The focus of the Pharmaceutical Care Management Association (PCMA) meeting was clear from the first general session, when presentations including HHS’s Proposed Rebate Rule: Implications to the Drug Supply Chain and The Future of PBM-Pharma Relations and Negotiations were presented. The stakeholders were nervous, perhaps even bordering on panic, at the implications of the HHS-proposed rule that would remove the rebate Safe Harbor and pass point-of-sale (POS) discounts to patients at the pharmacy. Attendees were nervous for one reason: the proposed rule fundamentally alters the way payers and manufacturers historically conduct business. However, the potential change to rebates provides an opportunity for payers and manufacturers to define product value.
Value was addressed in a few sessions, including one entitled Optimizing Healthcare Value in the U.S. – Can it be Done? and another, A Novel Approach to Linking Pharmaceutical Pricing and Value Assessments to Evolving Evidence, presented by PFV’s Larry Blandford. The discussion of value by multiple stakeholders at PCMA centered on a common theme: a world that rewards volume, whether by products sold or rebates gained, is no longer sustainable. Instead, the market needs to come together to ensure that worthwhile therapies are rewarded based on value.
The ideas on how to make the move to value were more varied at PCMA. Value-based contracts in pharmaceuticals are laborious and not working very well, as discussed by a presenter from Optum. But aligning product price around the evidence creates value and possibly gains more traction. With an evidence-based approach, manufacturers build the foundation to defend their launch price, and the justification for price changes later as new evidence is generated.
What does the future hold? A change from volume to value, which will require a reliable process for defining and assigning value. The attendees agreed that, no matter what form the new world takes, the market needs to change and they were best placed to change it.