VIable

NDHI
NAT IONAL DIALOGUE FOR
Healthcare Innovation
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Objective: Create a policy environment conducive
to allowing health plans and manufacturers
to enter into a variety of value-based
contracting arrangements, aligned with the
shift toward value-based payment and the
goal of promoting access to high-value care.
This may include creation of legislative/regulatory
exceptions for Best Price and all other
relevant government pricing calculations and
requirements as they relate to products sold
or transferred under value-based contracts,
as well as additional safe harbors (adherence
safe harbor, data analytics safe harbor,
warranty safe harbor) to the federal Anti-Kickback
Statute (AKS) that protect value-based
contracts from AKS liability.
Value Delivered
Many stakeholders can benefit from more open communication
between biopharmaceutical manufacturers
and health benefit companies as well as from a policy
environment more conducive to value-based payment
arrangements:
• Health plans would be able to establish rates and
benefits more effectively with increased information
and greater ability to drive value through innovation
in payment arrangements
• Manufacturers would be able to demonstrate the
value of their products for patients and for the healthcare
system sooner and more directly ensuring the
right patients are getting treatment at the right time
Path Forward
• In the short term, both companies will continue
educating policy decision-makers and health policy
thought-leaders on these issues. In the long term,
they hope to achieve the goals of the collaboration,
achieving policy changes that enable communication
and innovation to thrive in the healthcare industry,
in order to more successfully provide access to
state-of-the-art treatments to improve health and
cure illness.
• Patients would benefit from enhanced access to
medicines and more predictable insurance rates
Anthem and Eli Lilly Policy Collaboration
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