Pharmaceutical manufacturer contracting is a key element of account engagement to enhance and/or maintain market access; however, the contracting landscape can vary greatly upon on many idiosyncrasies within each therapeutic area. HIRC's report, The Contracting Environment in 2023, assists pharmaceutical manufacturers in understanding trends in contracting with payers across therapeutic categories spanning traditional, specialty, and oncology. The report addresses the following questions:

• What is the status of contracts in-place or offered to commercial health plans in the last 12-18 months across 40+ therapeutic areas? How does this vary by plan type (i.e., National, BCBS, Regional plans)?
• What is the status of contracts in-place or offered to pharmacy benefit managers in the last 12-18 months across across 15+ broad traditional and specialty categories?
• What contract approaches are most common overall and by therapeutic area (e.g., flat access rebates, price protection, market share rebates)?
• What are the most common average discount/rebate amounts offered across 40+ unique therapeutic areas? How have discount/rebate amounts changed over time?
• What is the status of alternative or novel contracting approaches, such as risk/outcomes-based, porfolio, and indication-based contracts?

Key Finding: The contracting environment in 2023 is active, but varies by therapeutic area, with a greater share of contracts reported in more competitive and/or crowded categories.

The Contracting Environment: Highlighting Diabetes. Across traditional Rx categories, contracts with commercial health plans are most often reported for diabetes medications. Roughly two-thirds of commercial health plans (64%) have or have been offered a contract in the last 12-18 months for diabetes drugs. A 'combination contract' approach that includes both a flat access rebate and price protection is most common. Average discount amounts are reported at around 37%.

A Greater Share of Commercial Plans Report Risk/Outcomes-based Contracts in 2023. The prevalence of risk/outcomes-based contracts increased in 2023; currently, 33% of commercial plans report a risk-based contract in-place, up from 23% in 2021 & 2022. The increasing availability of rare disease medications is likely driving the growth in this contract approach. The full report also examines the prevalence of portfolio and indication-based contracts with commercial payers.

Extensive Listing of Therapeutic Areas are Examined. The complete report reviews contracting prevalence, approaches/types, and most common average rebate discount amounts across the following therapeutic areas/product classes:

Research Methodology and Report Availability. Special reports draw upon data across HIRC services, allowing readers to glean insights into high level topics across varying market segments, channels, and/or therapeutic areas. HIRC's report, The Contracting Environment in 2023, includes survey and qualitative follow-up interview insights from various commercial health plan and pharmacy benefit manager panels, collected in 2023. The report is available now to HIRC’s Special Report Series subscribers at www.hirc.com.