WELLESLEY, MA - Harvard Pilgrim Health Care has signed two innovative, outcomes-based contracts with AstraZeneca for medicines to treat acute coronary disease and Type II diabetes. These are the latest two in a series of agreements the health plan has executed with pharmaceutical companies that measure the effectiveness of medicines in actual patients.
The first is a three-year contract for Brilinta, a medication used to lower a patient's chances of having another heart attack or dying from one.
Harvard Pilgrim will be monitoring specific criteria in patients following discharge from a hospitalization for acute coronary syndrome. The outcome will focus on measuring the reduction in hospitalizations for repeat acute coronary events for patients on Brilinta as compared to patients on another oral antiplatelet therapy.
The second contract is for Bydureon, a medication used to control blood glucose levels in Type II diabetes patients. Harvard Pilgrim will measure HbA1c levels in patients and evaluate the ability of patients who adhere to Bydureon to get to a predetermined HbA1c goal.
If the medicines fail to meet the agreed upon outcomes criteria in real patients, Harvard Pilgrim will be charged a lower amount. Through these contracts, AstraZeneca and Harvard Pilgrim agree that the health plan will be charged for medicines based on value to the patient, and not solely on volume of medicine sold.
"Linking the ultimate cost of these medicines to their real-world clinical effectiveness really puts patients at the center of focus," said Harvard Pilgrim Chief Medical Officer Michael Sherman. "Real world performance may differ from what is observed in well-controlled clinical trials, and the willingness of pharmaceutical companies like AstraZeneca to go at risk for delivering on these outcomes sends a positive message to health plans, prescribing physicians, and patients."
"Patient outcomes should be the primary driving force in healthcare. With a differentiated Cardiovascular and Metabolic disease portfolio which helps address important unmet patient needs, we are proud to share accountability for each patient by partnering with payers and health plans like Harvard Pilgrim through these types of innovative agreements," said Mike Crichton, VP, Cardiovascular and Metabolic Diseases, AstraZeneca US.
About Harvard Pilgrim Health Care
Harvard Pilgrim is a not-for-profit health services company that, along with its subsidiaries, is improving the well-being of its 2.7 million customers. Harvard Pilgrim's flagship health plans in New England provide health coverage to 1.3 million members, while another 1.4 million individuals are served through Health Plans, Inc., a subsidiary that provides integrated care management, health coaching and plan administration solutions to self-funded employers nationwide. Founded in 1969, Harvard Pilgrim has built its reputation on innovation and collaboration with a goal of lowering health care costs, improving care and enhancing the overall member experience. It is known for its excellent clinical programs, customer service, health improvement strategies and innovative tools that offer consumers greater transparency and empower them to make better decisions about their health care. Harvard Pilgrim is home to the Harvard Pilgrim Health Care Institute, a unique collaboration with Harvard Medical School. As Harvard Medical School's Department of Population Medicine, the Institute is the only appointing department of a U.S. medical school housed within a health plan. Funded primarily through external government and private sources, it provides critical information to all levels of our health care system on issues affecting population health and health care delivery. Harvard Pilgrim is consistently among America's highest-rated health plans according to an annual ranking of the nation's best health plans by the National Committee for Quality Assurance (NCQA)*.
*Harvard Pilgrim Health Care (private HMO/POS and PPO plans) and Harvard Pilgrim Health Care of New England (private HMO/POS plans) have been rated 4.5 out of 5 in NCQA's Private Health Insurance Plan Ratings 2016-17. NCQA's Private Health Insurance Plan Ratings 2015-16. NCQA's Private Health Insurance Plan Rankings, 2011-15, HMO/POS/PPO.