Payers partner with pharma to lower costs, improve outcomes


Insurers and pharmaceutical companies increasingly are joining forces to lower costs and improve outcomes while also leveraging each other's knowledge to achieve greater value.

The partnerships also advance clinical trials, increase each company's market share and provide insights into future drug development and business opportunities, according to the Burrill Report.

For example, Humana has partnered with Pfizer in an agreement that focuses on trust, shared risk to realize real-world information on adherence, adverse side effects and disease incidence prevalence. They hope the partnership will result in better medicines and improved patient compliance.

To achieve those goals, Humana needed a "willing participant with the same view," William Fleming, president of Humana Pharmacy Solutions, told the Burrill Report. Partnering with Pfizer will enable Humana to improve quality and lower costs faster than taking "a piecemeal approach on its own,"  he added.

The Pfizer partnership has led to one unexpected outcome for Humana--the creation of a predictive model for the type of members who are at risk of opiod abuse. The new model helps Humana identify members earlier and intervene to prevent their abuse and, therefore, lower their costs.

Insurers also can directly influence which drugs their members take by, for example, excluding some medications from coverage like Harvard Pilgrim did with compounded drugs, as FierceHealthPayer previously reported. So these relationships can favor pharmaceutical companies by allowing them to communicate with payers about their drugs' efficacy.

To learn more:
- read the Burrill Report article

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