This is the first time such an agreement applies outcomes-based contracts to cover Medicaid patients in the United States. The deal offers a novel approach to connecting outcomes with the effective net cost of products.
As a pharmacy benefit management and tech firm, Abarca — with offices in Miami and San Juan, Puerto Rico — helps clients manage their pharmaceutical spending by developing partnerships with health plans, government programs, union groups and other payers. This particular accord places accountability on Biogen to deliver safety, efficacy and value for the patients who receive these therapies, as well as for the payers who finance them.
“We are excited to partner with Biogen in implementing this innovative, data-driven and outcomes-based pricing program for MS drug therapies, Javier Gonzalez, Abarca’s chief operating officer, said in a press release. “We believe this program is a significant milestone in our efforts to collaborate with pharmaceutical manufacturers to find a better way to guide patients and payers down the path to value, especially in high-impact disease categories.”
Outcomes-based contracting refers to arrangements between manufacturers and payers, in which the manufacturer must comply with a set of predetermined rules, namely issuing or refunding payers depending on how well the therapy performs in the real world.
“We believe that contracting approaches like this will help expand access for patients,” said Jean-Paul Kress, Biogen’s executive vice-president. “We are excited to work with an innovative partner like Abarca Health and lead the way for MS care.”
Biogen has recently completed a Phase 2b clinical trial (NCT01864148) of its remyelination drug candidate opicinumab. Even though the candidate failed to meet its primary goal of improving disability in relapsing-remitting (RRMS) and secondary progressive (SPMS) forms of the disease, researchers still believe that the drug achieved somewhat strong improvements.
In an April 2017 presentation at the American Academy of Neurology (AAN) 2017 Annual Meeting in Boston, a study analyzed the efficacy results of the trial.
The study, “Efficacy Results from the Phase 2b SYNERGY Study: Treatment of Disabling Multiple Sclerosis with the Anti-LINGO-1 Monoclonal Antibody Opicinumab,” found that opacinumab triggered remyelination by preventing the actions of LINGO-1 — a factor that suppresses myelination and axonal regeneration.
Overall, patients receiving intermediate doses seemed to benefit most from the treatment, with a 65.6 percent to 68.8 percent improvement, while those in the highest-dose and lowest-dose groups saw estimated improvements of 51.1 percent and 41.2 percent.
Even though the trial did not meet its primary goal, Biogen doesn’t accept this as the end of the road for opicinumab and said it now plans to move forward with the middle dose of 10 mg — which seems to perform best — and recruit patients most likely to be responders to evaluate its performance.