This week’s webinar, VBA 2.0 Building and accelerating VBA for the next era, offered a deeper look at the current VBA landscape and perspectives on the future. HealthVerity hosts Sandy Leonard, VP of real-world evidence platforms and Reyna Klesh, senior director of data insights, were joined by Verpora CEO Nick Merryfield and Omar Ali, head of payers, to examine how value-based agreements (VBAs) are evolving given the proposed rule changes to "Medicaid Best Price" from CMS, as well as other challenges for payers and manufacturers alike.
During the session, Verpora’s Omar Ali shared valuable insights on US VBA growth over the past nine years, showing a steep increase in published contracts. Referencing data from the Verpora US VBA tracker, he also noted that the majority of US contracts are under-reported. While top payers are beginning to ramp up their VBA programs, Verpora’s research found that payers are also willing to contract across a broad range of specialties moving forward.
What is VBA 2.0?
Research shared in the webinar also highlighted that COVID-19 responses have not interrupted existing VBAs, nor deterred payers from plans to engage with them in the future. This is a good sign for manufacturers—but what else can they expect for the future of VBAs, or VBA 2.0?
- Increase shared risk to make VBAs more meaningful
- Speed up agreements to “fail fast” and prevent drop-off
- Increase access to real-world data for both parties
- Prepare for continued reliance on video communication
VBAs are already a significant component of the pharmaceutical landscape, and the Centers for Medicare & Medicaid Services (CMS) proposed rule changes will enable the expansion of VBAs even further. It will do so by removing one of the biggest challenges of VBAs, Medicaid Best Price, and the ability to set a rebate to zero with one failure. There are a number of other important changes included in the proposal, such as:
- Setting the value-based pricing (VBP) definition to 90% risk and to include IFA
- Bundle sales will prevent a negative outcome from setting best price to zero
- Extending past 36 months will open up long-term VBAs, where real-world data will be even more important
- Multiple best prices for different outcomes will be an alternative to long-term sales
Overall, the changes from CMS are positive and the team looks forward to the next phase of updates. But there are still further adaptations to be made in the life sciences industry and at individual organizations.
Challenges with VBAs
Teams involved in developing VBAs will still inevitably see challenges in developing highly effective and efficient value-based contracts. Some of the challenges addressed in the webinar include gaining organization-wide buy-in, developing VBAs at scale and speed, negotiating VBA contracts, putting enough value at risk, addressing cross-functional team inefficiency and stress and accessing real-world data.
The panel provided excellent tips for each category, from who to speak to in your organization to building negotiation skills in a now-virtual world. Through the partnership between HealthVerity and Verpora, life sciences can now build stronger VBAs using industry-leading solutions and the HealthVerity data ecosystem to inform contract strategy, define clinically relevant outcomes and access real-time VBA monitoring.
To learn more about how HealthVerity and Verpora are addressing questions on VBAs to drive speed, scalability and value, access the webinar recording below.