Alternative Healthcare system reform

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Scenario wherein the healthcare system is more integrated, shorter lines between pharma, medicine, insurance companies

Developments in time

****These are just items to be harmonized in the scenario story****

At the beginning of 2009, the global economic environment was still in a major state of flux.In the United States, the actions of the Obama administration and Congress were committed to addressing healthcare issues as part of economic reform. The global economic slowdown sparked acceleration of reform in other countries as well, whether in the form of increasing government demands for price cuts, as in Germany and the U.K., or encouraged use of generics, as in Japan.

In the U.S., in Europe the pharma industry is seeing a shift away from the model in which the physician is the major stakeholder. Payor organizations are taking on a more significant role, the distribution landscape is changing, and patients/consumers are taking on a larger role in healthcare decision making.

Pharmaceutical executives have taken some action—for example, increasing integration of the commercial and development sides of the business to ensure the commercial relevance of scientific and clinical innovation. The commercial side recognizes the declining value of the heavy “push model” of physician sales and is trying to redefine frontline marketing. Operationally, companies are streamlining, but are also taking a leadership role in adding safety and transparency in the supply chain. These initial moves make sense and are starting to take hold, but we believe that most of the industry must do much more to back up intentions with successful actions.

- Successful companies will work with payors in joint pharmaco-economic studies that will allow them to create value through joint programs and capabilities to deliver benefits and manage risk.

Another track of the regulatory side was also moving forward. Started by the FDA’s Sentinel initiative, launched in May 2005, sets out to provide access to existing electronic health information, including claims data, emerging electronic health records, and diagnostic databases. The FDA would use these databases to monitor the safety of drugs and devices, and the Sentinel database will likely support Phase IV post-marketing studies and surveillance. The eHealth Initiative (eHI), a private–public partnership, is currently conducting case studies for the FDA to understand how access to electronic health information will allow tracking of adverse events and support post-marketing surveillance.