Lilly's Performance Contract For Trulicity Hinges On Head-To-Head Superiority
This article was originally published in The Pink Sheet Daily
Price rebates will be based on whether Trulicity is superior to other GLP-1 agonists in lowering A1C blood sugar for Harvard Pilgrim members.
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Lilly's performance-based plans for Trulicity may be harder to sustain if Novo's competing once-weekly GLP-1 agonist semaglutide is approved in December, following superiority in a head-to-head diabetes study.
Although stakeholders are interested in value-based models that link a drug’s performance to emerging evidence of improved patient outcomes, such agreements are difficult to implement and too limited in scope to drive a shift to value-based reimbursement. The authors suggest a new, structured approach to bring these contracts into the mainstream, thus transforming product reimbursement and fueling the shift from volume to value.
Three-year contracts between AstraZeneca and Harvard Pilgrim focus on reduced hospitalization for Brilinta, reaching HbA1c goals for Bydureon; choosing appropriate products and outcomes are key challenge for the new reimbursement approaches.