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How Medicare Drug Plans Hope To Follow Private Sector Lead
Kaiser Health News

Aetna and Cigna inked deals in early February with drugmaker Novartis that offer the insurers rebates tied to how well a pricey new heart failure drug works to cut hospitalizations and deaths. If the $4,500-a-year drug meets targets, the rebate goes down. Doesn’t work so well? The insurers get a bigger payment.

In another approach, pharmacy benefit firm Express Scripts this year began paying drugmakers a special negotiated rate for some cancer drugs — to reward the use of the medicines for the specific cancers for which they have the most demonstrated effectiveness.

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