An unbranded infographic from Novartis, which has promised value-added services and pay-for-performance pricing with its new heart failure drug Entresto.

  • Novartis got its launch of Entresto – certain to be one of the biggest and most consequential launches in recent memory – underway with talk of pay-for-performance pricing and beyond-the-pill elements including remote monitoring. The heart drug hits the market at $12.50 per day – far more than the cheap ACE inhibitors it will replace – so Novartis needs to woo payers (and ExpressScripts is notably skeptical of pay-for-performance). Says CEO Joe Jiminez in the Journal: “We’re going to have to get smarter about services around the pill...and move into some areas that are different from just discovery of the drug.  You’re going to see Novartis go to payers with multiple services.”
  • In other Google news, FDA is talking to the search giant about how it can use search data to spot side effects.
  • The Times looks at the booming specialty pharmacy business – and its downsides, including “onerous refill policies,” tardy shipments, inaccessible pharmacists and “fox guarding the henhouse” conflicts of interest with PBMs running their own specialty pharmacies.
  •  …and at CVS’ transformation into a nose-to-tail healthcare goliath. Key passage: “The growth of CVS comes at a time when the way Americans get access to and pay for health care is evolving quickly. Surveys show that many of the estimated 30 million people who gained insurance coverage last year under health care reform do not have a primary health care physician or do not use one. Many, too, opted for high-deductible health plans and are expected to become picky with the dollars they spend, and less tolerant of the opaque pricing that is still the industry’s norm. And consumers in general are starting to demand more convenient, on-demand access to health care, closer to home.” Also: “CVS might have more sway reducing health care costs in its role as a middleman between drug companies and patients with drug benefits. The company is expected to start shifting the balance between end users on one hand, and drug manufacturers and wholesalers on the other.”

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