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

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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."