You are on page 1of 2

For Immediate Release Contact: Joan Fallon

May 2, 2017 joan_fallon@harvardpilgrim.org


617-509-7458

Harvard Pilgrim Signs Second Groundbreaking Contract with Amgen For Repatha
HPHC and its members will receive full refund if a cardiac event occurs while on the drug

(WELLESLEY, MA) Harvard Pilgrim Health Care has entered into a first-of-its-kind contract
with Amgen for its LDL cholesterol lowering drug, Repatha, that guarantees the health plan and
its members will receive a full refund of their costs for the drug if a member is hospitalized for a
myocardial infarction or stroke after taking Repatha for six months or more and maintaining an
appropriate level of compliance on the drug.

Repatha is one of a new class of biotechnology medicines known as PCSK9 inhibitors that have
demonstrated a promising new approach for treating elevated LDL cholesterol in patients
whose levels are not able to be controlled by current treatment options. The medication is
designed to target a protein that prevents the body from removing artery-blocking LDL
cholesterol from the bloodstream. Repatha works differently than statin drugs that prevent the
liver from making cholesterol.

Given by injection every two or four weeks, Repatha is intended for patients who have an
inherited disorder resulting in high levels of LDL cholesterol or have high-risk atherosclerotic
cardiovascular disease conditions, such as heart attack or stroke, that have been resistant to
treatment.

Repatha has been shown to have a significant outcome on reducing cardiovascular morbidity
for high risk individuals with elevated LDL cholesterol, said Harvard Pilgrim Chief Medical
Officer Michael Sherman. However, there have been concerns raised about the cost of this
new drug relative to existing statin treatments. We hope to negotiate more contracts of this
type, in which a pharmaceutical company truly has skin in the game going forward. This
agreement is the first we have signed in which there is a full refund of all costs related to the
medication if the patient experiences a heart attack or stroke while taking it.

"Cardiovascular disease is the largest public health concern in the world and for high-risk
patients who have already had a cardiovascular event or whose genetics puts them at risk, it is
important that these patients have access to an effective treatment shown to lower their
elevated LDL cholesterol in addition to their current lipid lowering regimen, said Joshua J.
Ofman, M.D., MSHS, senior vice president of Global Value, Access & Policy. "Amgens
agreement with Harvard Pilgrim demonstrates our commitment to seeking innovative
approaches that help break down the barriers of access to Repatha.

This is the second patient-focused outcomes contract Harvard Pilgrim has negotiated with
Amgen for Repatha. In the fall of 2015, the health plan signed an outcomes guarantee through
which Amgen provided HPHC with an enhanced discount if the reduction in LDL levels for
Harvard Pilgrim members is less than what was observed during Repathas clinical trials. In
addition, the agreement provides for additional discounts if the utilization of the drug exceeds
certain levels. This enables those patients who can most benefit from the drug to receive it
while continuing to encourage utilization of lower cost statins for the majority of patients.

#####

About Harvard Pilgrim Health Care


Harvard Pilgrim is a not-for-profit health services company that, along with its subsidiaries, is improving
the well-being of its 2.7 million customers. Harvard Pilgrims flagship health plans in New England
provide health coverage to 1.3 million members, while another 1.4 million individuals are served
through Health Plans, Inc., a subsidiary that provides integrated care management, health coaching and
plan administration solutions to self-funded employers nationwide. Founded in 1969, Harvard Pilgrim
has built its reputation on innovation and collaboration with a goal of lowering health care costs,
improving care and enhancing the overall member experience. It is known for its excellent clinical
programs, customer service, health improvement strategies and innovative tools that offer consumers
greater transparency and empower them to make better decisions about their health care. Harvard
Pilgrim is home to the Harvard Pilgrim Health Care Institute, a unique collaboration with Harvard
Medical School. As Harvard Medical Schools Department of Population Medicine, the Institute is the
only appointing department of a U.S. medical school housed within a health plan. Funded primarily
through external government and private sources, it provides critical information to all levels of our
health care system on issues affecting population health and health care delivery. Harvard Pilgrim is
consistently among Americas highest-rated health plans according to an annual ranking of the nations
best health plans by the National Committee for Quality Assurance (NCQA)*.

*Harvard Pilgrim Health Care (private HMO/POS and PPO plans) and Harvard Pilgrim Health Care of New England
(private HMO/POS plans) have been rated 4.5 out of 5 in NCQAs Private Health Insurance Plan Ratings 2016-17.
NCQAs Private Health Insurance Plan Ratings 2015-16. NCQAs Private Health Insurance Plan Rankings, 2011-15,
HMO/POS/PPO.

You might also like