Physicians say the pharmaceutical industry could be integral in helping value-based healthcare providers deliver better care at lower costs. However, pharma companies are failing to deliver the data needed to accomplish that goal, according to the findings of a new Oliver Wyman study.
The study included insight from 200 respondents who currently earn at least 25 percent of their income through value-based care arrangements, such as accountable care organizations (ACOs).
Sixty-one percent of respondents said they agreed or strongly agreed that there is a role for branded drug therapies in reducing the overall cost of patient care when used appropriately.
Only 37 percent agreed or strongly agreed with the notion that pharmaceutical companies have the capabilities to reduce the total cost of care and improve patient outcomes.
Accompanying interviews with senior executives at ACOs at various stages of development echoed physicians’ views. “Drugs can cost more, but they have to prove real value to the patient in order for payers to agree to pay more,” said the former CEO of a Medicare Advantage ACO, in a press statement. “You can’t just charge money for a new therapy unless the economics work.”
“Drug spend is not considered today in most contracts between ACOs and payers,” said Mark H. Mozeson, a partner at Oliver Wyman and co-director of the survey, in a press statement. “Many in the industry expect that to change in the near future. And as it does, drug makers will have the opportunity in many cases to move away from negotiating unit price with commercial health plans and instead contract directly with providers based on outcomes and ability to manage total disease costs. Their ability to demonstrate value will determine whether they have a seat at table.”
Physicians’ lack of confidence in pharma companies makes sense to Peter Gilmore, an Oliver Wyman partner and survey co-director. “Pharma companies have an image problem,” he said, in a press statement. “For years they have gone to payers and providers with data on how their drugs compare to the standard of care. They haven’t given their customers what they wanted: true evidence on how their drugs optimize total disease costs. That needs to change.”
Just last summer, the National Pharmaceutical Council together with the American Medical Group Association (AMGA) and the Premier healthcare alliance teamed up with seven provider organizations to form a working group on optimizing medication therapy in value-based care. The group developed a framework for considering the role of pharmaceuticals in achieving this value-based success.
“This framework provides guidance for providers who are working to implement value-based programs that achieve broader quality and cost-reduction goals,” said Donald W. Fisher, AMGA president and CEO, in a press statement. “As providers navigate this new landscape, they can rely on this road map to optimize medication therapy and ensure patients have access to, and support in using, the medications they need."