The Policy-Changing Power of a Payer-Pharma Collaboration


Last week I traveled to Arizona for a senior level team strategy session. As part of our “break,” we set out on a five-mile hike through the Arizona hills. When we’d finished, my Fitbit had registered 89 flights.

Much like stakeholders immersed in the evolving healthcare landscape – encouraging each other across the desert – we had to work together to accomplish a common goal.

Many stakeholders are recognizing collaboration as the key to delivering the highest quality care most affordable to the patient. In light of the growing importance of pharmaceuticals – new, breakthrough technologies such as the cure for hepatitis C – Anthem is working together with Eli Lilly & Company to help drive policy changes that will facilitate the transition from a price-based system to one that is value-oriented.

“While there are no silver bullets, we believe it is possible to start breaking down some of the hurdles that stand in the way of a value-oriented system,” Sam Nussbaum, Anthem’s former chief medical officer and currently chair of an alternative payment model work group in the Centers for Medicare & Medicaid Services’ Health Care Payment Learning & Action Network, and David Ricks, Eli Lilly’s senior vice president, wrote in a Health Affairs blog posting.

So far, the companies have identified two areas that they believe must be addressed in order to unleash a new wave of innovative approaches to pharmaceutical pricing: 1) facilitating more robust communication between health plans and drug developers prior to drug approval and 2) addressing legal and regulatory barriers to value-based payment arrangements.

These policy ideas are only the beginning of a necessary partnership. Lilly and Anthem both want the same thing for patients — to have access to new, innovative medicines now and into the future. By bringing together best ideas from the organizations, they will be able to more successfully provide access to state-of-the-art treatments to improve health and cure illness.

Related Articles

  • Closing Gaps in Real-World Evidence through Data LinkageClosing Gaps in Real-World Evidence through Data Linkage Dr. Kevin Haynes, PharmD, MSCEPrincipal Scientist, HealthCore-NERI Interview with Dr. Kevin Haynes, Principal Scientist, HealthCore-NERI. Dr. Patti Peeples, CEO of […]
  • Collaboration for InnovationCollaboration for Innovation Collaboration is key to innovation in health care. By fusing together disparate resources and diverse skillsets and perspectives, we can generate new knowledge and discoveries with the […]