«Ultimately,» Cohen said, «the primary goal of any health care system is to better coordinate the prices and value of health technologies and medical services. This can be achieved in a number of ways, including value-based agreements; However, the scope of value-based agreements is relatively narrow and logistical barriers, including data collection and consensus on value terminology among stakeholders, remain impressive. Value-based contracts (sometimes called risk-sharing agreements or results-based contracts) are a kind of innovative payment model that brings together two important players – health organizations and biopharmaceutical manufacturers – to provide medicines to patients. In value-based contracts, biopharmaceutical manufacturers and payers agree to link coverage and reimbursement levels to the efficacy of a drug and/or drug-rich use. Since the introduction of the first VBC in 2009, biopharmaceutical leaders have been conducting wide-ranging debates on the need and effectiveness of value-based contracts (VBCs). For the purposes of this Executive Insights, we define a VBC as a contract between a biopharmaceutical manufacturer and a health plan that provides access to a medically prescribed drug with conditions that are in addition to or rather to traditional volume-based rebates. While this is a broad definition, it reflects the breadth of the differences between the treaties that have been implemented to date. It is likely that in the future there will be more value-based contracting activities. This extension could be fuelled by (1) improved data systems, which could contribute to the implementation of mechanisms for monitoring patients` use of biopharmaceutical drugs and their effects on health outcomes; and (2) the shift in incentives within the health care system towards value-based orientations. The increased use of responsible care organizations can, for example, improve the health system`s focus on value-based contracts. However, there are barriers already described below that make it more difficult to design and implement value-based contracts in the current environment. Newswise – Lawrenceville, NJ, United States, April 22, 2020— The Value of Health, THE official journal of ISPOR – of the Professional Society for Health Economics and Results Research, today announced the publication of a series of articles that offer insights into biopharmaceutical mores and the future of risk-sharing agreements. The series was published in the April 2020 issue of Value in Health.

More recently, a proposal by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) in October 2019 contained new safe ports of protection against Kickback, which covered value-based agreements with health care providers, but excluded biopharmaceutical manufacturers, medical device companies and laboratories. Alex Azar, Secretary of HHS, confirmed that the department was working on protective measures to allow VBCs for biopharmaceuticals that the OIG could take into account in the future regime. In the United States, market activity based on value has so far been limited. But there is a great deal of interest in these agreements among both payers and biopharmaceutical producers, and the changing health environment could generate more activity in this area in the future. Similarly, health plans have generated a strong interest in value-based care. By the end of 2018, 50% of Cigna`s payments to healthcare providers in the top 40 markets had a value-based care component.