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.

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