Options, Expertise And Risk Tolerance Needed For Successful Value-Based Contracts
Biohaven Pharmaceuticals developed six different value-based contracting options to support the launch of acute migraine therapy, Nurtec ODT. Despite contract complexity and lingering regulatory risk, payers are aggressively pursuing value-based contracts, leading even small biopharmas to invest in strong health economics capabilities.
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A deeper understanding of rare diseases – how they differ across geographies and ethnicities, or which genes and biomarkers are most useful targets for new treatments – can help to accelerate and de-risk clinical trials. On the commercial front, patient data and insights could mean the difference between a category leader and a failure.
Value-based contracting in the US is moving toward high-cost drugs for rare disease and away from lower cost chronic treatments as payers plan for the coming pipeline of cell and gene therapies. Marketed gene therapies all have some kind of risk sharing deal in place but further progress on the most innovative payment models is hampered by regulatory and operational challenges.
The market for novel preventive and acute treatments grew from three anti-CGRP antibodies at the start of 2020 to four biologics and two oral drugs against CGRP plus a small molecule 5-HT1F inhibitor.