Friday
Jan122018

Accenture’s Advice to Pharma: It’s The Evidence, Stupid.

Accenture’s Advice to Pharma: It’s The Evidence, Stupid.
 

By Clive Riddle, January 12, 2018

 

Remember when Bill Clinton’s first presidential campaign mantra was “it’s the economy, stupid”?  Accenture advises the pharmaceutical industry to substitute evidence for economy in that equation and focus more on evidence-based solutions than products or brand.

 

Accenture has just released 16-page report: Product Launch: The Patient Has Spoken in which they conclude “brands are not major influencing factors when patients consider new pharmaceutical products. More than two-thirds (69 percent) of patients surveyed said the product’s benefits – i.e., treatment outcomes – are more important than the brand itself, with less than one-third (31 percent) citing a strong affinity to brands in a healthcare setting.”

 

Accenture tells us that for the report, they commissioned a survey of 8,000 patients in France, Germany, the U.K. and the U.S across eight therapeutic areas – immunology, cardiology, pulmonology, neurology, oncology, rheumatology, endocrinology and eye disease. Respondents represented three main age demographics: baby boomers, Gen Xers and millennials.

 

Accenture shared the following findings:

 

When patients were asked which factors influence their healthcare product and treatment decisions:

·         66% cited the doctor/physician relationship

·         55% indicated the ability to maintain their current lifestyle

·         53% said ease of access to the care they’ll need

·         But just 31% listed brand loyalty or popularity, and this ranked twelfth out of 14 influencing factors

 

The report notes that patient perspectives include:

·         38 % said they feel very knowledgeable about new or existing products coming to market for their condition

·         25 % reported having either very limited or no knowledge of new products that might be suitable for them

·         48 % believe that their doctors discuss the full range of product options with them

·         44 % feel that they have significant input into their treatment selection

·         63 % said they want to be involved in such decisions

·         47% said they’ve thought about switching their treatment at some point

·         62%of those who think about switching end up doing so

 

So if it isn’t product and brand, what does drive patient treatment choice decisions? Accenture says “despite survey results showing that many patients look online for information about new treatments, physicians remain the primary influencer of their treatment choices. In fact, the reason patients cited most often for switching treatments was a recommendation from their physician (cited by 81 percent of patients who switched treatments), followed by proven benefits compared to current treatment (79 percent) and fewer side-effects than their current treatment (78 percent).”

 

Regarding demographics, the survey “findings also identified differences in attitude and behavior by age group, with younger patients more likely than older ones to understand which treatments are available—and switch treatments when they believe there’s something better. For instance, while physician recommendation was the most-cited reason across all age groups for switching treatment, Millennials are almost twice as likely as Baby Boomers to be influenced by people posting alternative treatment options on social media.”

 

Of course what the report doesn’t focus on regarding treatment decisions is the role of insurance coverage, cost-sharing and formularies. But Accenture’s message in this value based era should still resonate. Accenture’s Jim Cleffi, a co-author of the report, tells us “given the significant budgets pharmaceutical companies devote to driving brand equity in the marketplace, our report findings should be a strong signal to the industry that launch strategies need to change. Patients in our study made it clear that outcomes matter most which means that pharma companies should focus their launch strategies and communications more on patient value and impact versus the brand—and do so in a much more precise and personalized way. Reallocating parts of launch budgets to programs that resonate the most with different patient segments would not only better meet patients’ needs and deliver better outcomes, but likely provide the companies with better ROI.”

 

Accenture provides pharma two recommendations in the report:

1)    Bring an outcome – not just a product – to market. Patients value outcomes over brands, so instead of launching just products, pharmaceutical companies should start launching evidence-based solutions, or products with services as a secondary offering. This will require collaborative data-sharing – between patients, providers and payers – along with advanced analytics to generate robust insights and delivery via digital channels. This mindset should begin at the clinical trial-stage so it informs new launch strategies and full commercialization.

2)    Make it personal and precise. One size no longer fits all; pharmaceutical companies need to understand patient sub-segments and develop value-driven launch strategies tailored to each segment. Harnessing advanced analytics and other new technologies that leverage the proliferation of health data will help enable companies to modify launch strategies that make new treatments more relevant to patients while also driving better-informed resource and investment allocations.

 
Friday
Jan122018

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Health Insurer Centene Is Sued Over Lack of Medical Coverage

People who bought policies from Centene, a large for-profit health insurance company, filed a federal lawsuit on Thursday claiming the company does not provide adequate access to doctors in 15 states.

The New York Times

Thursday, January 11, 2018

Legislators say they are close to CHIP deal

Republicans and Democrats in Congress have said they are close to approving a long-term funding deal for the Children's Health Insurance Program, which could come as soon as next week, according to The Hill. CHIP provides insurance for nearly 9 million low-income children across the nation.

Becker's Hospital Review

Thursday, January 11, 2018

Trump administration to let states adopt Medicaid work requirements

The Trump administration told U.S. states on Thursday they can for the first time move toward imposing work or job training requirements on people as a condition for obtaining health insurance under the Medicaid government program for the poor.

Reuters

Thursday, January 11, 2018

The impact of Medicaid expansion on hospital closures

Medicaid expansion significantly decreased the number of people without insurance, and in turn may have prevented some cash-strapped hospitals from closing, according to a new study.

Fierce Healthcare

Tuesday, January 9, 2018

Drug Overdose Deaths Soar Nationally But Plateau In Some Western States

The opioid crisis on the East Coast and in the Midwest has fueled a national surge in drug deaths, even as fatal overdoses have decreased or remained stable in parts of the West, new federal data show.

Kaiser Health News

Monday, January 8, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday
Jan052018

Ten Large Objects on the Highway to Healthcare in 2018

By Clive Riddle, January 5, 2018

We find ourselves suddenly situated in 2018. How did that happen? Where did 2017 go, and for that matter, 2016 and its younger siblings? A Meat Loaf ballad once lyricized how Objects in the Rear View Mirror Appear Closer Than They Are. With apologies to AC/DC - on the highway to healthcare, here are ten large objects that demand our attention to stay focused on the road ahead and not in that fabled rear view mirror:

Merger Mania

In 2015 three health plan mega mergers were hatched, but only the Centene-HealthNet one made it out of the nest, and no other mega deals immediately followed suit. Will the late 2017 CVS-Aetna and hospital mergers such as CHI-Dignity signal more major activity in 2018, such as the rumored St. Joseph-Ascension merger? The answer should be a big yes for hospitals and other providers. In the health plan arena, look for additional players to pursue out of the box approaches such as CVS-Aetna (see below.)

CVS/Aetna and Multi-Level Integration

CVS will become a distribution center for applicable Aetna products. Aetna will become a distribution system for CVS products. CVS will further build upon its base retail clinics to become a direct care delivery system for Aetna. It’s a different kind of integrated delivery system than traditional hospital-medical group-health plan integrated systems, but integration it is, all the same, at multiple levels.

Amazon and the Decline of Retail Pharmacies

Especially coming off the holiday season, we read reports on the continuing rise of online shopping and decline of brick and mortar retail. Mail order pharmacy has been around for decades but has been focused on maintenance meds. Now that Amazon has mastered rapid on-demand delivery and has filed for pharmacy licenses in various states, and can deliver the other non-prescription products typically purchased at retail pharmacies – the rush is on. Major retail pharmacies will try mightily to enhance their own online offerings or partnerships.

Consumer Embrace of Technology

Private practice physicians aren’t so wild about the demands of EHR, and are skeptical at times about all things new bright and shiny, but numerous surveys indicate consumers are enthusiastic about the range of advances in healthcare technology that touch them. Consumers have plenty to be grumpy about in healthcare – but their embrace of technology will continue to drive demand for telehealth, e-visits, apps, portals, wearables, and new treatment options.

Searching For Value in Value Based Care

In the business of healthcare, we love to give birth to innovative approaches in healthcare delivery and payment arrangements, and after a honeymoon period, we tend to eat our own. Studies are published that indicate the new approach doesn’t deliver on results. A chorus of naysayers rises. And then we rightly or wrongly move on to something else. Health Affairs recently published a study concluding that Medicare ACO program savings were more the result of patient selection than care efficiencies. Other studies have begun to question various value based care arrangements. Given the growing popularity of value based care, and the intrinsic notion that the proposition makes sense, there is much at stake for value based stakeholders to continue to demonstrate the true value in their arrangements.

All Things Healthcare CyberSecurity

Hackers are as plentiful and resilient as crabgrass. Healthcare provides fertile hacking ground. The challenges in cybersecurity will grow larger, not smaller in 2018. More data breaches, and ransomware and other intrusions will occur and disrupt. A greater portion of healthcare resources will have to be deployed from every budget.

Deploying Social Determinants of Health

SDOH has been around for some time, but in 2018 it will be put into practice for population health initiatives by healthcare organizations and health plans on a significantly wider scale, driven by analytics and innovative new approaches.

Ho-Hum Impact of Trump Health Insurance Reforms

Moving insurance plans offerings across state lines and promoting association health plans won’t make much of a dent in the individual health insurance market in 2018. Don’t count on these initiatives to drive much business.

The Certainty of Uncertainty

Uncertainly was the word of the year in 2017 as the ACA teetered on a year-long tightrope. The tax reform individual mandate axe further muddies the water, as well as threatened Medicaid funding and more in 2018, but then there are the November 2018 elections, and who knows what that will bring.

Fulfilling the Promise of Analytics

SDOH is just one of a spectrum of initiatives that analytics is driving that wouldn’t have been feasible in their current form earlier this decade. Analytics is helping to shape solutions for the Opioid crisis, healthcare identify management, and interventions throughout population health, readmissions management, complex case management, to name a few. Serious analytics requires no small sum of resources and scale, but the returns are mounting and will bear even more fruit in 2018.

Friday
Jan052018

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

By Claire Thayer, January 5, 2017

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Trump poised to take action on Medicaid work requirements

The Trump administration is preparing to release guidelines soon for requiring Medicaid recipients to work, according to sources familiar with the plans, a major shift in the 50-year-old program.
The Hill
Friday, January 5, 2018

Trump Administration Rule Paves Way For Association Health Plans

The Department of Labor on Thursday released proposed new rules that proponents say will make it easier for businesses to band together in “associations” to buy health insurance.
Kaiser Health News
Thursday, January 4, 2018

White House greenlights CMS' crackdown on Medicare Advantage plans

The White House has signed off on the CMS' proposal to ensure Medicare Advantage plans have adequate provider networks. Starting next year, the CMS will start reviewing Medicare Advantage networks on three-year cycles rather than only when a company applies to be or renews their status in the program.
Modern Healthcare
Wednesday, January 3, 2018

HHS updates rule on sharing patient substance use history

HHS issued a final rule Wednesday to ease the exchange of information on patients' substance use history between providers, insurers and third parties involved in the payment or delivery of care. The update to HHS' Substance Abuse and Mental Health Services Administration's regulatory rules aims to eliminate red tape that can slow the reimbursement process and impede timely access to care.
Becker's Hospital Review
Wednesday, January 3, 2018

Hospital groups dig in after cuts to discount drug program

Hospital groups are vowing to push forward with a fight against the Trump administration over changes to a federal drug discount program following a setback last week.
The Hill
Tuesday, January 2, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Wednesday
Dec202017

Looking A Little Deeper into CMS National Health Expenditure Report

Looking A Little Deeper into CMS National Health Expenditure Report
 

By Clive Riddle, December 20, 2017

 

 

The CMS Office of the Actuary recently released their annual National Health Expenditure Data, current and historical through 2016. We thought we’d take a slightly deeper look at data released to expand upon the publicized highlights.

 

CMS found that ”in 2016, overall national health spending increased 4.3 percent following 5.8 percent growth in 2015.” For comparison PwC in their annual Behind The Numbers medical cost trend report pegged the number at 6.8% in 2015; 6.2% in 2016; 6.0% in 2017 and project 6.5% for 2018. Of course overall national health expenditures measured by CMS are not an identical universe to how PwC measures medical cost trend.

 

The portion of national GDP that healthcare consumes has been one of the most used comparative measures of healthcare to the overall economy. CMS found that “During 2014 and 2015, the health spending share of the economy increased 0.5 percentage point from 17.2 percent in 2013 to 17.7 percent in 2015. Health care spending grew 1.5 percentage points faster than the overall economy in 2016, resulting in a 0.2 percentage-point increase in the health spending share of the economy – from 17.7 percent in 2015 to 17.9 percent in 2016.” Looking back into CMS historical files, in 1966 healthcare consumed 5.7% of the national GDP. In 1976 it was 8.1%. In 1986: 10.3; 1996: 13.3%; 2006: 15.5%; and last year to 17.9%.

 

CMS reports that “private health insurance spending increased 5.1 percent to $1.1 trillion in 2016, which was slower than the 6.9 percent growth in 2015.” Private insurance comprised 22% of national health expenditures in 1966, 25% in 1976, 29% in 1986, 32% in 1996, and 34% in 2006 as well as 2016.  

 

Regarding Medicare, CMS states “spending grew 3.6 percent to $672.1 billion in 2016, which was slower growth than the previous two years when spending grew 4.8 percent in 2015 and 4.9 percent in 2014.  Medicare comprised 4% of national health expenditures in 1966, 13% in 1976, 16% in 1986, 18% in 1996, 19% in 2006 and 20% in 2016

 

For Medicaid, CMS says “expenditures grew 3.2 percent in 2016, while federal Medicaid expenditures increased 4.4 percent in 2016. The slower overall growth in Medicaid spending was much lower than in the previous two years, when Medicaid spending grew 11.5 percent in 2014 and 9.5 percent in 2015.” Medicaid comprised 3% of national health expenditures in 1966, 10% in 1976, 9% in 1986, 14% in 1996 and 2006, and 17% in 2016.

 

CMS tells us that overall “out-of-pocket spending grew 3.9 percent to $352.5 billion in 2016, faster than the 2.8 percent growth in 2015.  Additionally, 2016 was the fastest rate of growth since 2007 and was higher than the average annual growth of 2.0 percent during 2008-15.”Examining out of pocket expenses as a percent of overall health expenditures, we found the percentage has decreased from to 48% in 1960; 33% in 1970; 22% in 1985; 15% in 2000 and 11% in 2016.

 

CMS reported that “retail prescription drug spending slowed in 2016, increasing 1.3 percent to $328.6 billion. The slower growth in 2016 follows two years of significant growth in 2014 and 2015, 12.4 percent and 8.9 percent, respectively” Looking back at historical files for Rx total spending, percentage of overall healthcare spending and the percentage paid out of pocket for the past six decades, we found:

1966: Total $4.0 Billion | 8.6% of Total Health Expenditures | 90.2% paid out of pocket

1976: Total $8.7 Billion | 5.7% of Total Health Expenditures | 74.7% paid out of pocket

1986: Total $24.3 Billion | 5.1% of Total Health Expenditures | 64.8% paid out of pocket

1996: Total $68.1 Billion | 6.3% of Total Health Expenditures | 35.6% paid out of pocket

2006: Total $224.1 Billion | 10.4% of Total Health Expenditures | 22.9% paid out of pocket

2016: Total $328.6 Billion | 9.8% of Total Health Expenditures | 13.7% paid out of pocket.