Shana Gunderson Hua PharmD

A panel of key opinion leaders consider how payers and manufacturers are increasingly embracing innovative contracting models that require strong value propositions, strategic planning, and significant upfront investment in data and stakeholder alignment.

Designing Effective Value-Based Contracts: Timing, Evidence, and Risk Alignment

There is no shortcut to executing a value-based contract. In this episode, experts lay out what’s required to bring these agreements to life: evidence alignment, data compatibility, and mutual incentive. Payers want results, not just risk transference—and developers must understand and speak to payer business goals.

Timeline and prerequisites for executing value-based contracts.

Understanding what matters to payers vs. regulators.

How to prototype contracting models for early feedback.

The importance of strong head-to-head clinical data as the foundation.

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Industry experts react to the developer’s role in preparing for value-based contracting, acknowledging that innovative agreements can support access when evidence is still maturing.

Effective Tactics for Pricing and Reimbursement in Today’s Market

In this episode, the panelists provide a candid look at how payers are increasingly open to innovative reimbursement structures—but only if the groundwork is thoughtfully laid. It’s not enough to pitch a novel payment model; manufacturers must bring solutions tied to the payer’s biggest challenges and be ready to share risk.

Designing outcome-based contracts aligned with payer data systems.

When and how to engage payer medical directors in model design.

Differences in feasibility across pharmacy and medical benefit products.

Why a strong value proposition must precede any innovative contract.

Edward Ahn, CEO of MEDIPOST, Inc., reacts to the challenge of launching orphan drugs without complete evidence, particularly given their high cost and limited patient populations, and suggests strategies that can be used to address evidence gaps, enable market access, and support long-term patient benefit.

Navigating Market Entry Challenges for Orphan Drugs

Not every product has a perfect data set at launch, and that’s where risk-sharing and value-based contracts come into play. This episode explores examples of how companies structure these agreements to address uncertainty, while still ensuring access. With large populations, like with osteoarthritis patients, cost-effectiveness becomes a primary lever.

The tradeoff between pricing and access in large populations.

Examples of successful risk-sharing and subscription models.

How to position therapies for payer engagement despite imperfect data.

Why targeting measurable, cost-driven outcomes is critical.

Expert panelists emphasize the importance of trusted data sources, strong payer partnerships, economic incentives, and AI-driven insights to address skepticism and support broader reimbursement and access strategies as payers balance real-world evidence with head-to-head clinical trials in their decision-making.

Aligning Real-World Evidence with Payer Perspectives

The trust gap between real-world evidence (RWE)/data and randomized controlled trials is growing. This episode examines when each evidence type is appropriate, how to reduce perceived bias in RWE, and how payer context varies by geography and structure. Insights from academic and payer partnerships show how joint research can establish credibility and unlock market access.

Strategies for reducing payer skepticism about real-world data.

The influence of health system structure on RWE acceptance.

Use cases for RWE in confirmatory versus primary evidence roles.

Shana Gunderson Hua PharmD

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