Despite the lack of evidence, experience to date with results-based agreements indicates a number of good practices. It is likely that the review of high drug prices will not dissipate in the near future, as highlighted by the Trump administration`s plan2 and other bureaucratic initiatives. It is up to the pharmaceutical industry to take control by looking at other market solutions, such as value-based agreements. B, which allow patients to access drugs without financially crippling them. Value-based agreements are still in their infancy and are likely to be even more painful. However, cooperation under these agreements is promising and demonstrates the willingness of health sector actors to adopt innovative approaches to value-based agreements. While much of the assistance to value-based contracts includes the concept of shared risk between the producer and the payer, the primary burden of this risk is primarily attributable to the health fund. Before seeing the results of the predefined result, the payer is responsible for covering the high costs of prescribed innovative therapies. Depending on the clinical results, this could mean covering a few dozen recipes for months or even years. Defining these measures and securing an agreement is a complex obstacle for stakeholders. It may also be difficult for drug manufacturers, payers and even suppliers to create a contract.11 HHS indicated that this proposal was not intended to undermine existing protection for value-based agreements between manufacturers and sponsors under Medicare Part D.18. Drug manufacturers will continue to face regulatory constraints with the introduction of innovative new therapies.
The Larotrectinib program put in place by Bayer prior to the HHS proposal is proof of how drug manufacturers can, without a contract, approach value-based agreements. In the future, we need to improve the ability to implement value-based agreements. If major interest groups are unable to deliver on their promise to provide innovative therapies to save lives while making them more affordable, the industry will take a big step backwards to simply focus on price. As the pharmaceutical industry continues to offer innovative therapies to meet the unmet needs of small patients, we must continue to seek market-based solutions that expand access to medicines and continue to promote innovation. Most value-based contracts are now executed in the fields of oncology and hematology, where innovative drugs can be costly for patients but potentially saved.8 Value-based contracts are useful in these clinical areas where there may be uncertainty about the effectiveness of a drug in the real world.