Healthcare Orgs Unaligned on Drug Pricing

When it comes to aligning care outcomes with pricing, consumers and healthcare providers are, well… unaligned, a new survey from BDO and the NEJM Catalyst reveals.

Most patients (74 percent) are interested in outcomes-based drug pricing, yet the majority of healthcare organizations (59 percent) are not yet working with drug manufacturers to track care outcomes—and have no plans to do so. Only 8 percent of patients, meanwhile, said they were not interested at all in outcomes-based drug pricing, while 11 percent of healthcare organizations said they are currently working with drug manufacturers to track care outcomes.

  • BDO’s quick take: The findings underline that while public pressure to curb drug prices continues to mount, the tactics of doing so realistically have not yet been realized. We believe this is because of continued high valuations paired with pharmaceutical companies that are under more pressure to maximize the profitability of a limited number of lucrative products. This provides little incentive for pharma to come to the table on outcomes-based pricing.

The December survey polled the NEJM Catalyst Insights Council, a qualified group of healthcare executives, clinical leaders, and clinicians at organizations directly involved in care delivery. Respondents also said they expect innovative mergers like the CVS-Aetna deal—along with new market entrants—to continue to disrupt healthcare.

Eighty-one percent expect such mergers to continue disrupting the industry over the next three years. When asked which companies are expected to have the most significant impact on the industry during that time, CVS-Aetna came first, followed by Amazon, Optum-DaVita, Google, and Apple.

  • BDO’s quick take: CVS-Aetna was a watershed moment in healthcare—one that will certainly unleash an avalanche. We see such deals giving consumers greater visibility into their care options and costs, offering them more convenient, effective, and streamlined services. But the potential for Amazon and other tech giants to disrupt is even greater. Amazon could purchase a health insurer (or any healthcare company) tomorrow—turning the traditional care delivery and pricing model upside down and forcing other healthcare organizations to reimagine their business models to remain competitive.

Interested in learning more about these trends? Check back on our blog for BDO insights from its Panel Trifecta event during the 36th Annual JP Morgan Healthcare Conference. We’ll hear from Karen DeSalvo, former national coordinator for Health Information Technology, and leaders from Purdue Pharma, UC Irvine, Genome Medical, HealthXL, Rebiotix, myowndoctor.com, and more.

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