Tuesday, August 18, 2020
Agreement advances Highmark’s commitment to ensuring its members have access to the most effective, affordable drugs
PITTSBURGH (August 18, 2020)—Highmark announced that it has entered an outcomes-based agreement with UCB, Inc. (“UCB”) for UCB’s medication CIMZIA® (certolizumab pegol). CIMZIA is a tumor necrosis factor blocker that is prescribed for adult patients with chronic inflammatory conditions that include Crohn’s disease, plaque psoriasis, psoriatic arthritis, rheumatoid arthritis, non-radiographic axial spondyloarthritis, and ankylosing spondylitis.
The outcomes-based agreement for the CIMZIA lyophilized powder healthcare professional administered formulation applies to all commercial members in Highmark's national and core health insurance markets in Pennsylvania, West Virginia, and Delaware. Approximately 380 Highmark members have prescriptions for CIMZIA.
With outcomes-based agreements between a pharmaceutical drug manufacturer and payer, reimbursement for a drug is based in part on its clinical effectiveness for those patients using the drug. If clinical outcomes are not met, the pharmaceutical drug manufacturer typically refunds part of the original purchase to the payer. The goal with these types of agreements is to help patients, including Highmark members, gain access to clinically effective, cost-efficient medications.
“Highmark is dedicated to addressing rising drug costs and enhancing our members’ health outcomes,” says Sarah Marchè, Highmark’s senior VP of pharmacy services. “Our agreement with UCB advances our leadership in the outcomes-based pharmacy space, and helps to ensure that our members receive effective treatments to manage their symptoms and improve quality of life.”
Autoimmune disorders affect the lives of more than 24 million Americans, according to the National Institutes of Health. Collectively, autoimmune disorders are responsible for more than $100 billion in direct health care costs each year, according to the National Institute of Allergy and Infectious Diseases.
“UCB is committed to continuing the evolution of the U.S. healthcare system to better recognize and reward the value solutions bring to patients,” said Duane Barnes, President and Head of U.S. Operations. “We are focused on delivering patient-centered solutions and affordable access for patients to the right medicine at the right time. We believe strongly in the value of CIMZIA as a therapeutic option for people living with chronic inflammatory diseases and to help reduce overall healthcare costs in communities across the regions served by Highmark.”
This value-based contract with UCB continues Highmark's streak of designing and implementing value-based agreements for pharmaceutical and biological products that focus on improved health outcomes for members and ensuring the medications that they are using are working for them. Highmark previously entered into value-based contracts with pharmacy manufacturer Takeda targeting autoimmune diseases, as well as with Boehringer Ingelheim and AstraZeneca for the treatment of COPD and diabetes, respectively. In 2019, Highmark announced that its contract with AstraZeneca for SYMBICORT demonstrated positive results in improving patient outcomes for the treatment of asthma and COPD.
For more information about CIMZIA, including full prescribing information, visit www.ucb-usa.com.
CIMZIA® is a registered trademark of the UCB Group of Companies
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 more than 5.6 million members in Pennsylvania, Delaware, and West Virginia. Its diversified businesses serve group customer and individual needs across the United States through dental insurance and other related businesses. For more information, visit www.highmark.com.
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