Optum and Merck Collaborate to Advance Value-Based Contracting of Pharmaceuticals
May 25 2017 - 2:00PM
Business Wire
Companies will use real world data to develop
and simulate models linking payment for prescription medicines to
patient health outcomes
Optum, the health services business of UnitedHealth Group (NYSE:
UNH), and Merck (NYSE: MRK, known as MSD outside the U.S. and
Canada), will collaborate to develop and simulate the performance
of contractual reimbursement models in which payment for
prescription drugs is aligned more closely with patient health
outcomes.
Through a multi-year collaboration on a shared “Learning
Laboratory,” the companies will explore value-based and
pay-for-performance models, known as Outcomes-Based Risk Sharing
Agreements (OBRSAs), and their potential for broad adoption among
health insurance companies, pharmacy benefit managers (PBMs), and
pharmaceutical companies. The initiative will involve the use of
real world data to co-develop and test advanced predictive models
and co-design OBRSAs to reduce clinical and financial uncertainty
with respect to payment for prescription drugs.
Under OBRSAs, health plans and other payers reimburse drug
manufacturers on the basis of clinical outcomes achieved. Prices
can fall or rise if the results succeed or fail to meet
expectations outlined in the agreement. Increasingly, OBRSAs have
become part of the conversation across the health care system due
to the desire by health plans, care providers, PBMs, and
pharmaceutical companies to base reimbursements on evidence-based
outcomes.
Because the measuring and monitoring of clinical outcomes is
crucial to the viability and applicability of these models, Optum’s
integrated claims and clinical records will be used to provide data
reflective of real world patient care and outcomes in the United
States. These data assets will enable the companies to assess OBRSA
models across different patient populations, clinical settings, and
therapeutic areas aligned with Merck’s product portfolio.
“Ensuring that health care dollars are spent on interventions
that improve patient care and health outcomes is a shared goal for
all stakeholders,” said Curt Medeiros, president of Optum Life
Sciences. “This collaboration offers an opportunity to leverage our
collective strengths to increase knowledge about the design and
implementation of outcomes-based contracts in the U.S. health
system.”
Optum and Merck plan to publicly share analytic insights,
findings and recommendations to help inform and facilitate the
understanding and use of pragmatic approaches to OBRSAs in the
health care system.
“Our collaboration will create a unique data-driven platform to
enable modeling and analysis of innovative contracts that are
needed to move to a value-based health care model,” said Susan
Shiff, senior vice president, Center for Observational and
Real-world Evidence, Merck. “The collaboration between Merck and
Optum will help advance both organizations’ common goals of
improving patient health outcomes, expanding access to innovative
therapies, and ensuring the best use of health care spending.”
Optum provides expertise in pharmaceutical contracting, health
economic and outcomes research, actuarial analytics, and health
policy and regulation, as well as access to data required for
exploration of these new models. Merck provides data science and
outcomes research expertise, a deep understanding of the
pharmaceuticals marketplace, and years of experience working with
large private and public customers to create flexible pricing
models across multiple therapy areas.
About OptumOptum is a leading information and
technology-enabled health services business dedicated to helping
make the health system work better for everyone. With more than
100,000 people worldwide, Optum delivers intelligent, integrated
solutions that help to modernize the health system and improve
overall population health. Optum is part of UnitedHealth Group
(NYSE:UNH). For more information, visit www.Optum.com.
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version on businesswire.com: http://www.businesswire.com/news/home/20170525005862/en/
OptumChristine Farazi,
952-205-6654christine.farazi@optum.com
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