Entering into the realm of performance-based deal making, Merck has signed a contract with Aetna to base the rebates for Januvia on clinical outcomes. Read about it here. Payers clearly like this kind of deal, and pharmaceutical companies are willing to enter into them in order to increase access and sustain sales of products that otherwise have plateaued.
Bottom Line. Let me get this straight. Doctors are compensated based on performance. Drug companies are compensated based on performance. What confuses me here is how do you tease out the interaction of physician performance and drug performance? And where does patient adherence fit into all of this?