AEE15: A Sidebar Conversation About the Importance and Challenges for Health Systems to Collaborate With Pharma Manufacturers, With David Carmouche, MD, From Ochsner, a Large Health System

In this sidebar episode, Stacey Richter continues her conversation with David Carmouche, MD, executive vice president of value-based care and network operations at Ochsner, about the challenges health systems face trying to collaborate and strike risk-share agreements with pharmaceutical manufacturers. WHAT YOU'LL LEARN ✅ Why creating collaboration between health systems and Pharma has been so difficult ✅ How weighing a more expensive drug against downstream episode-of-care costs complicates these deals ✅ Why assembling enough patients to make a pharma risk-share agreement worthwhile is a real structural challenge ✅ How payer and PBM plan design further narrows the pool of patients eligible for these arrangements WHY THIS MATTERS When a pharma company says its drug will save money downstream through avoided complications or better outcomes, testing that claim through a risk-share agreement means assembling enough patients on the same payer and the same PBM plan design to make the numbers work. That layered dependency — health system, payer, and PBM all needing to line up — helps explain why direct value-based contracts between health systems and pharma manufacturers remain rare, even when everyone agrees on the goal. === LINKS === 🔗 Show Notes with all mentioned links: Episode Page 🔗 Healthcare Industry Acronyms and Terms ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction 01:57 Why has creating collaboration across Pharma been difficult? 03:10 "Is it better over an episode of care to add a more expensive drug … or would we be better served using less expensive drugs?" 03:51 Why has it been difficult for health systems to execute agreements directly with pharma companies? 04:36 "The question is really just whether or not there's enough value that's created to make it worth our while."