May 27, 2015 – Curant Health COO, Marc O’Connor, in Specialty Pharmacy Times – Amidst the health care industry’s seismic shift away from fee-for-service to value-based care, the pharmaceutical industry remains firmly at odds. Manufacturers need to recoup massive R&D costs for curative therapies and PBMs need to drive down costs for their plan sponsors. The associated hard negotiations between the two and the oft absent inclusion of pharmacists and patients in the conversation comprises the current industry landscape, in which entered the 2015 Armada Specialty Pharmacy Summit.
The 2015 edition of the conference both energized and galvanized my resolve to help align the industry to the benefit of all concerned by putting patients first. Here are the top five insights I gained under the bright Armada lights in Las Vegas last month.
1. My intuition was right: There is a great opportunity to improve alignment of pharmacy industry stakeholders by really focusing on patients. The pharma industry is set at odds and a candid conversation about this status and how to improve the situation to the benefit of every stakeholder is necessary. From those gracious enough to attend my session with Kent and engage with us afterwards, I consistently heard about the necessity of industry constituents aligning to bring patient interests to the forefront. Utilizing effective medication therapy management ultimately improves patient outcomes and business metrics simultaneously.
2. New injectable statins will be the next point of contention. Misalignment remains in great magnitude between PBMs and manufacturers. Payers are highly concerned about growth in development, cost and prescription of new specialty therapies including injectable statins. On more than one occasion I sensed a “Here we go again,” reaction from our payer colleagues who are laser focused on driving down the costs of expensive therapies. Pharmaceutical manufacturers creating the truly curative therapies we’ve asked them to develop must work with top tier payers and PBMs before the drug comes out for appropriate pricing. With these new curative drugs, manufacturers are no longer able to recoup their R&D costs over 20 years. That time window is now just 12 weeks in many cases. This changes the financial model considerably. In addition, to enable more oversight, pharmaceutical manufacturer networks are looking to narrow their networks. In my presentation I asked the question “Should manufacturers be more focused on the quality of their networks versus the size of their networks?” How do manufacturers improve the quality of their networks and what do those quality metrics look like? For starters those metrics should include, adherence levels, patient outcomes and network delivery and efficiency.
To read Marc’s full article, visit Specialty Pharmacy Times.
To learn more about Curant Health, contact Kristin Lindsey, Marketing Director, at firstname.lastname@example.org.