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  "documentTitle": "Purdue High Impact Interventions",
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  "notes": "The slide uses a numbered list format to address four key questions about innovative contracting.",
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      "text": "We see 3 main objectives for Purdue in completing an innovative contract: (1) maintain formulary position/ avoid exclusion, (2) align incentives with payors to address the opioid crisis, and (3) demonstrate publicly its strong commitment.",
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      "text": "What type of contracts are used today, how often and when? While innovative contracts are becoming more visible in the U.S., the overall numbers remain low. That being said, most innovative contracts today are not made public. In the past, value contracts were concentrated in a few therapeutic areas – Oncology, hematology, CV, RA. Recently, they are becoming a common lever for newly launched drugs and in specialty, high-value brands",
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      "text": "How are payors/PBMs thinking about them? Payors/ PBMS think about this arrangement in terms of type of risk (e.g., budgetary, off-label use, dosage, etc). Not all payors/PBMs have same appetite. Cigna and Harvard Pilgrim have been most public about use; of the PBMs, CVS most open; CMS increasingly interested to pursue. Barriers for execution are still high – too complex, infrastructure not solid, hard to track",
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      "text": "What makes sense for Purdue? We see 3 main objectives for Purdue in completing an innovative contract: (1) maintain formulary position/ avoid exclusion, (2) align incentives with payors to address the opioid crisis, and (3) demonstrate publicly its strong commitment. As we consider what type of innovative contract may make sense, it’s also important to consider which type of account would make a good partner for this type of contract",
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      "text": "How are other pharmacos approaching this? Two broad types of contracts – predictability and outcomes-based – are most common, though there is a wide spectrum of experimentation. Leading players have a small, easy to communicate “menu of innovative offerings” (usually 2-3 options with clear terms that can be communicated in a page each)",
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