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From our Expert Voices conversation on drug pricing.

Innovative drugs like Kymirah deserve innovative reimbursement contracts – paying for value, not by the pill. Novartis is embracing that adage, and offering to waive the drug's $475,000 fee for patients who don't respond.

That's great, but we're not just paying for medicines. Bundled payments for all oncology-associated care (including hospital, ER costs, and physician visits) linked to patient outcomes can encourage providers and drug companies to collaborate — and compete— on delivering the best outcome for each patient as efficiently as possible.

Kymirah can make a great test case for this approach. Treatment centers that specialize in gene and cellular therapies can work with Novartis and other companies to build detailed patient registries that help oncologists use "real-world data" on what really happens to patients — and why — to improve outcomes while reducing unnecessary costs and avoidable side effects. We already take a similar approach with patient registries and bundled payments for organ transplants.

The bottom line: An outcomes-based payment system can help us put more patients' cancers into remission for longer periods of time – with fewer wasted treatments, and less need for follow on therapies. That's greater value for every dollar we spend on cancer care.

Other voices in the conversation:

  • Greg Aune, pediatric oncologist, Greehey Children's Cancer Research Institute: Value isn't just about surviving cancer
  • David Mitchell, president and founder, Patients for Affordable Drugs: Drugs don't work if people can't afford them
  • Usman Azam, president & CEO, Tmunity Therapeutics: How to evaluate breakthrough therapies
  • Austin Frakt, health economist, Department of Veterans Affairs, Boston University and Harvard University: The public should have a say in what a drug is worth

Go deeper

Updated 7 hours ago - World

Mexican President López Obrador tests positive for coronavirus

Mexico's President Andrés Manuel López Obrador during a press conference at National Palace in Mexico City, Mexico, on Wednesday. Photo: Ismael Rosas/Eyepix Group/Barcroft Media via Getty Images

Mexican President Andrés Manuel López Obrador announced Sunday evening that he's tested positive for COVID-19.

Driving the news: López Obrador tweeted that he has mild symptoms and is receiving medical treatment. "As always, I am optimistic," he added. "We will all move forward."

7 hours ago - Politics & Policy

Sarah Huckabee Sanders to run for governor of Arkansas

Sarah Huckabee Sanders at FOX News' studios in New York City in 2019. Photo: Steven Ferdman/Getty Images

Former White House press secretary Sarah Huckabee Sanders will announce Monday that she's running for governor of Arkansas.

The big picture: Sanders was touted as a contender after it was announced she was leaving the Trump administration in June 2019. Then-President Trump tweeted he hoped she would run for governor, adding "she would be fantastic." Sanders is "seen as leader in the polls" in the Republican state, notes the Washington Post's Josh Dawsey, who first reported the news.

Coronavirus has inflamed global inequality

Illustration: Aïda Amer/Axios

History will likely remember the pandemic as the "first time since records began that inequality rose in virtually every country on earth at the same time." That's the verdict from Oxfam's inequality report covering the year 2020 — a terrible year that hit the poorest, hardest across the planet.

Why it matters: The world's poorest were already in a race against time, facing down an existential risk in the form of global climate change. The coronavirus pandemic could set global poverty reduction back as much as a full decade, according to the World Bank.