Amgen Partners for Outcomes-Based Reimbursement for Blockbuster Enbrel

Amgen has formed an outcomes-based contract with Abarca, a pharmacy benefit manager (PBM), for Amgen’s blockbuster, Enbrel (etanercept), an anti-inflammatory drug.

Under the agreement, Amgen will issue rebates to Abarca’s clients for eligible members who discontinue the use of the drug after three months of treatment. This applies to members of commercial health plans who are using the drug for the treatment of moderate-to-severe rheumatoid arthritis.

Outcome-based agreements are of growing interest in the healthcare industry. Traditionally, agreements between payers and drug manufacturers have not been tied to the value or health outcome that medications provide. Outcome-based contracting in healthcare is a type of contracting agreement between a health plan and drug and device manufacturers that ties product reimbursement to clinical, quality, utilization, or other outcomes.

Abarca says that its platform has technology in place to track and report when a member discontinues a drug. The agreement between Abarca and Amgen was made possible by Darwin, Abarca’s smarter PBM platform, which tracks utilization in real-time and generates the detailed information drug makers need to issue a rebate.

This is the second outcome-based agreement between Abarca and Amgen. In 2018, the companies entered into an arrangement for Repatha (evolocumab), a drug for treating hyperlipidemia, which Abarca says was the first agreement of its kind involving this drug. Also in 2018, Abarca announced an outcomes-based contract with Biogen for medications used to treat multiple sclerosis. Abarca is currently collaborating with several drug manufacturers for similar agreements.

Source: Abarca


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