Wellesley, MA – Harvard Pilgrim Health Care has signed a value-based contract with Eli Lilly & Company for its osteoporosis drug, Forteo, which will measure patients’ adherence to the drug. The contract was developed to address the challenge of ensuring that patients keep taking the medication as prescribed by their physician.
Forteo is administered by self injection every day for 24 months and, in fact, should not be taken for a longer period of time. Ensuring that patients take the medication daily as prescribed is important if they are to benefit since inconsistent dosing may seriously reduce effectiveness in preventing fractures. Forteo is prescribed for both men and women with osteoporosis who are at high risk for having broken bones or fractures.
The contract rewards improvement in persistence in medication use as compared to the baseline level of adherence seen in the Harvard Pilgrim population. If meaningful improvements to Forteo persistence are realized in Harvard Pilgrim’s patients, Lilly will reduce the cost of the drug for Harvard Pilgrim. Harvard Pilgrim will work with its pharmacy network and Eli Lilly to drive improvements in patient persistency.
“We are pleased to have reached this unique agreement with Lilly,” said Harvard Pilgrim Chief Medical Officer Michael Sherman. “In order for Forteo to be most effective, patients need to take it daily for two years. Greater adherence makes for a more effective treatment for osteoporosis, and by effectively reducing the unit cost of the drug in return for regular use, Eli Lilly is improving the value proposition of its therapy, which matters to all of our stakeholders.”
About Harvard Pilgrim Health Care
Harvard Pilgrim is a not-for-profit health services company that, along with its subsidiaries, is improving the well-being of its 2.7 million customers. Harvard Pilgrim’s flagship health plans in New England provide health coverage to 1.3 million members, while another 1.4 million individuals are served through Health Plans, Inc., a subsidiary that provides integrated care management, health coaching and plan administration solutions to self-funded employers nationwide. Founded in 1969, Harvard Pilgrim has built its reputation on innovation and collaboration with a goal of lowering health care costs, improving care and enhancing the overall member experience. It is known for its excellent clinical programs, customer service, health improvement strategies and innovative tools that offer consumers greater transparency and empower them to make better decisions about their health care. Harvard Pilgrim is home to the Harvard Pilgrim Health Care Institute, a unique collaboration with Harvard Medical School. As Harvard Medical School’s Department of Population Medicine, the Institute is the only appointing department of a U.S. medical school housed within a health plan. Funded primarily through external government and private sources, it provides critical information to all levels of our health care system on issues affecting population health and health care delivery. Harvard Pilgrim is consistently among America’s highest-rated health plans according to an annual ranking of the nation’s best health plans by the National Committee for Quality Assurance (NCQA)*.
*Harvard Pilgrim Health Care (private HMO/POS and PPO plans) and Harvard Pilgrim Health Care of New England (private HMO/POS plans) have been rated 4.5 out of 5 in NCQA’s Private Health Insurance Plan Ratings 2016-17. NCQA’s Private Health Insurance Plan Ratings 2015-16. NCQA’s Private Health Insurance Plan Rankings, 2011-15, HMO/POS/PPO.
Contact: Mary Wallan
February 22, 2017 617-509-2419