CLIP — Point32 Trailblazes with Value-based Drug Contracts (STAT News)

Point32 Health continues to trailblaze drug price negotiation with a new value-based contract for lung cancer treatment.

Lung cancer drugs become a growing focus of value-based deals with health plans

by Ed Silverman, STAT News

In another bid to address the cost of prescription medicines, Takeda Pharmaceuticals (TAK) and Point32Health have reached a deal in which the drug maker will offer a “significant rebate” for a lung cancer treatment if the medication proves ineffective for patients.

Specifically, the deal involves Alunbrig, which is approved to treat non-small cell lung cancer. If a patient covered by Point32Health — the second-largest health plan in New England — does not remain on the drug for three months or more due to effectiveness or tolerability, Takeda will return an unspecified amount of money to the insurer. The drug has a $17,000 list price for a month’s treatment.

Such arrangements — often referred to as value-based or outcomes-based agreements — have become increasingly common in recent years as the pharmaceutical industry struggles to convince payers to provide reimbursement in the face of rising drug prices. But this latest deal appears to be one of the few known agreements to address cancer treatments and apparently only the second to target a lung cancer drug.

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