New reimbursement model for pharma 20DEC17
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For your consideration, a new reimbursement model for pharma that is sustainable and truly value-based.
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New reimbursement model for pharma 20DEC17
- 1. a new reimbursement model for pharma for your consideration: wayne pan, md phd mba wtp94015@gmail.com
- 2. we know that the healthcare reimbursement environment is changing
- 3. moving from fee for service to value-based model
- 4. do we want to be followers and wait for change to happen to us?
- 5. or do we want to be masters of our own destiny and lead the change?
- 6. think outside of the box
- 7. “You never change things by fighting existing reality. To change something, build a new model that makes the existing model obsolete” R. Buckminster Fuller
- 8. what’s our existing reality?
- 9. DRUG PRICE = R&D COSTS TARGET POPULATION ~
- 10. DRUG PRICE R&D EXPENSES = TARGET POPULATION ~
- 11. DRUG PRICE R&D EXPENSES = TARGET POPULATION ~ $ $$$$$ drugprice
- 12. DRUG PRICE R&D EXPENSES = TARGET POPULATION ~ $ $$$$$ drugprice population size
- 13. DRUG PRICE R&D EXPENSES = TARGET POPULATION ~ $ $$$$$ drugprice population sizetraditional model personalized healthcare
- 14. $ $$$$$ population size drugprice DRUG PRICE R&D EXPENSES = TARGET POPULATION ~ traditional model personalized healthcare *assuming constant R&D expenses
- 15. $ $$$$$ population size drugprice DRUG PRICE R&D EXPENSES = TARGET POPULATION ~ traditional model personalized healthcare max price market will bear *assuming constant R&D expenses
- 16. $ $$$$$ population size drugprice DRUG PRICE R&D EXPENSES = TARGET POPULATION ~ traditional model personalized healthcare max price market will bear *assuming constant R&D expenses
- 17. $ $$$$$ population size drugprice DRUG PRICE R&D EXPENSES = TARGET POPULATION ~ traditional model what about personalized healthcare? max price market will bear
- 18. $ $$$$$ population size drugprice DRUG PRICE R&D EXPENSES = TARGET POPULATION ~ traditional model personalized healthcare max price market will bear *assuming ability to reduce R&D expenses proportionally to reduction in target population
- 20. June 14, 2015 • by Liz Szabo
- 21. June 14, 2015 • by Liz Szabo October 31, 2016 • by Carolyn Y. Johnson
- 22. June 14, 2015 • by Liz Szabo October 31, 2016 • by Carolyn Y. Johnson A Look at Major Drug-Pricing Proposals by Katie Thomas May 29, 2017
- 23. March 15, 2016 by Kim Janssen June 14, 2015 • by Liz Szabo October 31, 2016 • by Carolyn Y. Johnson A Look at Major Drug-Pricing Proposals by Katie Thomas May 29, 2017
- 24. March 15, 2016 by Kim Janssen December 31, 2015 by Joseph Walker June 14, 2015 • by Liz Szabo October 31, 2016 • by Carolyn Y. Johnson A Look at Major Drug-Pricing Proposals by Katie Thomas May 29, 2017
- 25. EXISTING REALITY
- 26. EXISTING REALITY
- 28. DOES THIS REALLY CHANGE OUR REALITY?
- 29. IF YOU DON’T HAVE A SEAT AT THE TABLE YOU’RE ON THE MENU
- 30. A SEAT AT THE TABLE? DO WE WANT
- 31. WE GET A SEAT? HOW MIGHT
- 32. CLUE:
- 33. LOOK AT WHERE THE HEALTHCARE SYSTEM IS GOING CLUE:
- 34. adapted from IHI Triple Aim improvepopulationhealth lowerpercapitacostofcare improve healthcare experience the triple aim
- 36. VALUE BASED CARE
- 37. HOW COULD WE PARTICIPATE AS FULL PARTNERS IN VALUE-BASED CARE?
- 39. patients
- 57. “You never change things by fighting existing reality. To change something, build a new model that makes the existing model obsolete” R. Buckminster Fuller
- 58. moving from targeting patients
- 59. to managing the total population
- 60. let’s look at the populationthat we would be managing
- 61. using a forest as a metaphor
- 62. lush forest using a forest as a metaphor
- 63. lush forest forest fire using a forest as a metaphor
- 64. lush forest forest fire burnt forest using a forest as a metaphor
- 65. wellness palliative care using a forest as a metaphor diseased state
- 66. this is where pharma resources are focused under FFS wellness palliative carediseased state
- 67. from a system perspective, we’re not allocating enough resources to wellness and palliative care wellness palliative carediseased state
- 68. from a system perspective, we’re not allocating enough resources to wellness and palliative care wellness palliative carediseased state
- 69. 4QUADRANTS
- 70. Higher Price Transparency Lower Price Transparency HIGH TECH LOW TECH http://www.expressbpd.com/pharma/it-at-pharma/digitizing-drug-development-how-much-can-it-save/384883/
- 71. Higher Price Transparency Lower Price Transparency HIGH TECH LOW TECH Status Quo • Price inflation continues at current pace • New innovative products enter the market at premium prices • Fewer R&D efficiencies from technology http://www.expressbpd.com/pharma/it-at-pharma/digitizing-drug-development-how-much-can-it-save/384883/
- 72. Higher Price Transparency Lower Price Transparency HIGH TECH LOW TECH Status Quo • Price inflation continues at current pace • New innovative products enter the market at premium prices • Fewer R&D efficiencies from technology http://www.expressbpd.com/pharma/it-at-pharma/digitizing-drug-development-how-much-can-it-save/384883/
- 73. Higher Price Transparency Lower Price Transparency HIGH TECH LOW TECH Status Quo Doomsday • Price inflation continues at current pace • New innovative products enter the market at premium prices • Fewer R&D efficiencies from technology • Public pressure and government action forces put downward pressure on drug prices as the system moves to fee for value • Increased transparency into R&D costs • Margins contract http://www.expressbpd.com/pharma/it-at-pharma/digitizing-drug-development-how-much-can-it-save/384883/
- 74. Higher Price Transparency Lower Price Transparency HIGH TECH LOW TECH Rainbow’s End Status Quo Doomsday • Innovation continues to be rewarded with premium pricing • Core basket of drugs continues inflating at high double digits • Innovation in biology and technology leads to R&D efficiencies and better drugs • Price inflation continues at current pace • New innovative products enter the market at premium prices • Fewer R&D efficiencies from technology • Public pressure and government action forces put downward pressure on drug prices as the system moves to fee for value • Increased transparency into R&D costs • Margins contract http://www.expressbpd.com/pharma/it-at-pharma/digitizing-drug-development-how-much-can-it-save/384883/
- 75. Higher Price Transparency Lower Price Transparency HIGH TECH LOW TECH Rainbow’s End Status Quo Balancing Act Doomsday • Innovation continues to be rewarded with premium pricing • Core basket of drugs continues inflating at high double digits • Innovation in biology and technology leads to R&D efficiencies and better drugs • Price inflation continues at current pace • New innovative products enter the market at premium prices • Fewer R&D efficiencies from technology • Public and government put downward pressure on drug prices and increases transparency for R&D costs • Innovation in biology & tech leads to better drugs & R&D efficiencies to offset pricing pressures • Public pressure and government action forces put downward pressure on drug prices as the system moves to fee for value • Increased transparency into R&D costs • Margins contract http://www.expressbpd.com/pharma/it-at-pharma/digitizing-drug-development-how-much-can-it-save/384883/
- 76. Higher Price Transparency Lower Price Transparency HIGH TECH LOW TECH Rainbow’s End Status Quo Balancing Act Doomsday • Innovation continues to be rewarded with premium pricing • Core basket of drugs continues inflating at high double digits • Innovation in biology and technology leads to R&D efficiencies and better drugs • Price inflation continues at current pace • New innovative products enter the market at premium prices • Fewer R&D efficiencies from technology • Public and government put downward pressure on drug prices and increases transparency for R&D costs • Innovation in biology & tech leads to better drugs & R&D efficiencies to offset pricing pressures • Public pressure and government action forces put downward pressure on drug prices as the system moves to fee for value • Increased transparency into R&D costs • Margins contract ?http://www.expressbpd.com/pharma/it-at-pharma/digitizing-drug-development-how-much-can-it-save/384883/