Aetna (AET) Enters Value-Based Contract with Merck (MRK) Covering Januvia, Janumet

October 11, 2016 8:46 AM EDT

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Aetna (NYSE: AET) announced today that it has entered into a value-based agreement with Merck (NYSE: MRK) for the type 2 diabetes medications Januvia (sitagliptin) and Janumet (sitagliptin plus metformin).

Merck will also become the first health care company to participate in AetnaCareSM, a new personalized health and wellness care initiative that provides members the knowledge, tools, and support to take a proactive role in managing their own health.

Measuring value differently

Merck and Aetna have entered into a unique value-based contract that supports the objectives of Aetna and Merck to help adult patients with type 2 diabetes access appropriate treatment. Under this agreement, Merck’s rebates on Januvia and Janumet will be based in part on those products’ contributions to helping Aetna’s commercial member population with type 2 diabetes achieve or maintain treatment objectives.

“At Aetna, we believe that focusing on how physicians prescribe medications in real world settings is a key element in determining the value of the treatment,” said Dr. Harold L. Paz, Executive Vice President and Chief Medical Officer for Aetna. “It is in everyone’s interest to ensure that patients receive appropriate medicines to help patients achieve their treatment goals.”

“Merck shares Aetna’s commitment to focusing on patients, and we are confident that the value-based agreement will help advance our common goal of helping patients with type 2 diabetes,” said Robert McMahon, President, U.S. Market, Global Human Health, Merck.

What is AetnaCare?

In a separate initiative, Merck is also collaborating with Aetna on AetnaCare, a new innovative health approach which uses predictive analytics to identify target populations and proactively curate various health and wellness services that are available to each member. Working with a patient’s physicians and other caregivers, the program is designed to support treatment adherence, ensure that critical social support needs are met, and reinforce healthy lifestyle behaviors. The AetnaCare program will initially target patients with diabetes and hypertension in Mid-Atlantic markets.

“Today, individuals receive care in a variety of ways, including retail clinics, healthcare devices, pharmaceutical services, behavioral health, and social services, yet these services remain uncoordinated,” said Dr. Paz. “Working with their physicians, AetnaCare not only integrates all these services into a coherent plan for members, it also curates care so patients don’t have to figure out for themselves how to get the treatment they need.”

How is AetnaCare different?

AetnaCare is unique in being the first in the industry to combine three key features:

  • Real-time identification of the target population using advanced analytics
  • Individually customized care maps that promote evidence-based actions for specific conditions
  • Health ecosystem curation that brings together appropriate clinical and non-clinical services

The foundation of AetnaCare is an analytically driven care map – a longitudinal, customized and targeted health and wellness plan for individuals with a particular chronic medical condition. These care maps are triggered by key vulnerable moments in a member’s health journey, during which AetnaCare nurses meet with members – often in person and at home – to educate them about their condition, explain the value of key health services (such as nutrition, behavioral health, etc.), and working with their physician to develop an actionable health and wellness plan to help members achieve their personal health goals.

How is Merck collaborating with Aetna on AetnaCare?

The key to AetnaCare is building a health ecosystem in which every facet of the healthcare system is working to improve outcomes for patients. Merck has used its insights and experience to develop educational resources and tools to help address patient engagement, patient behavior and treatment adherence. Aetna will incorporate some of these resources from Merck’s inventory into AetnaCare to support more effective patient self-management. “Merck is pleased to collaborate with Aetna on this unique patient-centered approach to care by sharing our adherence and educational resources to help support the health and wellness of AetnaCare members,” said Mr. McMahon.

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