Payment to be based on patient outcomes

(Wellesley, MA) – Harvard Pilgrim Health Care has signed an outcomes-based contract with AstraZeneca for Symbicort, its drug to treat asthma and chronic obstructive pulmonary disease (COPD).  Through the agreement, Harvard Pilgrim will be monitoring whether asthma-related symptoms for patients on Symbicort are in line with the clinical trial results provided by AstraZeneca.  If the occurrence of worsening symptoms/exacerbations requiring medical intervention exceed predetermined thresholds based on the clinical trials data, Harvard Pilgrim will be charged a lower amount.

This is the third outcomes-based contract that Harvard Pilgrim has signed with AstraZeneca in the last two years and one in a series of value-based contracts the health insurer has entered into with the goal of tying payment for drugs to actual health outcomes in its members.

 “We believe that outcomes and value-based contracts are one way to begin to address the need for greater focus on value in our health system” said Harvard Pilgrim Chief Medical Officer Michael Sherman, M.D. “By entering into this agreement, AstraZeneca is making progress in moving from charging for medications based on their value to the patient rather than solely on the volume sold.”

“With innovative, value-based agreements now in place across our therapeutic areas, AstraZeneca recognizes the importance of a greater focus on value and shared accountability for patient outcomes,” said Rick R. Suarez, VP, Market Access, AstraZeneca US. “We are proud to partner with Harvard Pilgrim to stand behind the clinical value of Symbicort for their patients”

Symbicort contains a combination of budesonide and formoterol to reduce inflammation in the body and relax muscles in the airways to improve breathing. It is used to prevent bronchospasm in adults and children who are at least six years old. 

About Harvard Pilgrim Health Care 
Harvard Pilgrim and its family of companies provide health benefit plans, programs and services to more than 3 million customers in New England and beyond. A leading not-for-profit health services company, we guide our members –  and the communities we serve – to better health.    
Founded by doctors nearly 50 years ago, we’re building on our legacy. In partnership with our expansive network of doctors and hospitals, we’re improving health outcomes and lowering costs through clinical quality and innovative care management.  
Our commitment to the communities we serve is driven by the passion of the Harvard Pilgrim Health Care Foundation. Through its work, low- and moderate-income families are gaining greater access to fresh, affordable food — a cornerstone to better health and well-being.


Joan Fallon