Contract measures adherence, helps link price of therapy to clinical value

Given the growing use and cost of multiple sclerosis (MS) medicines, Prime Therapeutics LLC (Prime), a leading pharmacy benefit manager (PBM), and Biogen, a market leader of medicines to treat MS, have partnered on an outcomes-based contract for several MS drugs as part of Prime’s CareCentered Contract™program.

Prime’s CareCentered Contract is one of Biogen’s pilot outcomes-based contracts for its MS drugs, and the only pilot with a national payer. This contract places accountability on Biogen to deliver safety, efficacy, and value for the patients who receive these life-impacting therapies and for the payers who finance them.

As an integrated PBM with its health plan clients, Prime is uniquely positioned to empower members to take effective prescription medications by evaluating members’ medication persistency at regular intervals and through ongoing monitoring of outcomes data. Prime is experienced in designing outcomes-based contracts, having pioneered its first agreement in 2010.

And, as the leader in MS, Biogen is an ideal partner to work with Prime on innovative ways to provide value to patients.

“With increasing use of specialty medications for complicated diseases, it’s extremely important to make sure members are staying on track with their drug therapy regimen,” said Jonathan Gavras, M.D., chief medical officer at Prime. “Using outcomes data under the pharmacy and medical benefits, Prime can structure these types of drug-specific contracts to help align price to clinical value for our clients and improve health outcomes for members. We appreciate Biogen’s collaboration and willingness to back their products’ effectiveness.”