Prime Inks Trio of Value-Based Pacts for Migraine Drugs

December 23

In recent weeks, Prime Therapeutics LLC has entered into not one, not two, but three value-based contracts with drug manufacturers for a trio of migraine medicines. The PBM owned by 18 Blue Cross and Blue Shield plans tells AIS Health that it identified migraine treatments as a key target for value-based pacts — which tie reimbursement to outcomes and costs — because of how the market for such drugs is shaping up.

“Prime focused on the migraine class because there were new opportunities to bring value associated with both new chronic and acute migraine [drugs] to the class, more expensive than existing therapeutics,” says Kelly McGrail-Pokuta, vice president of trade relations and strategy and chief trade relations officer at Prime. “With new products there is no real-world evidence, so by implementing value-based contracts, Prime and the manufacturers are given the opportunity to look at data.”

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Radar on Drug Benefits

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.