UPMC Health Plan has entered into what it’s calling a pioneering value-based contract with AstraZeneca for its Medicare members taking ticagrelor, the heart drug sold as Brilinta. Brilinta is a blood thinner that can prevent heart attack, stroke, and other heart problems. It was first approved by the FDA in July 2011. Tying reimbursement to clinical outcomes, UPMC Health Plan will pay less for the drug if it fails to prevent a heart attack or unstable angina within 12 months of a patient’s first attack. If patients respond well to the treatment, the health plan will pay more.
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