Consumer-centric healthcare has been the buzz for years. But today there are signs that its time has finally come, and that
we're about to see the arrival of market-driven healthcare.
Lisa B. Bair
Look at some recent trends: Employers have begun shifting the burden—and the choice—of higher-cost prescription products to
employees. The average company health plan now offers a menu of options, from flexible spending accounts to defined contribution
plans and multi-tiered networks.
The federal government, meanwhile, has signaled its support of consumer-centric healthcare. During his re-election campaign,
President Bush endorsed consumer-driven healthcare plans (CDHPs) as a way to control rising healthcare costs. And, following
managed care's lead, Medicare is now placing the consumer firmly at the center of the healthcare decision-making process as
These make healthcare decision-making increasingly complex. For example, multi-tier co-pay designs force consumers to bear
the cost when they opt for branded therapies, pushing cost-conscious consumers toward generics. On the other hand, the skyrocketing
popularity of lifestyle therapies, for which consumers bear most or all of the cost, proves that consumer demand for prescription
products is growing despite rising co-pays and premiums.
Evolution of program strategies
Two Birds with One Stone
Brand managers can adapt to the changing times by developing a multifaceted approach designed specifically for patient-centric
healthcare and its primary players—patients and managed market customers.
Brand managers and managed markets have many goals in common:
- sharing in the healthcare decision-making process
- increasing consumers' knowledge of treatment options
- increasing patient adherence and compliance
- increasing productivity
These shared goals create the opportunities for partnerships between pharmaceutical companies and managed market customers.
Instead of using a mass-market approach such as DTC, companies can work with managed markets to develop initiatives that target
employees who are at risk for, or have been diagnosed with, chronic conditions. Outcomes-focused programs such as health fairs,
worksite healthcare education, and predictive modeling research can build brand loyalty with a large customer base in a way
that is much more targeted than advertising.
Anecdotal feedback from employers that have rolled out CDHPs indicates that their participants actively seek healthcare information.
Physicians, however, do not have the time or resources to provide all the information they demand. Enter pharma. Patient-friendly
healthcare information distributed in partnership with managed market customers has the potential to significantly influence
the purchasing decisions of a newly empowered group of consumers. Brand managers can capitalize on this by delivering unbranded
patient education and disease-management tools at the worksite or at employer-sponsored health fairs.
Case study After analyzing its situation using predictive healthcare modeling, the global mailing technology provider Pitney Bowes took
the drastic step of reducing its employees' co-pays for diabetes and asthma medications. The results: Increased usage of the
drugs by employees. Emergency room visits decreased by 35 percent among diabetic patients and by 20 percent among asthmatic
patients. What's more, Pitney Bowes estimated that overall annual drug spending among its diabetics and asthmatics decreased by 10 percent (compared to an 11 percent increase for the rest of the population), resulting in a savings of $1 million.
Once their primary disease was properly treated, these patients used fewer healthcare resources, a benefit to the employer.
And in this instance, GlaxoSmithKline benefited from the lower co-pays for Advair (fluticasone), from the acquisition of a
new base of loyal customers, and from additional market-share gains.
Recent trend reports from the Health Inequalities Research Collaboration (HIRC) indicate that, in response to OIG and HIPAA
guidelines, pharma and managed markets have begun forming partnerships to provide disease-management offerings such as appropriate-use
and compliance programs. There are opportunities for both pharma and managed market customers in programs that educate patients
about their chronic diseases or that use patient intervention strategies to improve disease outcomes.