Proving Product Value with Practice Data


Physician efficiency efforts open up avenues for information

November 24, 2014

From the proliferation of Electronic Health Records (EHRs) to the importance of measurable patient outcomes, big data is becoming a big deal in healthcare. And thanks to advances in the technology available across the continuum, there's more data available now than ever, and it's increasingly available in real-time from cleaner, more consistent sources.

For pharmaceutical manufacturers, access to patient data can be the key to product success. And the physician's office can be a critical access point for the information manufacturers need. But how - and precisely where - can manufacturers leverage data from practices for product success? That answer requires a closer look at what's going on in the healthcare provider's world.

The provider landscape
The shift in site of care as a result of the Medicare Modernization Act and changing reimbursement models is driving leaner business models for physician-owned practices. Even with tighter budgets, physicians are still taking on increased risk. Those with a substantial buy-and-bill business are carrying the cost of specialty drugs upfront in order to bill for them under the medical benefit and improve margins, while other practices are moving to white bagging - and receiving only administrative fees - to eliminate risk and reimbursement hassles. These practice dynamics ultimately impact manufacturers' ability to access data and patients, meaning they must take a more strategic approach to defining distribution channels. That, too, requires insight into practice informatics.

Provider initiatives
Despite financial pressures and revenue cuts of up to one-third, the physician market is seeking ways to thrive. They continue to be a part of the innovation cycle by administering specialty drugs with strong clinical indications in the interest of providing high-quality care, even in the face of financial risk. In fact, leaner business models are driving practices to look at solutions that can benefit manufacturers in terms of product and data access.

The market trend also seems to run counter to the economics for physicians, with studies showing that the greatest and most flexible access to care is in an independently owned practice, with equal quality and substantially lower cost to the patient. In fact, outpatient chemo centers run a very efficient model that is hard to replicate in the hospital setting. It may be this optimism that has practices piloting reform models and quality programs with payers - being open to partnerships that increase efficiencies and help them continue to provide quality care.

Manufacturers and practice data
Efficiency measures by practices mean improvements in the information manufacturers can obtain about their therapies. After all, the better the line of sight to where drugs are being purchased and services rendered, the better a manufacturer's ability to bring drugs to market and educate physicians and payers about their products.

So where does this visibility come from? The data manufacturers can glean from practice activities is actually a byproduct of day-to-day care, prescriber behavior and pure purchasing informatics, the sources of which can include:

  • Inventory management solutions. RFID-controlled cabinets are emerging as cost-efficient solutions for practices that need instant access to specialty drugs without having to carry the burden of cost. The benefit of these technologies for manufacturers is that they get insight into where, when and how frequently product is used - insight that helps them make better business decisions as they bring products to market.
  • EHRs and EMRs. While Electronic Medical Records maintained by a single provider and portable EHRs both offer providers the benefit of better patient relationships by streamlining the information available for coaching, treatment management and more, the technology also plays a critical role in medication reconciliation, and therefore, adherence - an area critical to proving product performance.
  • Group purchasing organization (GPO) contracts. GPOs have a long history of helping physicians control costs. The data available through GPO contracts can also help manufacturers identify potential performance gaps related to non-adherence. From underutilization to missed doses, using GPO data can potentially help manufacturers interject provider education before product performance suffers.
  • Patient support programs. When designed with the user in mind, high-tech support programs integrate seamlessly into the provider's workflow and enable efficiencies through services ranging from e-prescribing to benefits verifications. As a result, manufacturers - as the providers of patient support programs - have access to outcomes data through which they can demonstrate product value.

As targeted therapies become the new norm over blockbuster drugs, data-driven value propositions will drive product success. Improving the pool of information from which manufacturers can prove value, utility and outcomes - and thereby influence payer decisions - means looking for new sources of data. And it just may be that physician practice's efficiency efforts are that source, offering intelligence about product usage that has previously been untapped.


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