Highmark's outcomes-based contract for SYMBICORT® improves patient outcomes for asthma, COPD
PITTSBURGH, Pa. (Oct. 28, 2019) Highmark today announced that its outcomes-based contract with AstraZeneca for the respiratory medicine SYMBICORT® demonstrated positive results in improving patient outcomes for the treatment of asthma and chronic obstructive pulmonary disease (COPD).
Under outcomes-based contracts, drug companies are accountable for the clinical effectiveness of medications and the per-member, per-month medical and pharmacy costs for members who use the drug compared to the costs for members who use other drugs to treat their health condition. The goal is to ensure that Highmark members have access to the most clinically effective, cost-efficient medications possible.
Highmark initially announced its outcomes-based contract with AstraZeneca for SYMBICORT in April of 2018. SYMBICORT, approved for the treatment of asthma and COPD, helps decrease inflammation and open up the airways in patients' lungs. As part of the contract, Highmark reviewed specific pharmacy and medical criteria to determine if asthma or COPD-related symptoms for Highmark patients on SYMBICORT were in-line with the clinical trial results provided by AstraZeneca.
Highmark found that the number of patients taking SYMBICORT who saw a worsening of symptoms requiring them to visit a health care provider or hospital were substantially lower than expected. Among Highmark members on SYMBICORT with a primary diagnosis of asthma or COPD, more than half experienced a stabilization or improvement of their symptoms.
Highmark and AstraZeneca's contract for SYMBICORT was one of the first outcomes-based agreements involving asthma and COPD. The contract applied to Highmark's commercial members in its national health insurance markets and its core health insurance markets in Pennsylvania, West Virginia and Delaware. Slightly more than 30,000 SYMBICORT prescriptions were filled for Highmark commercial members in 2018.
Highmark has also forged outcomes-based contracts for the treatment of several other high-cost, chronic health conditions, including diabetes and inflammatory bowel disease.
"Outcomes-based agreements like this show the value of medicines like SYMBICORT to both patients and the health system in reducing exacerbations, hospitalizations and inpatient visits," says Sarah Marchè, senior VP of pharmacy services for Highmark. "As Highmark furthers its leadership in value-based strategies, results like these are proof that a shared commitment to identifying the right medicine and approach in a priority therapy area can improve patient outcomes."
About Highmark Inc.
One of America's leading health insurance organizations and an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. (the Health Plan) and its affiliated health plans (collectively, the Health Plans) work passionately to deliver high-quality, accessible, understandable, and affordable experiences, outcomes, and solutions to customers. As the fourth-largest overall Blue Cross Blue Shield-affiliated organization, Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of 4.5 million members in Pennsylvania, Delaware, and West Virginia. Its diversified businesses serve group customer and individual needs across the United States through dental insurance, vision care and other related businesses. For more information, visit www.highmark.com.