Providers, payers collaborate to tame rising drug costs

The current dynamics of healthcare delivery is prompting the pharmaceutical industry to more closely collaborative with providers and insurers to develop products that deliver better value to patients, according to a new study by the PwC's Health Research Institute entitled "21st Century Pharmaceutical Collaboration: The Value Convergence." It noted that after a more than 13 percent price increase for medications in the United States between 2013 and 2014, payers and other constituents in healthcare delivery have been striving to cut down their costs.

Recent pricing and spending trends in the pharmaceutical realm have risen much faster than other components of healthcare delivery, putting pressure on payers, patients and providers to push back.

"Patients are deciding which drugs are valuable in the real world. Provider groups are considering the impact of treatment decisions on the total cost of care. And patient data, in aggregate, are being used by insurers to decide when, how and at which price points to make new drugs available," the report states.

One initiative cited by the report is OptumLabs, a collaboration between Optum Health and the Mayo Clinic. The two entities have access to de-identified merged claims and clinical data for 15 million lives and claims data for 150 million lives. Using that data to undertake academic studies, it found most patients with diabetes have the same outcomes when treated with an older drug as they do with newer therapies that are far more expensive.

However, drug companies have of late been buying up the rights to old-line medications and then raising their prices, causing a quandary for some hospitals.

"The new environment has patients, health insurers and pharmacy benefit managers determining the value of therapies in the real world," said Douglas Strang, PwC's global pharmaceuticals and life sciences advisory leader, in a statement.

To learn more:
- read the PwC statement
- check out the study (registration required)

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