PIVOT Webinar

From Concept to Practice: How to tactically design a feasible outcomes-based contract in oncology

PIVOT Webinar:

From Concept to Practice: How to tactically design a feasible outcomes-based contract in oncology

Colorful lines intertwining into a rightwards pointing arrow

January 25, 2024

12:00pm – 1:00pm Eastern
Web conference

The session explored the essential components for successful contract design, addressing payer and developer uncertainties, and expediting patient access to innovative medicines.

Mark Trusheim, NEWDIGS Strategic Director, led the discussion on how to design a feasible outcomes-based oncology contract, focused on a fictional scenario: Astrotuminib, an oncology therapy for the treatment of Astrorenoma, a malignant kidney tumor. The panel tackling the task represented perspectives from developers, providers, and payers: Jamie Foley, Ron Potts, and Michael Sherman. Each panelist provided key insights on the topic from their respective stakeholder viewpoints.

During the interactive discussion, the panel debated the various aspects of what a value-driven short-term milestone-based outcomes contract could look like, along with its challenges. Among them:

The identification of usable metrics, such as discontinuation rates
What data are relevant for the contract
How and where to obtain the data used to evaluate the outcomes
What party or parties are responsible for analysis of the data
Whether the data are sufficient, and of sufficient quality, for the contract

The 70+ attendees participated in polling and Q&A to share their perspectives and assist panelists with building a hypothetical outcomes-based contract (OBC) for Astrotuminib. The session gave participants practical insights into the issues for these contracts. Thanks to the stakeholder perspectives from the panel experts, participants delved into the need for careful analysis, collaboration between industry and payers and the importance of addressing data-related challenges not just for the design of the contract, but also for its implementation. The session closed with the panelists emphasizing that overcoming these challenges is important to improve patient access to transformative new therapies in oncology.

Webinar recording and highlights

Webinar highlights

The playlist includes the recording of the full webinar, as well as excerpts from the speakers on strategies and tactics for successfully implementing value-based contracts for oncology treatments.

January 25, 2024

12:00pm – 1:00pm Eastern
Web conference

The NEWDIGS PIVOT Project invites you to join us on Thursday, January 25, 2024 from 12:00-1:00 pm Eastern for an interactive webinar: From Concept to Practice: How to Tactically Design a Feasible Outcomes-Based Contract in Oncology. Dive deep into the essential components for successful contract design, addressing payer and developer uncertainties, and expediting patient access to innovative medicines.

In this 1-hour session, we will:

Introduce the concept of value-based contracts (VBCs), focusing on outcomes-based contracts (OBCs) in oncology and examples of how they have been used.
Explore industry and payer perspectives on OBCs, including best practices and engagement strategies.
Engage in a case study to design an effective OBC for a hypothetical oncology product.

Participants will benefit from industry insights and practical considerations from experts Mark Trusheim, Ron Potts, Jamie Foley, and Michael Sherman and have the opportunity to engage in real-time polling on key topics like contract metrics, data challenges, and contract reconciliation.

We encourage you to share this opportunity with your colleagues and collaborators interested in payment innovation and OBCs. Looking forward to working together to make a difference!

Who should attend

This session is ideal for payers, industry professionals, researchers, and consultants interested in expanding their understanding of OBCs and VBC feasibility and implementation challenges.

Speakers

Mark Trusheim
Strategic Director, NEWDIGS

Ron Potts
Chief Medical Officer, 6 Degrees Health

Michael Sherman
Venture Partner, RA Capital Management

Jamie Foley
Global oncology value-based innovation biopharmaceutical industry professional

Hosted by Tufts Medical Center NEWDIGS Initiative

Panelists

Mike Ciarametaro, MBA
Vice President Research,
National Pharmaceutical Council

Michael Ciarametaro serves as the National Pharmaceutical Council's vice president of research. In this position, Mr. Ciarametaro conducts health policy research focused on addressing rising health spending and better aligning stakeholder incentives with value.

Mr. Ciarametaro has 20 years of experience creating value in the health care system through policy, research and leadership. His cross-disciplinary expertise spans multiple roles (policy researcher, strategic value and market access consultant, financial analyst, operations and process designer) and multiple areas of the health care ecosystem (health policy research organization, biopharmaceutical industry, private payers, public payers). For the past six-plus years, Mr. Ciarametaro has been focused on health policy research with an emphasis on addressing rising health spending and better aligning stakeholder incentives with value.

Mr. Ciarametaro holds a Bachelor of Science from the University of Virginia and received his MBA from George Mason University.

Dorothy Hoffman
External Engagement and Access Policy Lead,
Pfizer

Dorothy Hoffman leads the External Engagement and Access Policy team in Pfizer’s Healthcare Innovation Center. She is responsible for leading Pfizer’s Enterprise strategy on access policy with a focus on value-based healthcare, digital health, and equitable access to health.

Dorothy has over 18 years of experience in the pharmaceutical and managed care industries. Previously, she was Vice President of Prescription Drug Policy at UnitedHealth Group. Her team was responsible for implementing the company’s pharmacy care services transformation and growth initiative with federal and state health programs.

Dorothy started her career at Eli Lilly and Company where she held multiple roles of increasing impact and management responsibility in Corporate HQ, the US affiliate, the United Kingdom, and Belgium.

Dorothy has a Masters in Public Policy. She lives in the New York City area with her husband and son.

Gail Ryan, PharmD
Director, Pharmaceutical Transformation, Clinical Innovation
Point32Health

Gail Ryan is the Director of Pharmaceutical Transformation at Point32Health, the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan, two of New England’s most iconic nonprofit health care companies. Point32Health serves over 2 million lives and is an industry leader in innovation and value-based contracting. As a clinical pharmacist with 20 years of managed care experience, Gail’s practice has spanned the pharmacy benefit, medical drug policy, trend analysis, cost management initiatives and clinical innovation. In her current role and through partnerships with multi-stakeholders, she is driving equitable access to high-quality, transformative therapies while addressing emerging trends, challenges, and financial risk. Gail holds a Bachelor of Science Degree and a Doctor of Pharmacy, both from the Massachusetts College of Pharmacy and Health Sciences.

Mark Trusheim, MS
Strategic Director, NEWDIGS;
Visiting Scientist, Sloan School of Management,
Massachusetts Institute of Technology

Mark Trusheim is a Visiting Scientist and Executive-In-Residence at the MIT Sloan School of Management. He has been a Special Government Employee for the FDA’s Office of the Commissioner and is the Founder and President of Co-Bio Consulting, LLC. He holds degrees in Chemistry from Stanford University and Management from MIT. His research focuses on the economics of stratified (personalized) medicines, particularly the integrated quantitative modeling of stratified medicine development and commercialization, to inform public policy, corporate strategy and individual product development programs. Together with the FDA and industry, he led a multi-disciplinary consortium to examine the economic challenges of co-development of companion diagnostics and therapeutics whose work was covered by the Nature Review Drug Discovery.

In addition, he has been a frequent invited speaker on stratified medicine at international conferences and conducts confidential workshops and analyses for biopharmaceutical and diagnostic firms. Prior to his work in stratified medicine, he was a Board Member and Interim President of the Massachusetts Biotechnology Council. As an entrepreneur, he founded and was the first President and CEO of Cantata Laboratories which developed and marketed biochemical profiling clinical diagnostics and pharmaceutical biomarker services.

Prior to Cantata, he worked at Monsanto/Pharmacia, culminating his career there as Co-President and Chief Operating Officer of Cereon Genomics, LLC-a 5 year, $500M collaboration with Millennium Pharmaceuticals, and held roles of Vice President in the Health & Wellness Sector, Marketing Director in Searle Pharmaceutical and Director in Agriculture Division Strategy. He spent the first half of his career in the high tech industry at both Wang Laboratories in computer hardware and the start-up Kenan Systems Corporation which focused on developing quantitative models and artificial intelligence based applications for large corporations and government agencies.

Agenda

Welcome and introductions

Mark Trusheim, Strategic Director, NEWDIGS; FoCUS Project Lead; Visiting Scientist at MIT Sloan School of Management
Gigi Hirsch, Executive Director, MIT Center for Biomedical Innovation (CBI); Director, NEWDIGS Initiative at MIT

Framing the Issues
Definition of Cell and Gene Therapies and their unique challenges/risks for self-insured employers including toolkit.

Mark Hansan, President and CEO, CareMetx

Drug development pipeline
Currently approved treatments and near-term pipeline of expected products

Colin Young, Director, Drug Development Pipeline Research, NEWDIGS FoCUS Project

Implications for stop-loss coverage

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project and Moderator

New commercial solutions

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project and Moderator

PANEL & DISCUSSION

Actions self-insured employers can take today

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project and Moderator

Recap and conclusion

Mark Trusheim, Strategic Director, NEWDIGS; FoCUS Project Lead; Visiting Scientist at MIT Sloan School of Management

Registration