How can pharma add value and help ACOs work?

Like Will Rogers, Dr. David Nash is reluctant to predict the future. But when prodded, the dean of Jefferson’s School of Population Health described a post Accountable Care Act world in which pharmaceutical options will be dictated by outcomes and value. Pharmaceutical companies are trying to figure out the best way they can reduce costs and generate revenue.

“We’re going to see more emphasis on the cost effectiveness and cost benefit of products. Clearly any provider organization that’s going at economic risk…will care a lot more in 2015, 2016 about the economics of the pharma products they are using..We are in need of better population based data.”

The panel discussion at the CONVERGE conference in Philadelphia this week highlighted some interesting ways pharmaceutical companies can respond to these needs by Accountable Care Organizations and what else they can do to add value.


Improving outcomes by engaging patients

Vree Health, a subsidiary from Merck’s venture arm, is working to develop smoother transitions when patients are discharged from hospitals, particularly by improving care coordination and adherence. It’s led by Merck consultant Kyle Dolbow who has been president of the company since February. The initial focus is three conditions where CMS is penalizing hospitals for higher than average rates for preventable readmission — congestive heart failure, AMI and pneumonia. It is also getting approached by other pharmaceutical companies to provide ways to verify and improve adherence. Although everyone and their brother acknowledges the need to improve adherence for better outcomes, it will be even more important to have the means to prove it as drug developers share risk with payers for the development of complex therapeutics.

Accountable Care Organization Collaboration

As physicians and payers associated with public and private ACOs see it, drug developers could play a significant collaborating role. How? By using their data to recommend adherence protocols to improve patient engagement and reduce re-admissions. It could also provide monitoring tools to give relevant information like blood glucose levels for diabetics in realtime. “We believe at some point that through decapitated payment models, ACOs… being able to demonstrate better outcomes will find commercial adoption,” said Dolbow. “If you can’t demonstrate that your products generate better outcomes, you really don’t have anything.”

He added:  “George Merck once said if you care for the patient, the revenues will follow so we’re hoping that’s the case again,”

Leaner supply chains

Pharmly is developing an analytics engine to provide realtime data for medical facilities purchasing drugs. The pain point?  About 89 percent of medical facilities can’t find a drug they need for their patients.When they go outside their established suppliers they have to pay a huge mark up for them, according to its founder Samantha Godfrey. It uses a pool of licensed and vetted distributors to predict pricing trends and predict supply chain issues. Like a fine wine, the analytics tool is expected to grow in value the longer it’s around, as its data grows and it can be used to predict critical trends like raw material shortages.



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