A “warranty” pilot program from Pfizer offers both patients and health plans (including Medicare Part D plans) the opportunity to receive a refund for any amounts paid to purchase the company’s longstanding oral lung cancer therapy XALKORI when use is discontinued in the first three months for clinical reasons. The program is unique from other value-based arrangements that have emerged over the last several years for a number of reasons including that: it relies on a warranty as the mechanism for refund; it includes Medicare Part D plans alongside commercial payers; and because it offers refunds to patients for out-of-pocket costs, as well as insurers. Of course – this is a Medicaid blog – so we’d like to focus today on one particular question. How does the Pfizer warranty program avoid implicating Medicaid best price?
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