Health Care Reform

Lilly believes a health care system based on value to the patient is one of the most powerful and cost-effective ways to improve people’s lives. When the cost of drugs aligns with the real value they bring, patients benefit. Changes in health care are creating a system that focuses on outcomes for each individual patient.

We can develop valuable drugs and price them appropriately by:

Facilitating conversations between drug manufacturers and health plans.

  • Discussing critical scientific evidence about new drugs allows manufacturers and health plans to set accurate rates – meaning better availability for patients who need treatment.
  • By discussing drug features while under FDA review, health plans can better anticipate effects on patients, leading to more accurate efficacy and pricing data.
  • Existing laws and regulations prevent the marketing of a drug before the FDA determines it is safe, but the FDA should otherwise have no role in regulating business conversation between manufacturers and health plans. The FDA could facilitate these important conversations by confirming its limited role.

Forming value-based contracting agreements.

  • By focusing on outcomes, the drug financing model will help accurately price treatments of chronic and complex conditions, and reduce costs throughout the system.
  • Value-based arrangements are intricate, and manufacturers and health plans will need to align expectations of data outcomes, patient privacy, and other goals.
  • In these arrangements, the truest cost of a product may not be known for a substantial period of time after the product is sold, so the government must work to create regulatory safe harbors, define new pricing reporting regulations, set Medicaid rebate amounts, and more.

By enacting policy that bases health care on value to the individual patient, we can continue in the goal of improving their lives – a goal shared by manufacturers, providers, health plans, and state and federal governments.