The Shift to Patient-Centric Care and the Implications of Value-Based Medicine

Guest post by Brian Irwin, VP of Strategy, SHYFT Analytics.

Brian Irwin
Brian Irwin

The days of life science companies focusing on physicians and medical professionals as their main “customers” are numbered. Larger healthcare market trends, better access to real world data and increasing costs are driving the shift to a new customer – the patient.

As total spending on medicines globally reaches the $1 trillion level annually, payers are, not surprisingly, placing greater emphasis on ensuring they are receiving value for their investments. Payers are bringing closer scrutiny to all parts of the healthcare system they are funding. Patients, too, are spending more in today’s system and in turn are changing their expectations about value and outcomes. As a result, we are seeing a new focus on real world evidence as payers and patients seek proof that the medicines are contributing to improved patient outcomes, reduction in hospital admissions or re-admissions, and more efficient use of resources.

In response, life science companies are seeking new and more effective ways to leverage data and analytics across the clinical-commercial continuum and to adapt their go-to-market strategies to reflect their focus on patient outcomes. Capturing results-oriented data and making it usable is critical for this new model to work and for the patient to receive the most appropriate care.

With this shift to outcomes-based results and real world evidence, many questions arise around the data and analytics. Who defines “value” and what does success look like? Is it long-term value or short-term results? Additionally, how should this information be distributed to and evaluated by the various stakeholders? How do we achieve a level of consistency when data sources are not yet fully interoperable?

As the pharma industry starts to work through the answers to these questions and begins to redefine go-to-market strategies and commercial models, effective utilization of data and analytics will prove to be one of the greatest competitive advantages.

Defining Value in the New Healthcare Era

This focus on patient outcomes has broader implications for the industry with data sources now being aligned with the patient to enable decisions across the enterprise including drug development, market access, and commercial performance.

Physicians and payers have traditionally had transparency on the cost side, as well as on the benefit side of the equation. Patients, however, have had little insight other than looking things up online. As a result, they often lack a real understanding of the differences between one approach and another (the costs vs. benefits), but if given that information, they may be willing make trade offs previously unforeseen by their physician such as cost and side effects for efficacy and time to cure.

We can no longer put the burden of value definition on the physician. Value can be defined better and more completely than ever with the use of technology. Policymakers and payers can jointly seek ways to assure the best use of limited resources by not only turning to physician experts for better understanding—and definition—of value, but by enabling physicians with the evidence to improve outcomes and in the process, drive costs down. Then and only then, equipped with all the data, can a physician become the patient’s best advocate and resource for guidance in assessing the value of treatment options.

By integrating clinical and claims information, payers, patients, physicians and manufacturers all can and should have direct line of sight into the comparative effectiveness of all value measurements across all therapeutic areas. As such, the outcome of a treatment should drive its value in the market relative to other options. When all stakeholders have access to integrated insights, they all benefit.

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