Collaborating for Affordability and Innovation in Drug Pricing
LAS VEGAS – The escalating costs of drugs and healthcare spending are pressing issues that necessitate innovative solutions. A keynote session at AHIP 2026 brought together top leaders from both payers and manufacturers to explore how collaboration could be the key to balancing innovation with affordability.
Brian Evanko, President and Chief Operating Officer of Cigna Group, alongside Miguel Fernández Alcalde, President of EMD Serono, shared insights from their longstanding partnership, which most recently focused on fertility treatment pricing. Evernorth, a Cigna company, operates Freedom Fertility, the largest specialty fertility pharmacy service provider in the United States, while EMD Serono has a robust presence in fertility treatment manufacturing.
Addressing Drug Costs Through Strategic Partnerships
According to Evanko, their collaboration reached a new level last year when they partnered with the Trump administration to lower fertility treatment costs. Under this initiative, patients participating in Trump Rx could access treatments at cash prices ranging from $1,000 to $1,500, depending on the dosage requirements.
Alcalde noted, “From the beginning, Cigna Group was more of a partner than a transactional partner for us this year, and in the end we created something big. It’s a great example of what can be done when everyone involved cares about the patient.”
Innovation vs. Affordability: A Delicate Balance
The discussion highlighted the challenging equilibrium between encouraging innovation and maintaining affordability. Evanko emphasized that the U.S. market often prioritizes innovation, with about 90% of new drugs being immediately available, in stark contrast to 35% in other comparable countries.
Evanko stated, “We are not very picky about what it brings to market as long as it is clinically proven to be slightly better than a previous drug that already exists. The dilemma between innovation, access, and affordability has been very problematic so far.”
He pointed out that while generic drugs make up 90% of prescriptions, the bulk of prescription costs stem from the remaining 10% of brand-name drugs.
The Role of Outcome-Based Pricing Models
Alcalde stressed the importance of balancing cost and innovation from a manufacturer’s perspective. Without adopting new models, the pace of innovation and the development of new treatments could stagnate. He warned, “If we don’t start making these trade-offs, the innovation won’t be sustainable.”
Evanko sees outcome-based pricing models as a significant yet underutilized opportunity in pharmaceutical care. These models are particularly relevant for expensive treatments like gene therapies, which, while costly, could potentially cure complex diseases.
Moreover, successful collaboration requires the involvement of various stakeholders, including providers, patients, and government agencies. Evanko remarked, “There is no one party that can solve everything. We know we need strong partners – be they drugmakers or providers – to bring these things to life.”
Future Directions for Value-Based Pharmaceutical Programs
Alcalde is optimistic about the potential for modern technologies to facilitate the development of value-based programs in the pharmaceutical sector. He emphasized that a one-size-fits-all approach is not feasible, and customization is key.
Timing is another critical factor in deploying these models. Alcalde suggested that initiating value-based agreements during the active development phase of therapies could be beneficial. He concluded, “The value is not in manufacturing, but in research and development. This is the value of our entire world and it is not easy to put a value on a drug, but yes, we have to do it.”
For further details on how payers and drugmakers can collaborate to drive more outcomes-based contracts, visit the full article Here.
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