Nonprofit, nonpartisan 501(c)(3) educational and publi

1
Emerging Pharmaceutical Industry Strategies
Transparency, Privacy and COI Concerns

• Jennifer L. Reck,
• Policy Analyst,
• Prescription Policy Choices

NLARx Meeting Washington, DC December 8, 2008
2
Prescription Policy Choices

• Nonprofit, nonpartisan 501(c)(3) educational and
  public policy organization focused on
  prescription drug policy
• Evaluate policies and programs that effectively
  reduce prescription drug prices, increase access
  to medications, minimize conflicts of interest
  promote evidence-based prescribing

3
Opposition Research

• Sources
• Pharmaceutical industry trade magazines
• Pharmaceutical Executive (PE)
• Pharmaceutical Representative (PR)
• Webinars
• Quarterly opposition reports starting Q3 2008

4
Pharmaceutical Representative
5
An industry under pressure

• Dry pipelines
• Major brands going off patent
• Increased scrutiny of industry / medical
  profession relationships, new regulations
• Decreased physician willingness to meet with
  sales representatives the no-see trend

6
Time to shape shift
7
New service roles for pharma

• Disease management
• Enabling patient / physician communication
• Promoting patient compliance
• Worthy endeavors but appropriate roles for
  pharma?
• Conflict of interest, transparency and patient
  privacy concerns

8
New roles for pharma Disease management services
for MCOs

• Many companies are transitioning from merely
  selling a pharmaceutical product to providing a
  variety of integrated resources in addition to
  drugs that solve therapeutics challenges in
  specific disease areas (PR, Sept 08).
• The sales rep becomes
• a service provider to the healthcare system,
  and a disease management specialist, providing
  the uniform, agreed-upon protocols set by the
  health plan to physicians, pharmacists, etc.
• Services provided
• Disease-oriented symposia, educational materials,
  in-service trainings for practitioners, CME, drug
  utilization review

9
Whats in it for pharma?

• Partnerships with healthcare organizations in
  disease management programs offer benefits to
  the pharmaceutical company, including access to
  medical and pharmacy data and access to patient
  populations that could potentially use the
  companys product.
• Some companies have partnered with PBMs (an
  excellent source of patient and prescription
  data)
• Some have own disease management subsidiaries

10
Enabling physician/patient communication for a
large ROI

• Shire gave parents of children taking their ADHD
  drug a starter kit and invited them to join a
  feedback program (three surveys taken in early
  stage of product use)
• Shire shares the information with the doc
• 81 ROI docs who received feedback reports
  prescribed more of the sponsors product

11
Patient compliance

• Pharma estimates that it loses about 177 billion
  of potential revenue each year (out of 700
  billion in annual global revenues) due to
  patients not complying properly with their
  prescriptions
• With drying product pipelines, maximizing sales
  of existing products takes on greater importance

12
Patient Compliance

• The value of patient compliance depends upon the
  appropriateness of the prescription.
• Compliance programs involve data on individuals
  prescription drug use and raise important privacy
  concerns, especially given convergence with
  e-prescribing.
• What data are they getting access to? How are
  they accessing it? Using it?

13
Compliance programs aimed at minors

• Makers of Gardasil have used text-messaging to
  remind girls they need all three doses of the
  vaccine to make it effective
• Seranos website for its growth hormone offered
  kids free MP3 downloads for answering a quiz
  correctly (www.coollearnings.com)

14
Compliance online

• RealAge.com has compliance built into its basic
  business strategy of 20 mil. users, 9 mil.
  have opted to receive information for drug
  companies on their health issues
• AZ Measure of Success program log in or phone
  daily to report on use of asthma drugs and get
  rewards such as books on asthma
• Getting data directly from patients

15
Patients increase in importance

• DTC is now 40 of all promotional spending in the
  US
• Brand managers are beginning to view patients as
  an audience of equal value to prescribers.
• Implications for our current policy focus on the
  relationship between the industry and physicians?
  How can we also monitor address their
  relationships with patients?

16
Perfect Storm?

• New focus on disease management and patient
  compliance at the same time there are..
• New technologies for direct patient outreach (You
  Tube, text messaging, online compliance tracking,
  etc.), data collection (EHRs) and data mining
• Will pharma blur the line between marketing and
  clinical care the way it has blurred the line
  between marketing and medical research? And
  between marketing and education?

17
Policy Approaches

• Establishing standards for third party contracts
  (industry / MCO contracts, industry / PBM
  contracts, etc.)
• Tightening HIPPA protections relating to
  disclosure of patient data for marketing
• Anti-trust regulation related to industry
  ownership of disease management subsidiaries?

18
Contact jreck_at_policychoices.org