Geisinger has struck a deal with Boehringer Ingelheim to develop a risk-prediction model for three of the most common adverse outcomes from type 2 diabetes. The agreement is on behalf of Boehringer’s diabetes alliance with Eli Lilly and Company.
What makes this partnership interesting is that the players involved in this kind of pharma relationship are usually health plans. For example:
- In May, UnitedHealth Group’s Optum struck a deal to model reimbursement models in which payment for prescription drugs is better structured to improve outcomes.
- Earlier this year, Aetna cut a deal with Merck in which the two will use predictive analytics to identify target populations and offer them specialized health and wellness services. The program started by focusing on patients with diabetes and hypertension in the mid-Atlantic US.
- Another example is the 2015 agreement between Harvard Pilgrim health plan and Amgen, in which the pharma would pay rebates if its cholesterol-control medication Repatha didn’t meet agreed-upon thresholds.
As the two organizations note in their joint press statement, cardiovascular disease is the leading cause of death associated with diabetes, and diabetes is the top cause of kidney failure in the U.S. population. Cardiovascular complications alone cost the U.S. more than $23 billion per year, and roughly 68 percent of deaths in people with type 2 diabetes in the U.S. are caused by cardiovascular disease.
The two partners hope to improve the odds for diabetics by identifying their condition quickly and treating it effectively.
Under the Geisinger/Boehringer agreement, the partners will attempt to predict which adults with type 2 diabetes are most likely to develop kidney failure, undergo hospitalization for heart failure or die from cardiovascular causes.
To improve the health of diabetics, the partners will develop predictive risk models using de-identified EHR data from Geisinger. The goal is to develop more precise treatment pathways for people with type 2 diabetes, and see that the pathways align with quality guidelines.
Though this agreement itself doesn’t have a value-based component, it’s likely that health systems like Geisinger will take up health plans’ strategies for lowering spend on medications, as the systems will soon be on the hook for excess spending.
After all, according to a KPMG survey, value-based contracts are becoming a meaningful percentage of health system revenue. The survey found that while value-based agreements aren’t dominant, 36 percent of respondents generated some of their revenue from value-based payments and 14 percent said the majority of revenue is generated by value-based payments.
In the meantime, partnerships like this one may help to improve outcomes for expensive, prevalent conditions like diabetes, high blood pressure, arthritis and heart disease. Expect to see more health systems strike such agreements in the near future.