The Supreme Court upheld Healthcare Reform—the Affordable Care Act (ACA)—in June 2012, paving the way for every facet of the healthcare market to change. From how drug companies price and market their drugs, to who health plans cover, and how physicians are organized to care for patients. PSB polled doctors, health plans and pharma to get their view into the impact of the ACA. We shared the survey results and our guidance on how healthcare companies can thrive in this new environment in a Free Web Seminar, Building Winning Strategies in an ACA World, co-presented with market access experts WG Consulting.
Drug Companies, Payers and Physicians Are Split on Pharma’s Role in Assisting Its Customers with ACA Implementation
Although about 84% of pharmaceutical companies say they are somewhat or very closely following news on the Affordable Care Act (ACA), only about a quarter are taking any actions to assist payers and physicians in adapting to the new healthcare reforms. New research from WG Consulting and Penn Schoen Berland (PSB) reveals that all stakeholders—pharma companies, payers and physicians—are split about evenly on whether they think it is pharma’s job to help with ACA implementation. Approximately half of each audience believes pharma should focus exclusively on producing safe and effective treatments, while the other half thinks pharma should add supporting ACA execution to its responsibilities. The majority of payers and providers believe controlling costs is the most important action pharma can take to help them with the ACA.
“In this time of change, it’s critical that pharma companies develop new strategies for partnering with their payer and provider customers, supporting them in incorporating the ACA into their practices and businesses,” says Jonathan Kay, Head of PSB’s Healthcare Practice. “Our research shows that many physicians and payers want pharma’s help with the ACA--and have concrete suggestions on how drug companies can work with them to ease implementation of the ACA’s provisions. Though controlling costs tops the list, they’d also like to see pharma provide educational programs on the impact of reform changes, create better access to drugs, improve physician incentives to ensure proper use of treatments and demonstrate value through outcomes studies.”
“Pharma must take action around the ACA or risk having other groups in the driver’s seat,” adds Claire Gillis, CEO of WG Consulting. “Part of the inertia we see in the industry comes from uncertainty about what to do in this new world. Pharma leaders need to remember that though reforms are new to the US, many EU countries have been down similar paths—and American companies can learn a lot from EU experiences. Key lessons include engaging early with payers and providers to drive better outcomes, integrating clinical and health economics outcomes research at the beginning stages of product development, promoting close collaboration among internal teams, and developing and delivering clear and compelling value stories.”
Stakeholder Reactions to the ACA Vary, with Payers Most Positive
There are wide variations among the stakeholder groups in their responses to the potential impact of the ACA. Two-thirds of physicians anticipate they will see their incomes drop when the ACA takes hold. In addition, more than half believe their patients will be worse off, with less access to the treatments needed to provide positive health outcomes.
Pharmaceutical employees also expect increased challenges as a result of the ACA. Almost three-quarters—72%--believe it will be more difficult to get coverage and reimbursement for their products.
In contrast, most payers see positive effects coming from the ACA. In fact, payers have the most optimistic view of the ACA, with 62% predicting their revenues will increase as more patients receive health insurance coverage.
Full Study Results Are Available Free
Findings are based on an online poll of 101 primary care physicians; 50 payers; and 50 representatives from pharmaceutical, biotech and medical device companies. Full study results were presented at a recent webinar, Building Winning Strategies in an ACA World.
The webinar can be accessed free on demand at www.pharmavoice.com/ACA
For a copy of the Webinar presentation, please click here to download.