Tuesday, April 17, 2018
One of the first agreements announced in respiratory
PITTSBURGH, Pa. (April 17, 2018) — Highmark Inc. has entered into an outcomes-based contract with AstraZeneca for the well-known medicine Symbicort®. Indicated for the treatment of asthma and chronic obstructive pulmonary disease (COPD), Symbicort helps decrease inflammation and open up the airways in patients' lungs.
This contract marks one of the first outcomes-based agreements involving these chronic lung conditions and will apply to commercial members in Highmark's national and core health insurance markets in Pennsylvania, West Virginia, and Delaware.
"Highmark is committed to innovative contracting solutions that focus on clinical results and drive patients to products that will encourage better disease management. COPD continues to be one of the top spend therapeutic categories across our membership base," said Ryan Cox, RPh., director of specialty pharmacy strategies at Highmark Inc. "By entering into outcomes-based agreements with pharmaceutical companies, we are helping to ensure that our members have access to products that provide better patient outcomes."
As part of the contract, Highmark will review specific pharmacy and medical criteria to determine if COPD or asthma-related symptoms for Highmark patients who are on Symbicort are in-line with the clinical trial results provided by AstraZeneca. If Symbicort doesn't perform as expected, AstraZeneca will provide a corresponding rebate.
"As a leader in innovative, value-based agreements, AstraZeneca recognizes the need to evolve towards a greater focus on value and shared accountability for patient outcomes. We have entered into value-based agreements across our therapeutic areas, and we are proud to stand behind the science of Symbicort in this agreement with Highmark," said Rick R. Suarez, VP, Market Access, AstraZeneca US. "Our goal is to provide affordable access to AstraZeneca medicines for patients and this agreement honors our joint obligation to deliver better patient outcomes."
Healthcare organizations continue to implement value-based agreements and contracts to pay providers and pharmaceutical companies based on the quality of care for the patient instead of the volume of care being delivered or prescribed.
"As an Integrated Delivery and Financing System, Highmark has the unique ability to be a pioneer in implementing these types of innovative contracts that can truly track the medical outcomes by leveraging our members' integrated pharmacy and medical data" Cox continued. "As a result, our patients will be positioned to receive the most effective and efficient care that can improve their overall health."
According to the American Lung Association, more than 11 million people suffer from COPD making it the third leading cause of death in the U.S. In addition, the proportion of people with asthma continues to worsen with the number of people suffering from the condition increasing by nearly 15 percent in the last decade.
Highmark Inc. and its health insurance subsidiaries and affiliates collectively are one of America’s largest health insurance organizations and together with its Blue-branded affiliates, collectively comprise the third-largest overall Blue Cross and Blue Shield-affiliated organization in the country based on capital. Highmark Inc. and its affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve approximately 4.6 million members and hundreds of thousands of additional individuals through the BlueCard® program. Its diversified businesses serve group customer and individual needs across the United States through dental insurance, vision care and other related businesses. Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit www.highmark.com.
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Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Blue Cross Blue Shield of Western New York serves eight counties in Western New York and Highmark Blue Shield of Northeastern New York serves 13 counties in Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.
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