The U.S. healthcare system is undergoing its biggest changes in more than 40 years as the Affordable Care Act unfolds. Millions of U.S. citizens who were previously uninsured will now have access to prescription drug benefits, a boon to the pharmaceutical industry. But prescriber dynamics are changing to accommodate the other goals of healthcare reform: cost savings, more coordinated care, and improved outcomes.
Biopharmaceutical companies must understand the new prescribing dynamics and tailor their messages to stress value, improved outcomes, and overall cost savings in episodes of care. Biopharma can be a resource to physicians and hospitals who are under increasing pressure to bend the cost curve and provide value to patients.
Markets covered: United States.
Analysis of Accountable Care Organizations: Percentage of physicians who are full or partial owners of their practices; Quality of care metrics for Medicare Accountable Care Organizations; Drug reimbursement in an ACO; Insights from hospital and ACO management; Mechanisms to involve physicians in risk-sharing; Medical home standards.
Managed care’s growing influence in public markets: Growth of Medicare Part D, 2010-2013; U.S. Medicare Advantage growth, 2010-2013; Percent of Medicare Advantage plans by star rating; Oncologists’ participation in clinical pathways programs; Oncologists’ incentives to follow pathways; Impact of physicians’ use of EMR in diabetes.
Patient’s role in prescribing: Average copays and coinsurance for workers with 3 or 4 tiers of prescription benefits; Growth of health savings and health reimbursement account enrollment; Consumer actions after finding health/medical information online; Influence of information sources in key medical situations.