Roger Longman| Managed Healthcare Executive| May 10, 2013
Why payers should gain control of the drug benefit
One of the biggest changes in healthcare right now is the transformation from a fee-for-service economy, and it will likely take longer than we expect. Still, payers and providers—and the various big and small service providers hoping to serve them—are already trying to improve business processes as diverse as connectivity, transparency and consumer communication.
Yet, relatively little of this re-engineering aims at the purchase and management of drugs. continue reading…
Cathy Kelly| The Pink Sheet| March 18, 2013
UnitedHealth Drug Evidence “Hierarchy” Demands Observational Data Be Peer-Reviewed
During a March 12 symposium, UnitedHealth executive Lewis Sandy discusses evidence requirements for drug outcomes, employers’ interest in reference pricing for drugs and concerns with variations in specialty drug costs based on site of care.
Insurer UnitedHealth Group Co. is willing to accept observational data to support reimbursement for prescription drugs but the information should be published in a peer-reviewed journal, Senior VP Clinical Advancement Lewis Sandy said at the Real Endpoints reimbursement symposium in Philadelphia March 12. continue reading…
David A. Shaywitz | Forbes.com | March 12, 2013
Case Study: What Would You Do Here If You Were The Payor? The Doctor? The Patient?
Here’s a hypothetical question Roger Longman posed to a panel at the recent Real Endpoint Symposium that is probably worth a little thought from everyone; since the issues raised are intended to be general, I’ve modified this scenario slightly to try to make it as non-specific as possible, so it explicitly doesn’t (and isn’t intended to) apply to a particular disease state or to particular drugs.
Here’s his hypothetical: continue reading…
David A. Shaywitz | Forbes.com | March 11, 2013
Opportunities For Healthcare Innovation SXSW Hipsters May Have Missed
Since Lisa Suennen already captured beautifully the distinction between the SXSW and HIMSS crowds last year, I won’t belabor the point, other than to say that with all the ties and blue blazers present at today’s Real Endpoints Symposium in Philadelphia, no one would mistake the attendees for Austinhipsters; I was grateful not to get tossed for wearing jeans.
Unfortunately, I suspect that many of the hoodied SXSW technologists interested in digital health might have found today’s discussions especially illuminating, highlighting some of the key healthcare problems to be solved, and featuring many (but not all) of the key players. Pharmas, device makers, diagnostic companies, and payors seemed well-represented; providers: less so. Patients: essentially absent (I suspect in future years, forward-thinking disease foundations such as the Michael J Fox foundation and the Myelin Repair Foundation might find the dialog especially useful)…continue reading
Forbes – 03-January-2013
Digital Health Companies Must Make Themselves Indispensable To Established Stakeholders
In a post last year that must qualify as an instant classic, Psilos VC Lisa Suennen (aka Venture Valkyrie) compared her experiences at the old-school, tragically unhip (e.g.) 2012 HIMSS (Health Information and Management Systems Society) conference and at the “Woodstock for Geeks” (in her words) SXSW conference a few weeks later.
The money paragraph is this one:
“It is an interesting time in healthcare IT and I think that the incredible gulf between HIMSS and SXSW is a perfect metaphor for the challenge. We have to figure out a way to engage legions of young innovators who really understand next generation technology in channeling their energy into healthcare solutions. The old school enterprises who have the biggest presence at HIMSS are unlikely to be the leaders of the future if they don’t come up the social networking uber geek learning curve. On the other hand, too many of the new kids on the block can program a sophisticated piece of software in their sleep while eating a pizza with the other hand, yet don’t really understand the intricacies of how money moves through the healthcare system and where all the privacy, security and financial incentive bodies are buried.”
I was thinking about this exact challenge when reviewing the agenda for a fascinating upcoming industry conference I’m attending in early March, the Real Endpoints Symposium originally scheduled for last fall but postponed due to Hurricane Sandy. (Disclosures: none – I’m paying full fare, and I’ve no affiliation or business relationship with Real Endpoints, other than deep and longstanding admiration for its founder, Roger Longman). Continue reading…
PR Newswire – 10-October-2012
Ernst & Young to co-host new symposium focused on the revolution in product reimbursement strategies in health care
PHILADELPHIA/ — Ernst & Young today announced that it will be co-hosting the first annual Real Endpoints Symposium, which will bring together senior executives from leading life sciences companies, payers, providers, and policy makers to discuss new solutions and innovative strategies to address the rapidly changing reimbursement environment in healthcare. This unique forum, entitled Disruptors: revolutionizing product reimbursement strategy, will be co-hosted by Real Endpoints, and will take place November 1-2, 2012 at the Hyatt Regency in Philadelphia, PA…
Online PR News – 03-October-2012
Real Endpoints Interviews Most Innovative Thinkers And Do-ers In The World Of Product Reimbursement
In independent interviews with Real Endpoints analysts, Aetna, UnitedHealth, GSK and others discuss the 7 key issues that will set the reimbursement agenda for the next 24 months – and beyond.
Product reimbursement sits at the epicenter of the healthcare payment revolution. Product payments are 50%-plus of most plans’ controllable costs. And they’re everything to pharma and med-device businesses.
But…
American Health and Drug Benefits – September 2012
Payers Collaborate with Providers to Adopt Oncology Pathways, New Care Delivery Models
Payers throughout the US are reaching out to local provider networks to work through the “how” of developing oncology clinical pathways and negotiating the details around new care delivery and payment models.
“Payers Collaborate with Providers to Adopt Oncology Pathways, New Care Delivery Models” is based on Reimbursement Intelligence’s Oncology Survey (RIOS), which delivers key insights on the nuts-and-bolts of how payers are approaching oncology clinical pathways, the anticipated sources of cost-savings from formation of oncology ACOs, and the impact of these new care delivery and payment models on oncologic drug costs.
Online PR News – 15-August-2012
J&J and BMS join the list of thought leaders speaking at Real Endpoints Symposium in November
Steve Wooding, VP, Head of Market Access, EMEA, J&J, and Ammar Qadan, Exec Dir – Diabetes Payer Marketing & Market Access Strategy USP, BMS to speak on “Payer-Pharma Risk-Sharing: The Only Plausible Near-Term Solution to The Value Problem” at RealEndpoints.com/Symposium
The compelling logic behind payer-pharma risk-shares have already made them a growing, if still small, component of European access strategies. As health care costs continue to soar, some form of risk sharing will have to be part of the solution in the US too. So which models work? And do they pave the way for more permanent value-based pricing?
Online PR News – 09-August-2012
Real Endpoints to host Reimbursement Symposium this November
DISRUPTORS: Revolutionizing Drug/Dx Reimbursement, Nov 1-2, 2012, Philadelphia, PA Designed to bring together payers, providers, pharma to discuss both the promise and challenges of recent attempts to improve care and cost efficiency. Read on www.realendpoints.com/symposium
Adherence. Diagnostics. Palliative Care. What to prioritize?
By Deena Beasley
Fri Jun 15, 2012 12:20am EDT
Analysis: Drug costs become bigger issue in cancer care
(Reuters) – In the past, money was no object when cancer specialists considered which drugs would provide the best treatment for their patients.
But some top oncologists are rethinking that stance, given the soaring costs of new cancer medicines, reduced reimbursement by insurance plans and fresh research that has identified cases where cheaper generic drugs can work just as well – or better – than expensive brand-name medications…Continue reading