Updated: Mar 14, 2022
With the shift from volume to value in the healthcare marketplace, we witness significant changes in the payment model coupled with moves towards improved patient outcomes. As this occurs, drug manufacturers have entered into a variety of collaborations that look for more evidence of the effectiveness, benefits and harms of different treatment options from both a clinical and an economic standpoint.
With a focus on patient outcomes, and an abundance of data available from different points along the healthcare supply chain, providers, payers and manufacturers can form powerful alliances that prove mutually beneficial. There are, however, a number of barriers in such alliances.
Real World Evidence is Crucial for Success
As such, there are substantial gains to be made from heavy investment in Real World Data from both sides of the pay equality. Evidence collected from the large sample of data points post phase III can help lead to:
Better characterization of diseases and patient populations and possible patient populations cohorts that can be better targeted
Products and therapies developed specially for specific patient populations that use current competitive in market products and identification of patients for recruitment is possible
More acute inclusion/exclusion criteria for clinical trials
Identification of unintended uses/indications of drugs or therapies (Phase IV leads for example)
Targeted products and services that identify underserved patient populations, high cost areas for risk based product pricing, subpopulations with superior product response and track message effectiveness through prescribing behavior
We studied 61 of these connections and, in speaking with RWD leaders, selected 10 industry-leading collaborations between pharma, payers, providers and other stakeholders in this new report. The goal is to discover what exactly is being done to fasten the strength of such partnerships, including insights into collaborations between Eli Lilly/ T1D exchange, Deloitte/ Intermountain, Humana/ Astellas, GSK/ Community Care of North Carolina, Genentech/ PatientsLikeMe, IBM/ Premier, as well as multi-stakeholder approaches through Optum Labs, EMIF, OMOP and Merck’s M2i2.
The analysis of initial findings, presentations and our in-depth interviews with involved leaders allow me to draw 10 conclusions on what has already been learnt:
Creating a unified view of patient/member data is a challenging task and no one player has a total unified view of all patient/member data. As outcome based payment models and ACOs become more prevalent in the industry, working toward creating a unified view will be of utmost importance.
Pharma collaborate with payers to securely share real world data to many different ends to allow both parties to obtain a more unified view of the landscape.
The current emphasis in RWD is primarily cost reduction and increased patient safety.
There is, most certainly, selection biases in real world data. Proper analytical procedures need to be in place before actual benefit can be derived from any collaboration.
Pharma want to use real world data to generate advantage across the value chain, from understanding of diseases and treatments, to informing the design of products and trials, to gaining and defending market access.
Many organization’s current partnerships and efforts to use real world data are at an early stage and appear a reaction to shifts in the industry. Some companies pioneer, others lag behind and remain cautious.
Bureaucratic differences / organizational structures between partners in different industries have shown to be challenging for collaboration. Especially the cultural differences between providers and pharma are an obstacle. Some collaborations detailed here have performed extensive work to create teams of equal importance on both sides of the partnership to combat this issue.
Access to payer data will provide a better understanding of customer needs in each patient cohort. This will enable pharma to target sources of value more effectively. Furthermore, this access will help understand which drugs will have the greatest market impact.
Data from across the entire care spectrum, in general or specific population segments, will have to be linked, integrated and analyzed to allow all companies to target the unique health care of the groups it is interested in.
Premium pricing can be supported by real world data yet significant changes and results of these collaborations must be known.