Payer-pharma partnerships move 'beyond the pill'


Pharamceutical companies should implement "beyond-the-pill" strategies that move past their traditional business model and work with payers in new ways to meet challenges facing the healthcare industry, according to PharmaVoice. In the post-Affordable Care Act era, the pharmaceutical industry has an opportunity to help improve outcomes and enhance the efficiency of healthcare delivery, the article noted. Doing that starts with improving relationships with payers.

Pharma should compare drugs and not just placebos for payers, the article noted. Secondly, the pharmaceutical industry should focus on proving the long-term cost value of drugs as well as their value across multiple demographics. The industry also should compare clinical trial and claims data so payers can develop comparative cost effectiveness models.       

Moreover, pharmaceutical companies can extend their influence beyond patients taking medications and support payers by helping improve population health through data sharing on responders and non-responders. Pharma can help improve the patient experience by using media to communicate important information across all patient interfaces. Instead of focusing on medication reminders, informational consent and goal setting in isolation, pharmaceutical companies can create services that combine these tactics to support and motivate patients, caregivers and providers, the article argued.

Overall, "biopharma must strive to construct a value argument measured in clinical and economic terms, ensuring that new drugs meet the needs of payers, patients and physicians alike," John Doyle, Dr. P.H., senior vice president and managing director at Quintiles, told PharmaVoice.

Most payers recognize that pharmaceuticals play a major role in comprehensive approaches to providing quality health care. Meanwhile, insurers and pharmaceutical companies have previously joined forces to lower costs and improve outcomes by leveraging each other's knowledge.

The payer-pharma relationship hasn't always been rosy. however. Earlier this year, America's Health Insurance Plans faulted the drug industry for the soaring costs of new specialty medicines, saying such expensive pricing is unsustainable and takes unfair advantage of health insurers.

For more:
- here's the PharmaVoice article (.pdf)

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