Pharma facts 2012: Behind the curve on important health care changes

Editor’s Note: All this week Check Up will be sharing one new Pharma fact a day that was an important breakthrough in the world of pharmaceuticals in 2012. Today, Check Up delves into health care changes.

One of this year's memorable expressions came from a wise fellow at a major software company. He was developing cost-effective treatment guidelines for medical practices, based on electronic medical databases, when he said, "Pharma is not just in the caboose on this, they don't even know the train has left the station."

Pharma's entire customer base, their needs and what they expect from drug makers are changing enormously.  The customers will no longer be individual physicians, isolated in their offices and too busy to maintain state of the art knowledge about therapeutics.  Increasingly those physicians will be working for large groups that are part of integrated delivery networks.  In the future these larger corporate entities must share in the risk of patient outcomes and they will be pharma's customers.  In this capacity the large practice groups and networks will decide which drugs to use and when.  Individual physicians will be free to deviate from their network's preferred formularies, but they will seldom choose to do so.

Drugs with constantly growing price tags and benefits that have not been established in real-world settings hold a low ranking among the needs of at-risk providers.  If the compensation of these provider groups and their individual physicians will depend on the extent to which they use optimally cost-effective treatment protocols, then their reflexive need focuses on quickly deciding what's optimal. 

Rather than working to help providers and payers determine the most cost-effective treatments, pharma believes most of those determinations will put the kibosh on using super-expensive new drugs for all but a small percentage of patients.  For that reason, pharma would rather ignore the emerging environment and the consequent needs of their customers, preferring to rely on the mantra they've been chanting for nearly 40 years -- "Regardless how you're delivering care, use more of our drugs, use them earlier and more often, and that will save more expensive treatment costs down the line."

Now there's a statement that will go down in history alongside, "We don't need more lifeboats on the Titanic because it's unsinkable."

-          Dan Hoffman