Pharmaceutical companies appear to be embracing contracts where they return money if patient outcomes don’t meet goals, but similar approaches haven’t lowered costs.

ProPublica and the New York Times reported the arrangements can take on several forms, like drug makers paying rebates to insurers based on the number of the drugs sold. Pharma companies maintain plenty of control, however, deciding how those outcomes will be measured and setting the drug’s list price.

Peter Bach, MD, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center in New York, said drug makers are acting like rebates after treatment and value-based pricing are one and the same.

“But as long as you control all the contract terms, it can be a lot of optics but no substance,” he said.

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