Value-Based Contracts Resources

Advancement in medications, vaccines, and gene therapies requires innovation in payment and reimbursement methods. New value-based and alternative payment contracts are increasingly implemented across a variety of health care plans, and pharmacy benefit managers and a range of care delivery providers are also engaging in these contracts. However, the types of conditions treated (e.g., rare vs. common diseases), the compliance and regulatory requirements, contractual terms, and risk/payment models used are complex.

These AMCP, AMCP Learn, and Journal of Managed Care + Specialty Pharmacy resources can help advance the role of value-based contracts to improve access and affordability of medications.

AMCP Resources and Continuing Education

• Talking the Talk. In the World of Value-Based Care, Words Matter: A Lexicon for Value-Based Purchasing
  December 2023
  Value-based contracts often require significant time to reach final negotiation and implementation. Disconnect, misalignment, and lack of a common framework for value-based purchasing agreements has exacerbated these challenges. This lexicon provides a unified language for discussing and designing value-based contracts across payers, provider systems, and manufacturers.
  • Download the Lexicon | One-Pager | Slide Deck(Members Only)
  • Video | Press Release | Executive Summary
  • Press Release | Forum Proceedings | Forum Webinar
  • Press Release | Forum Proceedings | Forum Webinar
  • Press Release | Forum Proceedings | Forum Webinar

  Journal of Managed Care + Specialty Pharmacy (JMCP)

  • Performance-Based Risk-Sharing Arrangements for Devices and Diagnostics in the United States: A Systematic Review
    Jan 2022
    Performance-based risk-sharing arrangements have continued to emerge and evolve over the last 2 decades. To date, most of the attention and available literature have focused on pharmaceuticals. This JMCP review describes publicly available risk-sharing agreements for diagnostics and devices.
  • Using the Delphi Method to Identify Meaningful and Feasible Outcomes for Pharmaceutical Value-Based Contracting
    November 2020
    This Viewpoints article published in JMCP outlines an approach to more effectively align the interests of all key stakeholders and maximize the effect and transparency of value-based pharmaceutical contracts. The authors describe their experience using a validated Delphi surveying technique in five disease contexts to gather information and build stakeholder consensus on key elements before contract development.
  • Examining Misaligned Incentives for Payers and Manufacturers in Value-Based Pharmaceutical Contracts
    January 2020
    This JMCP study compares pay-for-success and pay-for-failure models to identify the short- and long-term incentives that manufacturers and payers should consider when developing value-based contracts. More research is needed on the effect of different types of value-based contract schemes on cost and clinical outcomes.
  • Regulatory, Policy, and Operational Considerations for Outcomes-Based Risk-Sharing Agreements in the U.S. Market: Opportunities for Reform
    November 2019
    Major reasons for the slow uptake of outcomes-based risk-sharing agreements in the U.S. are regulatory issues, operational requirements, and deficits in information sharing, according to a literature review published in JMCP.
  • Determination of Multiple Sclerosis Indicators for Value-Based Contracting Using the Delphi Method
    July 2019
    This JMCP article describes using a Delphi method approach with patients, payers, providers, and pharmaceutical company and pharmacy benefits manager representatives to identify meaningful multiple sclerosis indicators and inform a value-based contract for these medications.
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