Outcome-Based Contract Design for Pharma


The data analytics team at KMK can help you design an outcome-based contract achieving desired market access for your medication with formulary positioning in the lowest possible tier without restrictions.

The ability to reach optimal formulary positioning for medications is becoming more difficult daily in the face of outcome-based contracts. These performance-based contracts measure a product’s ability to positively impact disease outcome, and as such, can be difficult to measure. Data points such as quality of life, increases in life expectancy, productivity losses and healthcare costs all come into play. 

One needs to know how to navigate the various data sources and assess their validity before one can implement a formulary positioning strategy to achieve the desired market access.

KMK is experienced in working with the data and analytics in healthcare, and has developed a process for developing and evaluating outcome-based contracts drawing upon this expertise.

Step 1 – KMK brainstorms the contract design with our client based on clinical data and potential payer needs.

Step 2 – KMK assesses the contract value for the payer and the feasibility of implementation.

Step 3 – KMK evaluates the contract risk.

Step 4 – KMK implements an evaluation tool that reduces the payers’ administrative burden and ensures the reporting quality of outcome-based contract evaluations. These will ultimately demonstrate the value of the product based on data analysis of payers’ data.