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Pharma APMs: A Learning Curve Awaits You, Pharma.

Maggie Alston, Bruce Pyenson

Managed Care (Langhorne, Pa.)

|October 13, 2018

Summary

Pharmaceutical alternative payment models (APMs) offer valuable lessons but face unique operational challenges. Success hinges on addressing these logistical hurdles and data collection beyond standard claims.

Area of Science:

Health economics
Pharmaceutical policy
Healthcare management

Background:

Provider alternative payment models (APMs) offer insights for the pharmaceutical sector.
The success of pharmaceutical APMs is contingent upon overcoming specific industry challenges.

Purpose of the Study:

To analyze the applicability of provider APMs to the pharmaceutical industry.
To identify key operational and logistical challenges for pharmaceutical APMs.

Main Methods:

Review of existing literature on provider APMs.
Analysis of operational requirements for pharmaceutical industry payment models.

Main Results:

Pharmaceutical APMs can learn from provider APMs.

Keywords:

Costs and Cost Analysis Economics, Pharmaceutical Viewpoint

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Unique operational and logistical challenges exist within the pharmaceutical industry.

Pharmaceutical APMs may necessitate data collection beyond traditional claims data.

Conclusions:

Adapting provider APM strategies requires addressing pharmaceutical-specific logistical issues.
Enhanced data collection mechanisms are crucial for the viability of pharmaceutical APMs.