Through two new partnerships, Aetna and Merck aim to improve treatment adherence, care coordination and ultimately, health outcomes for patients with chronic conditions.
One venture, called AetnaCare, will use predictive analytics to target specific populations--starting with patients with diabetes and hypertension in Mid-Atlantic markets--then work with those patients’ providers to coordinate their care and connect them to relevant health and wellness services, according to Aetna.
AetnaCare, the insurer notes, is the first program in the industry to combine real-time identification of a target population using advance analytics; customized care maps that encourage evidence-based actions for specific conditions; and “health ecosystem curation” that marries clinical and non-clinical services.
The care maps, Aetna says, are triggered by “key vulnerable moments” for members that lead AetnaCare nurses to meet with those members to educate them about their conditions and design a health and wellness plan with their physicians.
Merck’s role in the venture is to create educational resources and tools to further patient engagement and treatment adherence, which AetnaCare will use to support better patient self-management, the announcement says.
Aetna and Merck also announced a value-based contract for two type 2 diabetes drugs. The agreement stipulates that Merck’s rebates on Januvia and Janumet are determined in part by how well the drugs help Aetna’s commercial plan members with type 2 diabetes either achieve or maintain their treatment objectives.
Aetna is not the only insurer to strike a deal with a pharmaceutical company that bases a drug’s rebate on product efficacy. Earlier this year, Cigna and Novartis agreed on a value-based pricing deal for the heart medication Entresto, and the insurer announced a similar agreement with Amgen and Sanofi/Regeneron for the pricey cholesterol drugs Repatha and Praluent. Humana, meanwhile, has value-based pricing contracts with 13 companies covering treatments for diseases including cancer, multiple sclerosis and diabetes.