What Payers Can Contribute to Pricing Discussions During Clinical Development

Doug Fulling, MA, president of Precision AQ, and Andrew Cournoyer, senior vice president and director of the access experience team at Precision AQ, spoke with The American Journal of Managed Care^® about how introducing payers into clinical spaces earlier could improve pricing conversations with manufacturers.

This transcript has been lightly edited for clarity.

Transcript

Can the pricing conversations with manufacturers be affected by payers being introduced to clinical trials earlier?

Andrew Cournoyer: I do think there is some benefit when it comes to pricing. I mean, payers are looking at drug categories, whether it's a new category that has no options or ones that are somewhat commoditized, and have a sense of what price to value looks like. I think in the earlier discussions, clinical development programs, payers can give that sense of what their expected tolerance for various price points are given a certain threshold of benefit. It could be efficacy, safety or differentiation. How that threshold or tolerance for price varies could be directly related to the performance of the drug and the clinical trial and how it moves the needle vs a standard of care. And then how much does it move the needle? Because ultimately, the better a drug performs in safety [and] efficacy, it's going to drive a better outcome which has a better downstream impact on health care resource use, or mitigation of a health board resource use, such as hospitalizations, ER visits. I think knowing that stuff up front, to put it eloquently, is what's going to better help inform pricing and contracting strategies downstream. So there is that benefit to it.

Doug Fulling: Oftentimes, pricing can be impacted just by the length of development, meaning how much time do I have in market to recoup the investment. So if we can accelerate clinical trials, because we've got patient populations that we know are eligible and can participate upfront, and we can proactively identify them for enrollment. Pulling a drug in a year or 2 earlier than was anticipated to hit the market is good for patients, because we know they're going to benefit from it. But it's also good for the manufacturer. They've been able to obviously be able to take that investment and start to generate revenues sooner which could have a positive impact on overall pricing. So through the acceleration, we believe that there can be a benefit to patients and manufacturers.