Every year, the business of healthcare gathers en mass at the annual J.P. Morgan Healthcare Conference. What will we learn? What will we hear? What will be missing?
Sadly, I do not believe we will learn or hear anything of substance, especially when it comes to patient care. This conference is about the healthcare business, not the patient care business, which is our focus. Yet we will be there focusing on improving patient outcomes in every conversation we have because medication management done right has the ability to align the healthcare community in ways few, if any, initiatives can.
Pharma’s at-risk day is here: where is the “smart money?”
Recent congressional hearings on drug pricing are capable of forcing manufacturers and payers to begin to align their divergent interests in earnest. That said, I do not anticipate any demonstration in real alignment, or patient focus, at J.P. Morgan 2016. From manufacturers, we will hear about new therapies that have completed phase three trials and are about to go commercial. We will hear them defend their drugs’ prices. We will hear things analysts like to hear.
From the payers and PBMs, we will hear about how drug prices are too high and that manufacturers may be cut out of payers’ formularies if pricing, value and efficacy are not proven for new specialty therapies. We will hear more of the same rhetoric we have been hearing for the past decade. Not a high-value proposition.
Pharma’s at-risk day is here. This has the ability to move the meter on alignment and reduce the risk profiles for both manufacturers and payers. We will be eager to hear from manufacturers and payers about how this is going so far and who has plans to go “at-risk” in 2016. Providing risk-mitigation through medication management programs proven to improve adherence and outcomes is where Curant Health excels.
What will be missing: Patient access and easing of the prior authorization process
Prior authorizations are here to stay and are a huge hurdle to access for chronically ill patients who desperately need access to life-saving therapies. What is needed to streamline this process is easier access to patient adherence and lab data so that patients have access to the most effective, value-driven therapies where “value” equals outcomes divided by costs.
Currently there exists no good platform to gather and share this data. It must be acquired in a torturously slow, painful process involving clinicians, administrators and antiquated technology. This is an opportunity for the tech community to create a desperately needed, elegant pathway to deliver these data. Currently, a clinical pharmacist fills out a prior authorization response to answer the payer’s questions, then phones both the payer and the prescriber, then fights and claws and scratches until the prior authorization request gets approved because we know it is what is needed to improve patient outcomes to the benefit of all parties involved.
Because the clinical pharmacist is becoming the “hub” of the care team with the capability of using the longest lever available to improve outcomes and reduce costs (medication adherence), we need a more empirically-driven platform. In order to prove the ideal patient for Repatha™, three or four months of adherence and labs data on Lipitor® is needed first. The infrastructure for this does not exist yet, but it is desperately needed.
Curant Health is looking for creative solutions focusing on improving patient outcomes and access. We are not seeking another online portal or patient support platform: those are not sea-change opportunities that impact our business. We need tools that: 1. prove patient adherence to medication therapies and, 2. provide an elegant feedback loop that makes it easy for clinicians to deliver lab and other outcomes-based data to ancillary providers like Curant.
If you are a pharmaceutical manufacturer seeking near-clinical-trial conditions for patients taking your high priced therapies or,
If you are a payer seeking to ensure the greatest value is derived from patients' medication therapies , or,
If you have a technology solution to our adherence and data flow needs, we want to connect at the J.P. Morgan Healthcare 2016 Conference.
Contact me at moc@curanthealth.com to request a meeting.