A blog covering the health/care ecosystem and people.

Since the advent of the so-called consumer-directed health care era in the mid-2000s, there’s been a love-gap between health plan members of traditional plans, living in Health Plan World 1.0, and people enrolled in newer consumer-driven plans – high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs). That gap in plan satisfaction continues, according to the Employee Benefits Research Institute (EBRI)’s poll of Americans’ consumer engagement in health care. The survey was conducted with the Commonwealth Fund. As the bar chart illustrates, some 62% of members in traditional plans were satisfied (very or extremely) with their health insurance in 2012.

Women are the Chief Health Officers of their families and in their communities. But stress is on the rise for women. Taking an inventory on several health risks for American women in 2013 paints a picture of pain: of overdosing, caregiver burnout, health disparities, financial stress, and over-drinking. Overdosing on opioids. Opioids are strong drugs prescribed for pain management such as hydrocodone, morphine, and oxycodone. The number of opioid prescriptions grew in the U.S. by over 300% between 1999 and 2010. Deaths from prescription painkiller overdoses among women have increased more than 400% since 1999, compared to 265% among men.

  Most Americans are concerned about their ability to for medical bills, even when they have health insurance. As a result, most are comfortable asking their doctor about how much their medical treatment will cost. People are becoming savvier health care shoppers largely because they have to: 37% of people in the U.S. have an annual health insurance deductible over $2,000, according to the Spring/Summer 2013 Altarum Institute Survey of Consumer Health Care Opinion, published on 11th July 2013. Many of the media stories coming out of the Altarum survey since its publication have been about people and their trust in

When it comes to who’s most responsible for reducing the cost of health care in America, most doctors put the onus on trial lawyers, health insurance companies, pharma and medical device manufacturers, hospitals, and even patients. But physicians themselves ? Not so much responsibility – only 36% of doctors polled said doctors should assume major responsibility in reducing health care costs. And, in particular, most U.S. physicians have no enthusiasm for reducing health care costs by changing payment models, like penalizing providers for hospital re-admissions or paying a group of doctors a fixed, bundled price for managing population health. Limiting

In June 2013, even though news about the economy and jobs is more positive and ObamaCare’s promise of health insurance for the uninsured will soon kick in, most Americans are concerned about (1) money and (2) the costs of health care. The Kaiser Health Tracking poll of June 2013 paints an America worried about personal finances and health, and pretty clueless about health reform – in particular, the advent of health insurance exchanges. Among the 25% of people who have seen media coverage about the Affordable Care Act (alternatively referred to broadly as “health reform” or specifically as “ObamaCare”), 3

While the blockbuster erectile dysfunction (ED) drug has been shipped directly to consumer’s homes for years via pharmacy benefits management companies and specialty pharmacy retailers catering to the ED segment, Pfizer wants in on the transaction and has decided to get into the Direct-to-Consumer (DTC) distribution business for a prescription drug. Call this market development Direct-to-Home, or DTH. This is a kind of sentinel event signaling a pharmaceutical manufacturer cutting out the middle-man (read: retail pharmacy), and in this case getting up-close-and-personal with users of a drug that represents quality of life. Another motivation for Pfizer is trying to stem

I can think of 3 reasons why workers at Cummins Engine are blessed: They are employed. They receive health insurance from their employer. They are about to be able to access a tool designed to help them become better health care consumers. Cummins, based in Columbus, Indiana (far from Silicon Valley), has 24,000 employees and dependents who will be covered by this plan. The company ranked 186 on the Fortune list and has 46,000 employees worldwide. So the firm’s health spending would be in the range of many millions of dollars. I found the company’s employee health plan HealthSpan offering

  With U.S. health consumers spending $45 billion out-of-pocket for prescription drugs in 2011, pharmaceutical products are morphing into retail health products. As such, as they do with any other consumer good, consumers can vote with their feet by walking away from a product purchase or making the spend based on the price of the product and its attributes, along with whether there are substitutes available in the marketplace. When it comes to prescription drugs, it’s not as clear-cut, according to the Centers for Disease Control‘s analysis of data from the 2011 National Health Interview Survey titled Strategies Used by

  Exploiting Big Data in industry is Big News these days, and nowhere is the potential for leveraging the concept greater than in health care. McKinsey & Company estimates that harnessing big data across five dimensions of health care could yield nearly one-half trillion dollars’ worth of value in The ‘big data’ revolution in healthcare. The chart summarizes McKinsey’s calculations on the value of Big Data in health care at its maximum. Before digging into the value potential, just what is Big Data in health care? Statistics and information are generated in the health care system about patients: say, during visits

Comparing health care prices in the U.S. with those in other developed countries is an exercise in sticker shock. The cost of a hospital day in the U.S. was, on average, $4,287 in 2012. It was $853 in France, a nation often lauded for its excellent health system and patient outcomes but with a health system that’s financially strapped. A routine office visit to a doctor cost an average of $95 in the U.S. in 2012. The same visit was priced at $30 in Canada and $30 in France, as well. A hip replacement cost $40,364 on average in the

PwC has seen the future of health care for the next year, and the crystal ball expects to see the following: Affordable Care Act implementation, with states playing lead roles The role of dual eligibles Employer’s role in health care benefits Consumers’ role in coverage Consumers’ ratings impact on health care Transforming health delivery Population health management Bring your own device Pharma’s changing value proposition The medical device industry & tax impact. In their report, Top health industry issues of 2013: picking up the pace on health reform, PwC summarizes these expectations as a “future [that] includes full implementation of

Reed Tuckson of UnitedHealthGroup was the first panelist to speak at the kickoff of the Digital Health Summit, the fastest-growing aspct of the 2013 Consumer Electronics Show (#2013CES). Tuckson implored the spillover audience to all, “self-deputize as national service agents in health,” recognizing that technology developers in the room at this show that’s focused on developers building Shiny New Digital Things have much to bring to health. As Andrew Thompson of Proteus Medical (the “invisible pill” company) said, “we can’t bend the health care cost curve; we have to break it.” This pioneering panel was all about offering new-new technologies

Consumer price inflation grew 2% between September 2011 and September 2011. The price of branded drugs increased over 13% in the same period according to the Express Scripts 2012 Q3 Drug Trend Quarterly report, issued in November 2012. But the overall trend, including generics, was flat — 0.1%. This, due to the use of generics, now comprising 80% of prescription drug utilization. Since 2008, the brand prescription price index grew from a base of 100 to 163; the generic index fell from 100 to 61. The CPI index grew from the 100 base to 110. Generics have proven to be a

While most players in health care see potential ROI through investing in health informatics, there’s a supply-side problem in the market in two ways: a labor shortage of health IT talent, and a dearth of clean and comprehensive data needed for specific objectives. Even with sufficient budgets, health care providers, plans, and pharma companies say, these two limiting factors prevent fully realizing the promise of health data. Deloitte and AMIA polled health providers, plans and life science companies on the state of informatics in health care, the results of which are summarized in The 2012 Deloitte-AMIA Health Informatics Industry Maturity Survey.

The 78% of U.S. adults with primary care physicians (think: medical homes) are very satisfied with their doctors’ visits. The main reasons for this high level of satisfaction include communication (listening, talking), customer service (caring, personable), and clinical (good diagnosis and treatment). More women than men have a primary care physician relationship, more college grads do, and more people with incomes of $75,000 a year or more do, as well. 90% of those 55 and over have a primary care doctor – a stat heavily influenced by the fact that Medicare coverage kicks in for older people. This consumer profile

A teddy bear in the arms of a child with diabetes can change health care. At least, Jerry the Bear can. Yesterday kicked off the sixth autumn mega-version of the Health 2.0 Conference in San Francisco. Co-founded by Matthew Holt and Indu Subaiya, a long-time health analyst and physician, respectively, this meeting features new-new tools, apps and devices aimed at improving individual and population health, as well as health processes and workflows for physicians, hospitals, pharma, and other stakeholders in the health care ecosystem – even health lawyers, who met on October 7 to discuss up-to-the-minute  e-health law issues. Yesterday was

It’s American Pharmacist Month, so let’s celebrate that key member of the health care team. Most Americans live quite close to a pharmacy, compared with peoples’ proximity to doctors, hospitals and emergency rooms. The pharmacist is not only a trusted health professional in the eyes of consumers: he/she is a key influencer on peoples’ health. And seeing as the #1 barrier to people taking prescription drugs is cost, the community-based pharmacist is in a prime position to educate, influence and motivate people to become more informed and activated health consumers. CVS Caremark’s survey of pharmacists is discussed in the company’s

It’s become evident that more health care does not often lead to better health: Shannon Brownlee’s seminal book, Overtreated, uncovered the negative relationship between more health care and worse outcomes. However, when it comes to accessing primary care, more may be a good thing. In Extended Office Hours and Health Care Expenditures: A National Study, published this week in the Annals of Family Medicine, researchers found that offering longer office hours, into evenings and weekends, leads to lower total health care expenditures for patients than practices without extended hours. Extended hours are also associated with lower prescription drug and office visit

As women are generally thought of by marketers as the Chief Health Officers of their families, images of men in health advertising and media have been fewer than their female counterparts. In 1998, Pfizer promoted Viagra through Bob Dole. In 2003, Magic Johnson represented GSK’s HIV treatment Combivir. That same year, Mike Ditka, football coach, hawked Levitra, the ED drug, for GSK. Dr. Robert Jarvik has repped Lipitor (controversially), and Bobby Labonte, a NASCAR driver, endorsed Wellbutrin XL. But since the advent of direct-to-consumer health advertising, there haven’t been as many celebrity men promoting health as there have been women. Now, it’s the

  On Tuesday, 9 July 2012, health industry stakeholders are convening in Philadelphia for the first CONVERGE conference, seeking to ignite conversation across siloed organizations to solve seemingly intractable problems in health care, together. Why “converge?” Because suppliers, providers, payers, health plans, and consumers have been fragmented for far too long based on arcane incentives that cause the U.S. health system to be stuck in a Rube Goldbergian knot of inefficiency, ineffectiveness and fragmentation of access….not to mention cost increases leading us to devote nearly one-fifth of national GDP on health care at a cost of nearly $3 trillion…and going up.

The antidepressant market is worth $20 billion in the U.S. Antidepressants were the third most common prescription drug taken by Americans of all ages in 2005-2008 and the most frequently used by people age 18-44 (according to the National Center for Health Statistics). About one in 10 Americans age 12 and over takes an antidepressant medication. But there is little evidence that pharmacotherapy should be used as a first line of treatment for mild to moderate depression. Why are anti-depressants the first line of treatment for mild to moderate depression in the U.S.? The answer lies in the fact that

Half of patients globally expect that mobile health will improve health care. These health citizens expect that mobile health will help them manage their overall health, chronic conditions, how they manage their medications and measure and share their vital health information. Welcome to the new mobile health world, a picture captured in PwC’s report, Emerging mHealth: Paths for growth, published in June 2012 and written by the Economist Intelligence Unit. Patients’ views on mHealth are bullish, and while most doctors and payors share that vision, they also expect mHealth to come into focus more slowly, recognizing the institutional, cultural and

On May 23, 2012, Pfizer announced its teaming with EatingWell magazine to launch a mobile app for patients on Lipitor. Eight days later, on May 31, 2012, generic versions of Lipitor will hit the market. Lipitor is the best-selling drug in pharmaceutical history, to-date. Sales of the product top $125 billion. While generic atorvastatin has been available in the U.S. since November 2011 from two manufacturers, low prices for the generic will drop to $10 or less for a month’s supply at the end of May. This is Pfizer’s first foray into a prescription drug-affiliated app. The free mHealth app,

Transparency, data-based pharmacy decisions, incentivizing patient behavior, and outcomes-based payments will reshape the environment for marketing pharmaceutical drugs in and beyond 2012. Two reports published this week, from Express Scripts–Medco and PwC, explain these forces, which will severely challenge Pharma’s mood of market ennui. Express-Scripts Medco’s report on 9 Leading Trends in Rx Plan Management presents findings from a survey of 318 pharmacy benefit decision makers in public and private sector organizations. About one-half of the respondents represented smaller organizations with fewer than 5,000 employees; about 20% represented jumbo companies with over 25,000 workers. The survey was conducted in the

Some 500 data analytics gurus representing the health care ecosystem including hospitals, physician practices, life science companies, academia and consulting came together on the lush campus of SAS in Cary, North Carolina, this week to discuss how Big Data could solve health care’s Triple Aim, as coined by keynote speaker Dr. Donald Berwick: improve the care experience, improve health outcomes, and reduce costs. Before Dr. Berwick, appointed as President Obama’s first head of the Centers for Medicare & Medicaid Services, Clayton Christensen of the Harvard Business School, godfather of the theory of disruptive innovation in business, spokee about his journey

Even though Inside-the-Beltway economists have said The Great Recession of 2007 is officially over, it doesn’t look that way when you ask consumers about health spending in 2012, based on results from a survey conducted on behalf of the American Osteopathic Association (AOA). One in 5 U.S. adults is trying to lower their personal health spending. One in four is seeking free or alternate sources of health care. Overall, 1 in 5 people says their health has been negatively impacted by the economy. The AOA discovered that people in the U.S. whose health has been negatively impacted by the economic downturn were

One in 3 Americans uses social media for health discussions. Health is increasingly social, and PwC has published the latest data on the phenomenon in their report, Social media ‘likes’ healthcare: from marketing to social business, published this week. PwC polled 1,060 U.S. adults in February 2012 to learn their social media habits tied to health. Among all health consumers, the most common use of social media in health is to access health-related consumer reviews of medications or treatments, hospitals, providers, and insurance plans, as shown in the graph. Social media enables people to be better health “consumers” by giving them peers’

The ability to get the data is the #1 obstacle that will slow the adoption of data analytics in health care, according to IBM’s report, The value of analytics in healthcare: from insights to outcomes. Healthcare “high performers,” as IBM calls them, use data analytics for guiding future strategy, product research and development, and sales and marketing functions. 90% of healthcare CIOs told IBM that developing “insight and intelligence” were key focuses of their organizations over the next 3 to 5 years. Underneath this macro objective are 3 business goals that data analytics addresses in healthcare: to improve clinical effectiveness

Technology, autos, food and consumer products — two-thirds of people around the globe trust these four industries the most. The least trusted sectors are media, banks and financial services. Welcome to the twelfth annual poll of the 2012 Edelman Trust Barometer, gauging global citizens’ perspectives on institutions and their trustworthiness. This survey marks the largest decline in trust in government in the 12 years the Barometer has polled peoples’ views. Interestingly, trust in government among US citizens stayed stable. The top-line finds a huge drop in global citizens’ trust in government, with a smaller decline for business. There’s an interplay

U.S. employers’ health insurance-response to the nation’s economic downturn has been to shift health costs to employees. This has been especially true in smaller companies that pay lower wages. As employers look to the implementation of health reform in 2014, their responses will be based on local labor market and economic conditions. Thus, it’s important to understand the nuances of the paradigm, “all health care is local,” taking a page from Tip O’Neill’s old saw, “all politics is local.” The Center for Studying Health System Change (HSC) visited 12 communities to learn more about their local health systems and economies, publishing their

“Value” in prescription drugs is first and foremost about outcomes, in the eyes of physicians and biopharma. For managed care, “value” is first about safety, then patient outcomes. However, although one-third of patients managing a chronic condition cannot define “value” in health care, 9 in 10 say that prescription drugs are “valuable” to their health and wellbeing. In fact, 80% say that the money they spend on prescription medications is “worth it.” Yet patients feel largely out of the prescription drug development process. These findings come from Quintiles research report, The 2011 New Health Report, subtitled: exploring perceptions of value and collaborative relationships among

Randomized controlled trials (RCTs) have been the rational cornerstone of medical decision making for decades. RCTs demonstrate a drug or therapeutic course’s efficacy – that is, the extent to which a specific intervention, procedure, or regimen produces a beneficial result under ideal conditions. Of course, how a particular therapy works in an individual is highly personalized based not only on a body’s biochemistry, but personal preferences, perceptions, and personality. That’s why Dr. Andrew Weil and his colleagues, Dr. Scott Shannon and Dr. Bonnie Kaplan, say that medical decision making should take into account the patient perspective. In Medical Decision Making in

Two mega-trends are driving down branded pharmaceutical sales in the U.S.: switches from branded to generic prescription drug products for major chronic conditions; and, the lack of new-new branded Rx products that (could) command higher prices. A down-market picture emerges from The Use of Medicines in the United States: Review of 2010, based on market data analyzed by the IMS Institute for Healthcare Informatics (IMS). While U.S. market growth for pharma overall ranges from 3% to 5%, IMS says, protected Rx brands were negatively impacted through the switch to cheaper generic substitutes. Generics now comprise 78% of pharma market share. The key sentence

Anyone attending a Health 2.0 or health IT meeting in the past 18 months has (hopefully) been exposed to the force known as  Todd Park, Chief Technology Officer of the Department of Health and Human Services, and his mantra of “Data Liberación.” Data Liberación is the act of freeing data — in this instance, health data — locked within data silos, to be ‘liberated” allowing it to move about so that analysts can learn from it and develop strategies to better manage health for individuals and populations. Now there’s a force advocating for “Social Media Liberación” in Health: health activists, the most engaged patients

Unique visits to online health sites continue to grow as a proportion of total unique visitors to the Internet, based on comScore’s research of web activity from January 2010 to January 2011. comScore published its Fifth Annual Online Marketing Effectiveness Benchmarks for the Pharmaceutical Industry in March 2011 based on a one million person U.S. panel coupled with 77 studies into specific pharmaceutical cases. The growth in people using online health resources is an opportunity for health marketers — in this case, pharmaceutical drug marketers — to reach potential patients and develop more effective education campaigns that are unbranded (to provide information

The Family Sarasohn-Kahn is sailing on the Caribbean this week for a long-overdue winter break. Imagine my surprise and ironic delight when at our port this morning we happened onto a storefront called, “Drugs & Deli.” Inside, there’s the usual combination of barcodes that are the hallmark of convenience stores: Pringles, Gatorade, candy, gum, and since we’re on the sea, sunscreen. But there’s another product group sold here in a very retail way: prescription drugs. The décor tells the story:  while the name of the store tells the headline, the interior of the shop screams the storyline. Above our heads

  About 1 in 10 people in the U.S. suffer from migraine headaches. The direct cost to business for medical care and wage replacement is over $1 bn, but this underestimates the total economic impact of lost productivity to the economy and personal lives (for more on  whole-health costs, read yesterday’s Health Populi, Lost Costs: Lost Productivity Represents One-Half of Health Costs for U.S. Employers). There are actually 14 kinds of headaches, as classified by the International Headache Society (IHS). Among these, there are four primary headache types: migraine, tension-type headaches, cluster headaches and trigeminal autonomic cephalagias, and a fourth

The U.S. has few bright spots when accounting for global trade: we import much more than we export. Entertainment is America’s #1 export. After that, medical innovation shines. But the window on that lead is closing. 92% of Americans believe it’s important for the U.S. to be the global leader in medical innovation and research. And, most Americans believe the U.S. has been in a strong position in medical innovation, research and development, and technical innovation, especially for new cures and treatments for patients, and medical innovations that create jobs and drive economic growth; but a weakening position in science,

One in 3 managers in life science companies — including biotech, pharma, medical device and diagnostics firms — have no plans to engage with online social networks, according to a survey conducted by Deloitte. The key reasons for shying away from social networks include lack of guidelines offered by the Food & Drug Administration (FDA), concerns about consumer privacy, and low or uncertain return on investment. On the other hand, 41% of life science execs already use social networks, and another 21% plan to do so. There are many benefits for life science companies in using online social networks, including using them for

What happens when a company becomes a proverbial fly on the wall in the physician’s exam room as she’s meeting with patients? Real-life insights into what health consumers ask for, and how they converse with doctors — neither of which match up to a pharma marketer’s dream (or business objective) of motivating consumers to ask their physicians to describe specific brands of drugs. Bloomberg/Business Week published a story online on November 4, 2009, which talks about Verilogue, a company that has recorded thousands of conversations between physicians and patients in different U.S. geographies and across a broad range of medical specialties. What Verilogue found through

Americans trust their supermarkets and local hospitals more than other industries they deal with. while tobacco and oil companies remain at the bottom of the trust-list for U.S. consumers, health insurance and managed care aren’t much ahead of them. Pharmaceutical companies rank fairly low, with only 11% of U.S. adults seeing them as “honest and trustworthy.” As a result, nearly one-half of Americans would like to see increased regulation on pharma. Over 1 in 3 Americans would like to see managed care and health insurance companies more regulated. The latest Harris Poll has found that oil, pharmaceutical, health insurance and tobacco are

Two weeks ago at the company’s AnalystDay conference, Greg Wasson, the CEO of Walgreens, told the audience that the pharmacy chain was on a mission to “own well.” In the New York Times magazine dated November 12, 2010, an article titled Fresh Approach  talks about Walgreens work in low-income Chicago neighborhoods coupling with greengrocers to bring “food oases” to inner cities. Two weeks ago, I learned that Walgreens is teaming with Orbitz to provide travelers’ health services. Married to an international banker who travels globally, I am pleased to know he can get his esoteric inoculations in local, convenient retail mode. Walgreens’ data found that 25% of

Prescription drug formularies are getting more complex to drive cost-savings as well as promote adherence to drug regimens, as told by the data in the 2010-2011 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda Pharmaceuticals NA. The average rate of drug cost increases is 6.3%, compared to 4.4% in the 2009-2010 survey — the lowest rate of increase since this survey was launched. A key part of the story of the new value-based benefit design is told by the co-payment differentials for Rx drugs, shown in the chart. Health consumers who have three-tiered prescription drug insurance face an

Contrary to stereotypes, older people can adapt, learn, and use new products and services. The introduction of Medicare Part D five years ago was an experiment in public policy, with some policymakers fretting about seniors’ ability to navigate a new system. It appears Medicare Part D is a hit, and people are working well with it across gender, age cohorts, incomes (from very low to upper-income strata), educational levels, and especially very sick and disabled people. Among all seniors, 90% have prescription drug coverage. 61% of U.S. adults 65 and over have a Medicare prescription drug plan, 16% are covered by an employer-sponsored

The U.S. health system could conserve $170 billion in avoidable medical costs related to patients not taking prescription drugs as-prescribed. That’s known as “sub-optimal pharmacy care,” and it’s estimated that 3 in 4 prescription drug users fall into this category. In other words, only 1 in 4 patients on Rx drugs take their prescriptions as directed by their physicians (known as compliance) or weren’t prescribed the optima drug therapy in the first place. At least 1 in 4 patients never even fill their first prescription for a drug their physician has prescribed. CVS Caremark has found that health citizens can become more

Detractors of direct-to-consumer advertising (DTC) contend that the ads promote consumers asking for pills they don’t often need, medicalize normal life conditions (such as menopause and sleeplessness), and drive up unnecessary medical spending. A team of researchers now finds that DTC can play an important, positive role in motivating health consumers to adopt healthy behaviors. “The intention to engage in healthy lifestyles was strengthened by exposure to familial risk cues in DTC ads and this effect was mediated through enhanced efficacy to take healthy actions,” the paper concludes. Familial risk cues engendered positive self-efficacy. This is the first empirical study that

Now showing in a 60-second spot during the 6 o’clock news: Andy Griffith’s got the starring role in promoting the peoples’ use of the Patient Protection and Affordable Care Act of 2010 (PPACA). Here is the announcement of the ad in The White House blog of July 30 2010. In the ad, Andy, now 84, recalls the signing of Medicare by President Johnson and moves into some details about the good things PPACA brings to seniors in the U.S. The Christian Science Monitor covers the story and shows the video here. This has caused quite a stir among Republicans who say

Two weeks ago, I bought a package containing 100 caplets of Tylenol PM caplets from my grocery store’s pharmacy aisle. I checked the lot number marked on the box against the list on the McNeil consumer healthcare website, and my lot appears to be fine. Today, Avandia, the prescription drug that treats diabetes, hit the headlines of the world’s major newspapers: Avandia Panel Hints At Doubts of Credibility, says the New York Times Avandia Hearings To Reveal True Dangers of Popular Drug, according to FOXNews GlaxoSmithKline Hid Negative Avandia Data: Lawmakers, reads ABC News Glaxo to Pay $460 million in Avandia Settlement, notes Reuters. And there’s also

People responsible for managing the health care industry supply chain have always been concerned about regulations and compliance requirements that can negatively impact their ability to manage the materials, technologies, goods and services they need to fulfill their organizations’ medical missions and businesses. Now “health reform” joins regulation as a pain point in the supply chain. UPS, the logistics and transport company, has surveyed executives from pharma, biotech, medical and surgical device companies, to ascertain their current perspectives on the health care supply chain. The results of this study are in the report, UPS 2010 Pain in the (Supply) Chain