UPMC Health Plan and Boehringer Ingelheim Announce Innovative, Value-Based Agreement

By a News Reporter-Staff News Editor at Insurance Weekly News -- The UPMC Health Plan announced the initiation of a value-based contract with Boehringer Ingelheim effective 1/1/2019 for Jardiance® (empagliflozin), an oral type 2 diabetes medicine also indicated to reduce the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease. The goal of the contract is to align the incentives of the manufacturer, Boehringer Ingelheim, with the UPMC Health Plan, and will link reimbursement of the drug to costs associated with clinical outcomes in the real-world population. In a first-of-its-kind contract, reimbursement for the medication will be linked to total costs of care for all people with diabetes treated. Previous contracts for Jardiance measured costs only in those with existing heart disease. Jardiance is a product in the Boehringer Ingelheim and Eli Lilly and Company diabetes alliance portfolio.

"We think this type of contract really changes the paradigm around how we pay for medicine. Rather than the standard approach which focused solely on price negotiations, we are now paying for results, to encourage the insurer and the manufacturer to be on the same page - and that page is focused on the health of the patient," said Chronis Manolis, RPh, Chief Pharmacy Officer of UPMC Health Plan.

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