MM: What roles do agencies play in pharma companies' partnerships with third parties?
Glick: When pharma companies already have partners, the agency's role is that of an honest broker, to develop programs that are acceptable to both sides. But often, pharma companies rely on agencies to have the contacts and introduce them to the right partners-which is valuable because there are many organizations and it's challenging to find partners whose objectives match.MM: What can companies still learn about partnering?
Glick: Pharma can't come to an organization and say, "I'll give you money if you sign on the dotted line." Most credible organizations want to have conversations, be consulted, and agree on campaign objectives.
Companies should also make long-term commitments to patient groups. It behooves both sides to come into a relationship understanding that it will not be for only a month or even a year. Long-term commitments leave an open door for third parties to create new opportunities with pharma and for companies to remain in touch with those organizations that are not only shaping public policy but have the resources to reach patients quickly and cost effectively.
MM: Where do pharma companies' and patient groups' objectives meet?
Glick: The middle ground came about with baby boomers who, unlike older patients, felt they should be involved in their healthcare and should challenge physicians' decisions.
Pharma companies, particularly those with state-of-the-art treatments, recognize that empowered patients are more likely to want the best treatments and the newest therapies, even though they might be the most expensive, and will readily engage physicians in getting that care.
Advocacy organizations empower patients and caregivers by understanding options and resources to help them treat their disease. With that information, patients might decide they want the more expensive therapy, and if needed, advocate access and reimbursement to get it.
MM: How can pharma and patients work together to tackle those two fronts?
Glick: There is a real marriage between industry and patient groups in the area of clinical trial access. Until recently, Medicare didn't cover patient participants because clinical trials were considered experimental therapy. Patient groups and the pharma industry worked together to change that situation.
Partnerships are also needed to make government policy catch up with science. For example, Medicare does not cover oral chemotherapy, which is why a broad coalition of patient advocacy groups, medical societies and pharma companies have joined forces to press for new legislation that will provide Medicare beneficiaries with access to new oral anti-cancer drugs. Although this legislation has not yet been approved by Congress, if passed, it will ultimately increase patient access to a number of new oral oncology drugs now in companies' pipelines.
MM: What issues will patients and industry tackle in 2002?
Glick: One big new problem will involve the Center for Medicare and Medicaid Services' intention to change the average wholesale price reimbursement formula, which has particular implications for drugs delivered in doctors' offices, like chemo-therapy for cancer.
The new pricing structure will reimburse physicians at a lower rate. That is significant, because it will discount the costs that deal with the delivery of the healthcare, such as nursing and the time spent administering the therapy. The original reason for the formula was to allow Medi-care patients access to the newest and most expensive therapies. If the pricing structure changes, it's likely that physicians will administer less expensive treatments that may not be in patients' best interest.