Global access and pricing

Global access and pricing position statement

Our approach and commitment to advance access to our medicines

Bristol Myers Squibb believes in the clinical utility our medicines bring to patients and society, and our role in transforming care to help patients live longer, healthier, and more productive lives. We are committed to achieving unfettered patient access to our potentially life-saving medicines, while addressing health inequities and regulatory barriers to high-quality, affordable healthcare. 

Many countries require sustained investments in strengthening healthcare systems to enable the use of specialty medicines that could positively impact millions of patients. Our efforts to ensure patients worldwide can gain access to the medicines they need, regardless of location or ability to pay, are based on three core principles:

• Embedding access considerations as a core tenet across our business.
• Employing innovative pricing models based on the ability and willingness to pay, from both a patient and health system perspective, including payors.
• Creating long-term sustainable global solutions to address health inequities.

Embedding access considerations as a core tenet across our business

Our work to help ensure that patients who need our potentially life-saving medicines can access them begins by ensuring that 100 percent of our marketed products are supported by access plans. Embedding access considerations is a core tenet across BMS that fundamentally defines how we do business. We begin the process of developing access pathways early in the drug development journey to better understand market dynamics that may impact coverage at the local level, refining our approach even after a drug or biologic comes to market to account for the ever-changing environment. Today we have defined access pathways for every country in which our medicines may be available to patients. 

Innovative pricing models based on affordability

We recognize that the price and affordability of medicines, as well as the total cost of a beneficiary’s medical care is a concern for all who come to require the services of a physician, health system, or life supporting or sustaining products and services. That is why our approach to pricing considers the clinical utility our medicines provide, patient and system accessibility and affordability, and the scientific innovation and investment required to develop and deliver our products.

BMS prioritizes the value our medicines deliver for patients, healthcare systems, and society. The prices of our medicines also reflect our investment in scientific innovation. Our research and development (R&D) efforts focus on breakthrough science that aims for first-in-class/best-in-class therapies to treat the world’s deadliest and most debilitating conditions across oncology, hematology, immunology, and neuroscience. Through our investment in leading edge platforms such as cell therapy and protein degradation, BMS is delivering transformational outcomes and creating new standards of care that improve patients’ lives with products that are lifesaving. We estimate that the BMS pipeline, accounting for overlap in indications, has the potential to impact roughly 22 million patients by 2030 . Innovations that ultimately make their way to patients are often built on the learnings of the failed drugs that came before them. Our pricing approach accounts for the risks associated with scientific innovation allowing for continued research in new disease areas or finding more uses for existing products.

BMS also considers affordability and the overall budget impact of our medicine in the context of the local setting when developing prices. Our approach ranges, depending on the geography, from public and private reimbursement that reflects the value of our innovative medicines to assistance to reduce patient out-of-pocket burdens. In low- and middle-income countries (LMICs), we account for ability and willingness to pay and offer tiered pricing, including not-for profit pricing for least developed countries where we do not have a commercial presence and where appropriate. We also consider ways to enable medical centers of excellence in these countries to gain access to our specialty care products.

Our approach to making medicines available outside the U.S.

The prices of our medicines vary around the world because each country pays for health care differently. In many countries, a single government entity is solely responsible for negotiating the price of our products. In some instances where market conditions allow, this dynamic can allow for innovative agreements anchored to value, outcomes, or budget constraints. Most of these types of innovative arrangements are less common in the U.S. due in part to the fragmented mix of public and private payers and their lack of coordination, as well as the absence of a centralized value assessment authority. 

BMS believes that innovative agreements can reduce payer risk of exposure to failed outcomes, more closely associate drug costs and utility, and make medicines more affordable for patients.  We consider real-world benefits to patients, the suitability to a product, and local market dynamics when entering any type of innovative arrangement. Optimal arrangements include a well-defined patient population and clinical endpoints with measurable outcomes along with mechanisms to encourage patient access and adherence, which will improve utilization of a medicine. We continually evaluate how to engage with partners and are innovative and flexible in pricing strategies to enhance patient access to our medicines.

BMS utilizes diversified types of innovative approaches to help ensure the broadest access, including: 

• Value-based pricing – BMS is paid based on the clinical efficacy a particular medicine provides for patients. Payments can be made over time (e.g., if milestones are met for single-use therapies) or directly tied to a clinical benefit, of the product overall for a specific indication.
• Caps on expenditures - BMS provides rebates after a maximum amount of product or expense is reached for patients or payers.
• Refunds for discontinuations or recurrence – BMS provides rebates should patients stop treatment or experience a negative clinical outcome.
• Discounts/rebates – BMS offers discounts overall, or for large volumes of sales.
• Free initial doses - BMS offers initial upfront doses at zero cost to payers and patients, to support access in specific circumstances.
• Free goods – BMS offers options based on a patient’s ability to pay, which can include free goods for patients without access to healthcare funding.

Our approach to making medicines available in the U.S.

BMS takes steps to help patients overcome barriers to access to the medicines they need. We provide programs to support commercially insured patients with out-of-pocket costs, as well as programs that help individuals navigate their treatment journey. We also donate product to an independent foundation that can help eligible patients without insurance or limited insurance coverage gain access to their prescribed medicines in the United States (US). 

In the US, the price of medicines is influenced by the complexity of the healthcare system. BMS evaluates affordability, both from a patient and health system perspective. This includes not only direct patient costs, but also costs to the healthcare system. We consider how the total cost of medicines will be absorbed by different stakeholders, including insurers, providers, and patients, and account for potential unintended consequences. For instance, even if a patient has little direct costs for a medicine, costs may be passed on to them in other ways such as through higher monthly insurance premiums or limited coverage of other treatments. By evaluating affordability from various stakeholder perspectives, BMS aims to maximize patient access to its medicines.

While BMS develops prices for its medicines, it does not determine what patients pay out-of-pocket. Typically, the price a patient pays directly for medicine is set by insurance companies and the companies that assist them. BMS provides meaningful discounts to these organizations, but these discounts are not generally reflected in the amounts that patients pay when they pick up their prescriptions at the pharmacy counter. On average, 46 cents of every dollar of our gross sales goes back into the healthcare system in the form of discounts, which lead to lower net prices not accounted for in the list prices referenced in media and research. 

Insurance companies may not pass on savings to patients, and some intermediaries may benefit from higher list prices. More insurers are implementing benefit designs that may harm patients, such as high-deductible health plans, which force patients to spend more out of pocket for a longer period each year before insurance starts contributing. To help alleviate these burdens in the last five years (2019-2023) BMS provided $2.5 billion to various patient support programs to help with out-of-pocket costs for commercially insured patients, and other support programs that help individuals navigate their treatment journey. BMS offers a $0 copay program for all eligible commercially insured hematology and oncology patients. You can learn more about the BMS access support by visiting BMS Access Support® | Co-Pay and Financial Assistance.  

In the U.S., BMS donates medicines to the Bristol Myers Squibb Patient Assistance Foundation (BMSPAF), an independent, nonprofit organization. BMSPAF provides eligible patients prescription medicines donated by BMS company. It is estimated that in 2023, we donated more than $4B worth of medicines to assist more than 171,000 patients in the U.S. Our approach to pricing is evidence-based and strives to balance the clinical benefit of our current and future medicines with the unique environment of the US healthcare system. BMS strongly believes that patients should know exactly what their costs are, and we continue to advocate for transparency in out-of-pocket spending.

Creating long-term sustainable global solutions to address health inequities

At BMS, we know that no organization alone can drive positive health outcomes for all and aim to work across traditional silos by collaborating with public, private and nonprofit sectors. We incorporate the voices of patients and underserved groups to determine how BMS can more effectively address health inequities. That is why we aim for our policy partner initiatives to have a health equity component and for 50% of our funding for patient advocacy groups to support health equity. 

We have long been a leader in health-equity-focused collaborations—including Access Accelerated, the largest global collective industry effort—to address inequities in chronic noncommunicable disease (NCD) care in LMICs. This collective effort, which BMS co-founded in 2017 and continues to serve through the Executive Committee, is resulting in government prioritization of NCDs, policy change and mobilization of funding to scale up proven solutions. BMS is also a founding partner with the Access to Oncology Medicines (ATOM) Coalition, an industry coalition establishing an NCD platform to provide broader access to oncology medicines to LMICs. BMS supports advocacy organizations worldwide in our focus areas of oncology, hematology, immunology, and neuroscience. Our focus through our partnerships and corporate giving efforts is to advance the state of health for underserved communities around the world, striving to create sustainable, scalable health interventions and systems.

BMS believes strongly in the merit our medicines bring to patients and society and invests heavily in transforming care to help patients live longer and healthier lives. We are committed to continuing to find sustainable solutions and forging innovative partnerships to help patients gain access to our medicines.

ⁱInternal pipeline as of February 2024 (Phase 1 to Phase 3). Epidemiology (diagnosed treated patient projections) from Decision Resource Group, Clarivate. Only accounting for unique indications, excludes unspecified indications or categories (e.g., autoimmune disease, heme malignancies, and others.). Subject to positive registrational trials and health authority approval.