With increasing cost-containment measures, payers have emerged as the key decision-making group, as proving the economic and clinical value of a drug is of central importance in achieving commercial success. As a result, pharma-payer deals have been used not only for launch products but also for mature brands in order to drive market share in the face of branded and generic competition alike.Analysis of success drivers and resistors of pharma-payer deals as a lifecycle management strategy.Discussion of how pharma-payer deals can satisfy key stakeholder needs.Case study of recent successful and unsuccessful pharma-payer deals.Risk-sharing agreements are based on a "guaranteed" outcome resulting from the treatment, be that based on financial or outcome/performance criteria. If the outcome is achieved the payer will pay; if not, the pharmaceutical company refunds the payer for the cost of the drug.Risk-sharing agreements have the potential to reconcile the needs of different stakeholders: pharma companies secure market entry, the payer is financially protected from patients who fail to respond to drug treatment, and patients gain access to innovative therapies.While straightforward discount and rebate deals are usually used to maintain sales later in the lifecycle when the drug in question is facing greater competition, recently, creative risk-sharing deals have also been used for mature brands in order to drive market share in the face of branded and generic competition alike.How can pharma-payer deals drive or maintain franchise sales'How can pharma-payer deals be used at different stages of a brand's lifecycle'In which markets are pharma-payer deals commonly used'
Inguinal Hernia Global Clinical Trials Review, H1, 2013
Lifecycle Management Strategies: Pharma-Payer Deals - Creative agreements are used at different stages of the brand lifecycle to maximize sales
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Lifecycle Management Strategies: Pharma-Payer Deals - Creative
agreements are used at different stages of the brand lifecycle to
maximize sales
Published on August 2012
Report Summary
With increasing cost-containment measures, payers have emerged as the key decision-making group, as proving the economic and
clinical value of a drug is of central importance in achieving commercial success. As a result, pharma-payer deals have been used not
only for launch products but also for mature brands in order to drive market share in the face of branded and generic competition
alike.Analysis of success drivers and resistors of pharma-payer deals as a lifecycle management strategy.Discussion of how
pharma-payer deals can satisfy key stakeholder needs.Case study of recent successful and unsuccessful pharma-payer
deals.Risk-sharing agreements are based on a "guaranteed" outcome resulting from the treatment, be that based on financial or
outcome/performance criteria. If the outcome is achieved the payer will pay; if not, the pharmaceutical company refunds the payer for
the cost of the drug.Risk-sharing agreements have the potential to reconcile the needs of different stakeholders: pharma companies
secure market entry, the payer is financially protected from patients who fail to respond to drug treatment, and patients gain access to
innovative therapies.While straightforward discount and rebate deals are usually used to maintain sales later in the lifecycle when the
drug in question is facing greater competition, recently, creative risk-sharing deals have also been used for mature brands in order to
drive market share in the face of branded and generic competition alike.How can pharma-payer deals drive or maintain franchise
sales'How can pharma-payer deals be used at different stages of a brand's lifecycle'In which markets are pharma-payer deals
commonly used'
Table of Content
EXECUTIVE SUMMARY'Introduction
'Strategic scoping and focus
' Key findings
'Related reports
PHARMA-PAYER DEALS OVERVIEW'What are pharma-payer deals' - Early-stage risk-sharing deals to gain reimbursement
approval
- Mid- to late-stage LCM pharma-payer deal strategies
'Drivers and resistors of pharma-payer deals as lifecycle management strategy
'Pharma-payer deals focus on satisfying payer needs
'Risk-sharing deals are increasing in numbers in the EU - Payer contracting becomes more creative in Germany
'US: deals with individual payer organizations are appearing
'Case study summary
PHARMA-PAYER DEALS CASE STUDIES'Januvia (sitagliptin) and Janumet (sitagliptin/metformin): Merck & Co. agrees
performance-related discounts deal with Cigna - Lesson
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- Background
- Impact
'Enbrel (etarnecept): Pfizer/Wyeth develop a compliance support program with German payer - Lesson
- Background
- Impact
'Aricept (donepezil): Pfizer/Eisai are testing "integrated care" to assess the cost-effectiveness and impact of its dementia drug Aricept
- Lesson
- Background
- Impact
'Cimzia (certolizumab; UCB): positive recommendation in the UK is based on a patient access scheme - Lesson
- Background
- Impact
'Actonel (risendronate; Sanofi/Procter & Gamble): risk-sharing deal used to stave off both generic and branded competition - Lesson
- Background
- Impact
'Aclasta (zoledronic acid; Novartis): "no cure, no pay" deal used to boost uptake before new competitor entry - Lesson
- Background
- Impact
BIBLIOGRAPHY'Publications and online articles
'Datamonitor reports and products
APPENDIX'Exchange rates used in this report
TABLES
'Table: Pharma-payer deals case studies summary
'Table: Currency exchange rates, 2011
FIGURES
'Figure: Early-stage risk-sharing agreements improve uptake and maximize peak sales
'Figure: Pharma-payer deals can be used in middle and later stages of the brand lifecycle to maximize peak sales and extend sales
after patent expiry
'Figure: Drivers and resistors of pharma-payer deals as an LCM strategy
'Figure: Pharma-payer deals need to target key stakeholders' needs to be successful
'Figure: Benefits of a performance-based contract between Merck & Co. and Cigna
'Figure: Benefits of compliance support program between Pfizer/Wyeth and Taunus
'Figure: Benefits of Pfizer/Eisai and AOK dementia study
'Figure: Benefits of patient access scheme between UCB and NICE
'Figure: Actonel's risk-sharing deal in the US is used late in the brand lifecycle to stave off competing generics
'Figure: Aclasta pharma-payer deal in Germany
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Companies Mentioned
Hutchison 3G UK Limited, Janssen Pharmaceuticals, Inc.
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