Optum, Merck to collaborate on value-based reimbursement models for prescription drugs

Eden Prairie, Minn.-based Optum, the health services platform of Minnetonka, Minn.-based UnitedHealth Group, entered a multiyear agreement with Merck to link prescription drug reimbursement to patient outcomes.

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Here are three things to know.

1. The organizations will use Optum’s claims and clinical records data to create and assess valued-based prescription payment models.

2. Optum and Merck will publicly share their assessments of the payment models “to help inform and facilitate the understanding and use of pragmatic approaches to [outcomes-based risk sharing agreements] in the healthcare system.

3. The partnership is the latest in a growing number of valued-based reimbursement collaborations for prescription drug payments. 

  • Bloomfield, Con.-based Cigna has entered seven outcomes-based deals since 2009, according to Bloomberg.
  • Danish drugmaker Novo Nordisk recently signed its first pay-for-performance contract with Louisville, Ky.-based Humana for the diabetes treatment Victoza.
  • Novartis, Amgen, Sanofi and Eli Lilly & Co., have also signed similar contracts with various insurers in the past year, according to the report.

More articles on payer issues: 
7 questions about UnitedHealth’s false claims lawsuits, answered
How Aetna, Anthem, Humana and UnitedHealth fared in Q1
CMS seeks to remove small business plan enrollment from ACA marketplace: 3 things to know

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