Fact: Healthcare Is Changing

Efforts to reform healthcare are moving forward as it is clear that as a nation we must decrease healthcare costs. Right now there are more questions than answers about the impact of the Affordable Care Act (ACA) that the US Supreme Court recently upheld. One thing is clear—the US healthcare system is changing. Below are my thoughts on three key areas the life science industry must prepare for.

Articulate the value of your product.

Conventional end points of safety, efficacy, and quality of life are no longer sufficient. Be prepared to demonstrate cost-effectiveness or cost-avoidance.

Implementation tips...

1) Work collaboratively with your colleagues in marketing, managed care marketing, pharmacoeconomics, clinical affairs, medical affairs, and regulatory to understand the data that is desired by various stakeholders when they are determining if a product is valuable or not. Develop plans to obtain the needed data.

2) Determine which patients are most likely to benefit from your product. Communicate to healthcare providers the patients that are most likely to benefit from treatment. Additionally, assist with screening and referring appropriate patients to local physicians or study sites.

Plan for government rebate plans and pricing controls.

If your treatment is expensive, be prepared for limitations on its use compared to less expensive alternatives.

Implementation tips...

1) Adjust your forecasts

2) Begin working on how to articulate the value of your product (see above for insights)

Provide programs that enhance outcomes for individual patients.

Shift your focus to taking care of patients and improving their outcomes. Patients will stay on treatment and future healthcare expenses resulting from patient non-adherence will decrease.

Implementation tips...

1) Plan and implement programs that support patients on their treatment journey.

2) Understand the barriers patients face in remaining adherent and compliant with therapy.

3) Develop and implement patient support programs that are a resource and guide for patients during their treatment journey. This can include offering access to healthcare-trained representatives for questions or providing educational materials to help patients continue with treatment.

There are many ways you can articulate the value of your product. Additionally there are many options for providing programs that enhance patient outcomes. As a pharmaceutical call center, we provide as needed call-in support for patients, caregivers, and healthcare providers to answer questions about a product and its side effects, enroll patients in a support program, connect patients with healthcare providers in their local area, and connect patients with co-pay assistance resources. Our experiences show that within 6 months of implementing a patient support program patient adherence increases 10% to 15%. Patient adherence to treatment decreases future healthcare costs related to treating complications from earlier non-adherence.

The June 2012 issue of PharmaVOICE magazine has an article on healthcare reform and the potential impacts of it on the life science industry. If you are interested in additional perspectives on the impact of healthcare reform you can access the article here.

I’d like to hear from you. How are you preparing for the impact of the ACA? What areas have you identified as opportunities? What kinds of initiatives and programs are you planning? Please join the conversation and share your thoughts, challenges, and questions on the ACA implementation. We can all learn from each other.

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