However, asNt Karlin-Smith and Pittman note, the content of the resulting agreement has been criticized, particularly its one-month delay, which would have compromised its effectiveness. CMS Administrator Seema Verma said today that she did not think the agreement would have been „successful as suggested,“ which gave credence to the idea. The administration`s decision to abandon the agreement is therefore understandable. The kymriahs approval by the Food and Drug Administration last August was accompanied by the announcement of a new results-based agreement with the CMS, in which CMS would only pay for Kymriah if patients had responded before the end of the first month. The CMS tacitly withdrew from this agreement. What does the agreement – and the task that follows – tell us about CMS` participation in future results-based contracts? However, their decision to abandon the agreement in secret is a missed opportunity for the administration. CMS could have taken this opportunity to acknowledge its errors, both substantively and procedurally, and to improve this agreement or to ensure that it uses a more appropriate procedure for others in the future. Based on this experience, CMS could have used its convening power to develop a set of best practices for payers and companies wishing to participate in these agreements. By issuing its proposed drug prices or authorizing the waiver of Oklahoma, CMS could have recognized both the importance and difficulty of successfully implementing these agreements.
CMS didn`t do any of that. The plan introduced by Trump in May to bring down drug prices encourages these paid agreements where a drug manufacturer only earns money if the drug or therapy works as promised. In theory, this saves money and encourages companies to follow treatments that have the greatest potential to improve patients` lives. Critics fear that the agreements offer pharmaceutical companies a backdoor way to keep prices high, as manufacturers can structure agreements with public or private payers in their favour, for example by increasing the base price to compensate for the ability to pay discounts for patients who do not respond.