PBM signs on Jardiance for outcomes-based contract

 

As part of its CareCentered Contracting program, pharmacy benefit manager Prime Therapeutics LLC has entered into an outcomes-based contract with Boehringer Ingelheim for Jardiance, an oral type 2 diabetes medicine indicated to reduce the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease.

As a PBM owned by 18 Blue Cross and Blue Shield plans, company leaders say Prime is uniquely positioned to analyze both medical and pharmacy claims data to evaluate and manage total cost of care. Prime looks at members’ experiences holistically, and this CareCentered Contracting agreement will focus on the total cost of care for members taking Jardiance and comparing that to the total cost of care for patients taking other diabetic medications. In this manner, executives say, Prime can truly evaluate the combined cost of pharmacy and medical on select therapies and its impact on overall health costs for the members we serve.

“Because diabetes affects nearly 10 percent of the U.S. population, Prime actively works to find solutions that can improve our members’ health outcomes and control the overall costs of diabetes,” says Jonathan Gavras, M.D., chief medical officer at Prime. “Establishing a CareCentered Contracting agreement for Jardiance allows us to collect and analyze important data beyond pharmacy claims. These insights help drive the greatest value from the treatment.”

“We’re pleased to enter into this outcomes-based contract with Prime, which represents an important step towards improving outcomes by lowering the total cost of care of people with diabetes,” says Christine Marsh, VP, Market Access, Boehringer Ingelheim Pharmaceuticals Inc. “Diabetes and cardiovascular disease put a significant financial burden on the healthcare system, and we are confident Jardiance may improve outcomes by reducing the overall healthcare costs of people with type 2 diabetes and cardiovascular disease.”

Jardiance adds to Prime’s portfolio of CareCentered Contracting agreements in the diabetes category; the comprehensive treatment of diabetes is an area of strategic focus for the company.

“While not the only approach we take to help ensure members are getting the value they deserve from the drugs they take, outcomes-based and/or value-based contracts are integral to our contracting strategy,” says Alec Mahmood, chief financial officer at Prime. “This contract, plus several others we’ve added in recent months, demonstrate Prime’s continued commitment to align manufacturers, members, payers and providers around the goal of improving health by helping to ensure drugs work as they are intended.”