research and developed the value-based contract.
Previous value-based contracts for MS drugs have connected payment to outcome indicators derived from claims and electronic health record data, says Rochelle Henderson, Ph.D., Express Scripts' vice president of research and a co-author of the study report.

"This research [gives] a greater level of transparency into the outcome indicators that rank the highest in terms of value for stakeholders," she says. "The key advantage of patient-reported outcomes is that it gets at information that can be used to evaluate the success of a medication where that information is not available by traditional means."

The graphic below shows the current market access to Tecfidera and Avonex for all controllers under the pharmacy benefit.
Trends 01162020

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Topics: Industry Trends, Market Access, Data & Analytics