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Related Experiment Video

Updated: Dec 10, 2025

Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation
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Pricing methods in outcome-based contracting: δ6: adherence-based pricing.

Nimer S Alkhatib1,2, Marion Slack1,3, Sandipan Bhattacharjee1,3

  • 1Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA.

Journal of Medical Economics
|August 27, 2020
PubMed
Summary

This study introduces Six Delta, a platform for outcome-based drug pricing. It shows adherence-based pricing for osimertinib in non-small cell lung cancer can reduce costs.

Keywords:
AdherenceC00D40lung cancerosimertiniboutcome-based-contractingpricing methods

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Area of Science:

  • Health Economics
  • Pharmaceutical Pricing
  • Oncology Therapeutics

Background:

  • Outcome-based pricing models are emerging for pharmaceuticals.
  • Patient adherence significantly impacts treatment efficacy and cost.
  • Osimertinib is a targeted therapy for EGFR-mutated non-small cell lung cancer (NSCLC).

Purpose of the Study:

  • To describe the methodology of the sixth dimension (δ6) of the Six Delta platform, focusing on adherence-based pricing.
  • To present a proof-of-concept application of this methodology to osimertinib for NSCLC treatment.
  • To evaluate the potential cost impact of adherence-based pricing.

Main Methods:

  • Proposed two adherence-based payback models: in-advance (clinical trial data) and in-arrear (real-world data).
  • Utilized a 7-step method including efficacy endpoint definition, data extraction, predictive modeling, and Monte Carlo Simulation (MCS) to estimate adherence-adjusted drug prices (DSPAdherence).
  • Conducted a proof-of-concept with osimertinib in NSCLC for 1-year and 2-year hypothetical contracts, using inflated 2018 Wholesale Acquisition Cost (WAC).

Main Results:

  • For a 1-year contract, the average DSPAdherence was $13,785, representing a 5.69% decrease from the 2018 WAC.
  • For a 2-year contract, the average DSPAdherence was $12,582, representing a 13.92% decrease from the 2018 WAC.
  • In-advance payback was estimated due to the unavailability of real-world adherence data for osimertinib.

Conclusions:

  • Adherence-based pricing methods can be successfully integrated into the Six Delta platform.
  • The proof-of-concept demonstrates the potential for cost savings through adherence-linked contracts.
  • Future expansion should incorporate the in-arrear pricing method using real-world data for a comprehensive evaluation.