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The Unbearable Heaviness of Inflation: Will Consumers’ Financial Stress Erode Their Health?

“Inflation is the big story,” the economics team at Morning Consult told us yesterday in a call on “How to Think Like An Economist.” While I already thought I did that, Team @MorningConsult updated us on the current state of consumers and what’s weighing most heavily on their minds…inflation being #1. An hour after the Morning Consult session, I brainstormed the topic of consumers-as-payers of medical bills and prescription drugs with GoodRx strategy leaders. In my data wonkiness, inflation certainly played a starring role in setting the stage for Mind, Body and Wallet — the title of one of the sources

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Only in America: Medical Debt Is Most Peoples’ Problem, KHN and NPR Report

When high-deductible health plans became part of health insurance design in America, they were lauded as giving patients “more skin in the game” of health care payments. The theory behind consumer-directed care was that patients-as-consumers would shop around for care, morph into rational consumers of medical services just as they would do purchasing autos or washing machines, and shift the cost-curve of American health care ever downward. That skin-in-the-game has been a risk factor for .some patients to postpone care as well as take on medical debt — the strongest predictor of which is dealing with multiple chronic conditions. “The

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The Evolution of a Patient Ambassador – Learning from Stacy Hurt

“I am a health care executive who happens to be a patient, caregiver, and advocate,” Stacy Hurt explained to me in a Zoom chat we shared on 31 May. I asked her to meet with me to discuss her professional news update: being appointed Parexel’s first Patient Ambassador.                       My Zoom invitation to Stacy was a very convenient excuse for me to catch up with a friend in the field: we have known each other since Stacy started to grow her health-social media presence on Twitter. And that involvement in

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What If Costco Designed the Prescription Drugs Sales Model?

The good news about prescription drugs, in the context of medical spending in the U.S., is that 9 in 10 medicines prescribed are generics. They comprise only 3% of all U.S. healthcare spending.           But there’s bad news about prescription drugs in the context of medical spending in America. U.S. Consumers Overpay for Generic Drugs, a new paper from the Leonard Schaeffer Center for Health Policy & Economics asserts, with recommendations to address the intermediaries who benefit from the way Americans currently pay for medicines. Generics are “an American success story,” the authors call out, bringing

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A New Chevy Equinox SUV, a Year in Grad School, or Health Care for Four – The 2022 Milliman Medical Index

A new Chevy Equinox SUV, a year in an MS program in kinesiology at Pacific Lutheran U., or health care for a family of four. At $30,260, you could pick one of these three options.             Welcome to this year’s 2022 Milliman Medical Index, which annually calculates the health care costs for a median family of 4 in the U.S. I perennially select two alternative purchases for you to consider aligning with the MMI medical index. I have often picked a new car at list price and a year’s tuition at a U.S. institution of

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How Trust and Geopolitics Will Impact Health and Business – Edelman 2022 Trust Barometer at the World Economic Forum in Davos

When we think about the state of Trust in in mid-2022, there is some good news: Trust is rising (at least in democratic countries, while falling in autocratic ones). The bad news: the gap in Trust has dramatically widened between higher-income people compared with those earning lower-incomes, globally.             And that gap is “tinder” that can be quickly sparked into a socio-political fire in countries around the world, Richard Edelman cautioned today when introducing the latest look at the 2022 Edelman Trust Barometer, focusing on geopolitics and business. We have never seen numbers like this

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Patients Look Beyond the Pandemic to Pharma for Engagement, Innovation, and Integrity

The COVID-19 pandemic has impacted patients who were already deeply engaged with their own health care before the coronavirus emerged. Compared with a year ago, more patients and their advocates are seeking quality therapies, innovation, engagement, and integrity from pharmaceutical companies, based on research published today from PatientView. PatientView, based in the UK, has collaborated with over 40,000 patient advocacy organizations globally marking over 10 years doing this research. The eleventh annual report on the Corporate Reputation of Pharma was conducted among 2,150 patient groups between November 2021 and February 2022, covering health citizens in Europe (with 1,229 organizations), North

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What Person-Centered Interoperability Looks Like: Seqster

He had me at the statement, “I believe health data is medicine.” Those were the words of Ardy Arianpour, CEO and Co-Founder of Seqster, when sharing with me how his company was founded. We met up last week at the DIA Europe 2022 meeting (Drug Information Association) in the cool SQUARE Conference Center in Brussels, Belgium (my current home base for work and life). It was a rare opportunity to sit still with this on-the-go guy with whom an hour spent is the equivalent of three hours with most other folks. Ardy and the team call Seqster “the operating system

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Can a Food-As-Medicine App Extend Chronic Health Management at the Grocery Store?

Foogal, a recipe app designed to support patients’ healthy cooking and eating, launched on 24th March. In its initial version, Foogal addresses several specific diet paradigms: for patients demanding a wellness protocol, an autoimmune protocol, or wanting to address insulin resistance. Foogal got my attention via a tweet @FoogalApp on 25th March. The snippet featured a photo of a delectable Salad Lyonnaise, one of my favorite things to eat, which adds a soft-cooked egg and bacon lardons to the greens for an easy light (and delicious!) meal. Foogal was developed by Todd Knobel, who has worked in law, in plastics,

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The Financial Toxicity of Health Care Costs: From Cancer to FICO Scores

The financial toxicity of health care costs in the U.S. takes center stage in Health Populi this week as several events converge to highlight medical debt as a unique feature in American health care. “Medical debt is the most common collection tradeline reported on consumer credit records,” the Consumer Financial Protection Bureau called out in a report published March 1, 2022. CFPB published the report marking two years into the pandemic, discussing concerns about medical debt collections and reporting that grew during the COVID-19 crisis. Let’s connect the dots on: A joint announcement this week from three major credit agencies,

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Human-Powered Health: How Abbott Is Unlocking the “Possibility of You” at CES 2022

Yesterday, we heard all about autonomous cars and sustainable mobility from Mary Barra, CEO of General Motors. Autos, TVs, and telecomms are the usual fare of the big stage speeches at the annual big show of consumer electronics. Gary Shapiro, President and CEO of CTA, introduced today’s CES keynote speaker, Robert Ford, as the “first-ever keynote speaker from health care” at CES, calling out the fact that Abbott’s Freestyle Libre System garnered one of CES 2022’s Innovation Awards. Ford is the Chairman and CEO of Abbott, one of the largest global life sciences companies. Ford let us know up-front that

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Health Care Planning for 2022 – Start with a Pandemic, Then Pivot to Health and Happiness

One of my favorite Dr. Seuss characters is the narrator featured in the book, I Had Trouble In Getting to Solla-Sollew. I frequently use this book when conducting futures and scenario planning sessions with clients in health/care. “The story opens with our happy-go-lucky narrator taking  a stroll through the Valley of Vung where nothing went wrong,” the Seussblog explains. Then one day, our hero (shown here on the right side of the picture from the book) is not paying attention to where he is walking….thus admitting, “And I learned there are troubles of more than one kind, some come from

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Why #CES2022 Will Be Keynoted By A Health Care Innovator for the First Time

In October 2021, the Consumer Technology Association (CTA) announced that Robert Ford, CEO and President of Abbott, would give a keynote speech at CES 2022, the world’s largest annual convention of the technology industry. “This marks the first time in CES history that a healthcare company will take the mainstage for a keynote at the show,” CTA’s press release stated. I covered this announcement in the Health Populi blog at the time, and today want to double-down on the significance of Ford’s leading presence at #CES2022. When announced, the news was a signal that health care and the larger tech-enabled

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The 2022 Health Populi TrendCast for Consumers and Health Citizens

I cannot recall a season when so many health consumer studies have been launched into my email inbox. While I have believed consumers’ health engagement has been The New Black for the bulk of my career span, the current Zeitgeist for health care consumerism reflects that futurist mantra: “”We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run,” coined by Roy Amara, past president of Institute for the Future. That well-used and timely observation is known as Amara’s Law. This feels especially apt right “now” as we enter 2022,

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Fastest-Growing Brands for 2021 Are About Digital Money, Social Connections and Boomers’ Best Lives

Two pharmaceutical companies bubble up among the 20 fastest-growing brands for 2021 in Morning Consult’s report on the Fastest-Growing Brands of 2021. But the surprise in this year’s top 20 brand rankings was that five of them addressed consumers’ financial flows: Coinbase, AfterPay. Cash App, Mastercard, Chime, and Bitcoin. One year ago when I covered this study, I found  that the fastest-growing brands of 2020 had everything to do with the pandemic. They dealt with home entertainment, digital connectivity, hygiene, and indeed, health (with Pfizer and AstraZeneca the two pharma brands top-of-mind for consumers). In this year’s update, exploring consumers’

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Support for Drug Price Negotiation Brings Partisans Together in the U.S.

Most U.S. adults across political parties favor allowing the Federal government authority to negotiate for drug prices — even after hearing the arguments against the health policy. Drug price negotiation, say by the Medicare program, is a unifying public policy in the current era of political schisms in America, based on the findings in a special Kaiser Family Foundation (KFF) Health Tracking Poll conducted in late September-early October 2021. Overall, 4 in 5 Americans favor allowing the Federal government negotiating power for prescription drug prices, shown in the first chart from the KFF report. By party, nearly all Democrats agree

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Why CES 2022 Will Be Keynoted by a Health Care Executive

The Consumer Technology Association (CTA) announced that Robert Ford, CEO and President of Abbott, will give a keynote speech at CES 2022, the world’s largest annual convention of the technology industry. This news is a signal that health care and the larger tech-enabled ecosystem that supports health and well-being is embedded in peoples’ everyday lives. Digital health as a category has been a growing feature at CES for over a decade, starting with the early wearable tech era of Fitbit, Nike, Omron and UnderArmour, early exhibitors at CES representing the category. By 2020, the most recent “live, in person” CES,

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A Negative Outlook for US Hospital Margins Through 2021

In the fourth quarter of 2021, U.S. hospital margins will still be lower than before the COVID-19 pandemic, Kaufman, Hall & Associates project in their latest read on hospital finances. Kaufman Hall has been monitoring hospitals’ financial health in the coronavirus era since March 2020, month-by-month. This new report looks into the Financial Effects of COVID-19: Hospital Outlook for the Remainder of 2021. This report was conducted on behalf of the American Hospital Association (AHA), who succinctly summarized the forecast saying, “COVID-19 [is] expected to drive continued hospital losses throughout 2021.” That projection is further couched in the concern that

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Pondering Prescription Drugs: Pricing Rx and Going Direct-to-Consumer

There is one health care public policy issue that unites U.S. voters across political party: that is the consumer-facing costs of prescription drugs. With the price of medicines in politicians’ and health citizens’ cross-hairs, the pharmaceutical and biotech industries have responded in many ways to the Rx pricing critiques from consumers (via, for example, Consumer Reports/Consumers Union and AARP), hospitals (through the American Hospital Association), and insurance companies (from AHIP, America’s Health Insurance Plans). The latest poll from the University of Chicago/Harris Public Policy and the Associate Press-NORC Center for Public Affairs Research quantifies the issue cross-party, finding that 74%

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Doctors’ Offices Morph into Bill Collectors As Patients Face Growing Out-Of-Pocket Costs

In the U.S., patients have assumed the role of health care payors with growing co-payments, coinsurance amounts, and deductibles pushing peoples’ out-of-pocket costs up. This has raised the importance of price transparency, which is based on the hypothesis that if patients had access to personally-relevant price/cost information from doctors and hospitals for medical services, and pharmacies and PBMs for prescription drugs, the patient would behave as a consumer and shop around. That hypothesis has not been well proven-out: even though more health care “sellers” on the supply side have begun to post price information for services, patients still haven’t donned

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Eli Lilly Bets on U.S. Well-Being at the Olympics

The U.S. Olympic team will be competing in Tokyo for first-place medals across many athletic events, each nation’s most physically-fit citizens going for gold. When it comes to the U.S. ranking on the world roster of population health outcomes, American ranks low on many key metrics, especially given that the U.S. does rank #1 in one key stat: healthcare spending. Reminding us of America’s lowly-placed health outcomes, the Eli Lilly Company is collaborating with Team USA, the US Olympic and Paralympic teams, to promote “Our Collective Health” with the message that, “Watching the success of our athletes will once again

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Healthy Living Trends Inspired by COVID-19: Retailers, Food, and Consumers’ Growing Self-Care Muscles

“Self-care” took on new meaning and personal work-flows for people living in and through the coronavirus pandemic in the U.S. Acosta, the retail market research pro’s, updated our understanding consumers evolving as COVID-19 Has Elevated the Health and Wellness Trends of the Recent Years, results of a survey conducted among in May 2021. In the U.S., consumers’ take on self-care has most to do with healthy eating and nutrition (for 1 in 2 people), getting regular medical checkups (for 42%), taking exercise, relaxing, using vitamins and supplements, and getting good sleep. Healthy relationships are an integral part of self-care for

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Dollar General, the Latest Retail Health Destination?

“What if…healthcare happened where we live, work, play, pray and shop, delivering the highest levels of retail experience?” I asked and answered in my book HealthConsuming: From Health Consumer to Health Citizen. The chapter called “The new retail health” began with that “what if,” and much of the book responded with the explanation of patients evolving toward health consumers and, ultimately, health citizens empowered and owning their health and care. This week, Dollar General announced the hiring of its first Chief Medical Officer, Dr. Albert Wu. With that announcement, America’s largest dollar-store chain makes clear its ambitions to join a

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Aduhelm and Alzheimer’s Disease: A Potential Medicare Budget-Buster Puts A Blazing Light on Health Care Costs and Innovation

The FDA’s approval of the first therapy to treat Alzheimer’s Disease in over twenty years brought attention to a not-yet-convened debate of U.S. health care costs and spending, innovation, and return-on-the-investment (as well as “for whom” do the returns accrue). In my latest post for Medecision, I explore different angles on the Aduhelm and Alzheimer’s discussion, covering: The macro- and micro-economics of Alzheimer’s and the $56,000 list price for the drug The FDA regulatory process and aftermath U.S. consumers’ bipartisan support for drug price regulation through Medicare negotiation and private/commercial sector adoption Congressional legislation addressing the price of medicines in

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The Healthcare and Macro-Economic Impacts of Living with Endemic COVID – Listening to Fitch

Getting totally rid of the coronavirus isn’t likely, so we humans must accept the fact that SARS-CoV-2 will be endemic. The economic and healthcare system impacts of this were explored in the Post-Covid Healthcare Landscape, delivered by Fitch Solutions’ Jamie Davies and Beau Noafshar, leaders in the Pharmaceuticals, Healthcare, and Medical Devices groups. I welcomed the opportunity to learn from this team’s approach in weaving together the dynamic issues that help us to plan for the long-tail of COVID-19 and its impact on the economy and prospects for the health care industry and health citizens. The first graph illustrates the

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What Do Democrats and Republicans Agree On? Allowing Negotiations to Lower Rx Prices

People living in the U.S. have weathered over fifteen months of life-shifts for work, school, prayer, fitness, and social lives. So you might think that the most important public priority for Congress might have something to do with COVID-19, vaccines, or health insurance coverage. But across all priorities, it turns out that prescription drug costs rank higher in Americans’ minds than any other issue in the Kaiser Family Foundation Health Tracking Poll for May 2021. Two-thirds of U.S. adults said that allowing the federal government and private insurance plans to negotiate for lower prices on Rx drugs was their top

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Healthcare, Heal Thyself! How the Industry Can and Should Play the Trust Card

The emergence of the COVID-19 vaccine “infodemic” has slowed the ability for nations around the world to emerge out of the public health crisis. Growing cynicism among some health citizens facing the politicization of public health tactics like vaccines and facial masks is what we’re talking about. At the root is peoples’ lack of trust across a range of information providers, including government, media, business, and even peers. The 2021 Edelman Trust Barometer spotlighted the infodemic and eroding trust in the U.S. in the voices of public health, the public sector, and media. This is a global challenge as well,

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Trust in Healthcare is Under Stress in the US and Globally, Edelman Finds

You’re stressed, I’m stressed; most of us have felt stress in the COVID-19 era which began in the U.S. in the first quarter of 2020. Nearly eighteen months later, a 2021 Edelman Trust Barometer update finds that consumers’ trust in the health care industry is under stress, too — in the U.S. and around the world. The first chart from the Edelman health care update demonstrates that in most countries polled, health citizens’ trust in health care was buoyed in the first five months of 2020 (January through May): up 18 points in the U.S., 14 points in Canada and

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Health and Getting Outside – What the 2021 Axios Harris Poll 100 Brands Mean for Health/Care

We want to go outside, drive our cars, shop for groceries, stay and get healthy. These are the key themes coming out of the 2021 Axios Harris Poll 100 on the most visible brands with high (and low) reputations among U.S. consumers. In the top-ranked “excellent” and “very good” brands numbered 1 through 50, we find five core health care brands that were most visible to U.S. consumers: Moderna ranked #3, Pfizer #7, CVS Health #24, Walgreens #46, and Kaiser Permanente #47. The only pure healthcare brand in the bottom 50 was Johnson & Johnson at #72, between Dollar General

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Spending on Medicines In and Post-COVID Say a Lot About Patients and Larger Healthcare Trends – an IQVIA Update

Spending on medicines, globally, will rebound this year and rise above pre-pandemic levels through 2025. Between 2021 and 2025, the annual growth global growth rate for prescription drugs spending is expected to range from 3% to 6%, a $1.6 trillion bill for the worlds’s total Rx medicines market. That relatively low single-digit growth rate is tempered by savings from biosimilars and the loss of brand exclusivity (that is, more generics coming to market). On the faster-growth side, we can expect two big therapeutic areas to drive spending upward: oncology and immunology, projected to expand by 9% to 12% each year

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The Continued Erosion of Trust in the Age of COVID

A year into the COVID-19 pandemic, most Americans are still in “survival mode,” according to an update of the 2021 Edelman Trust Barometer, Trust and the Coronavirus in the U.S. Updating the company’s annual Trust Barometer, Edelman conducted a new round of interviews in the U.S. among 2,500 people in early March. [For context, you can read my take on the 2021 Edelman Trust Barometer published during the World Economic Forum in January 2021 here in Health Populi].  The first chart shows that two in three people in the U.S. are still in a pandemic mindset, worried about safety and

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Value-Based Health Care Needs All Stakeholders at the Table – Especially the Patient

2021 is the 20th anniversary of the University of Michigan Center for Value-Based Insurance Design (V-BID). On March 10th, V-BID held its annual Summit, celebrating the Center’s 20 years of innovation and scholarship. The Center is led by Dr. Mark Fendrick, and has an active and innovative advisory board. [Note: I may be biased as a University of Michigan graduate of both the School of Public Health and Rackham School of Graduate Studies in Economics].   Some of the most important areas of the Center’s impact include initiatives addressing low-value care, waste in U.S. health care, patient assistance programs, Medicare

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Ten Forces Shaping Health Care in 2021: A View from CVS Health

Expanding omni-channel, data-driven, cost-effective health care in the community, tailoring that care, and attending to mental health paint the picture of health through the lens of CVS Health. The company published the Health Trends Report 2021 today, calling out ten forces shaping health care this year. Those themes are, The Year of the Pharmacist The Next Step Forward in Cardiac Care Cancer Needs a Better Roadmap The EHR Hits Its Stride The Mental Health Shadow of COVID-19 Tailor Care to the Older Patient More Agents that Predict Disease Paying for the New Medical Miracle Virtual Care Goes Mainstream, and Diabetes

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The Remarkable Rise of Pharma’s Reputation in the Pandemic

The reputation of the pharmaceutical industry gained a “whopping” 30 points between January 2020 and February 2021, based on the latest Harris Poll in their research into industries’ reputations. The study was written up by Beth Snyder Bulik in FiercePharma. Beth writes that, “a whopping two-thirds of Americans now offer a thumbs-up on pharma” as the title of her article, calling out the 30-point gain from 32% in January 2020 to 62% in February 2021. Thanks to Rob Jekielek, Managing Director of the Harris Poll, for sharing this graph with me for us to understand the details comparing pharma’s to

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The Social Determinants of Prescription Drugs – A View From CoverMyMeds

The COVID-19 pandemic forced consumers to define what were basic or essential needs to them; for most people, those items have been hygiene products, food, and connectivity to the Internet. There’s another good that’s essential to people who are patients: prescription drugs. A new report from CoverMyMeds details the current state of medication access weaving together key health care industry and consumer data. The reality even before the coronavirus crisis emerged in early 2020 was that U.S. patients were already making painful trade-offs, some of which are illustrated in the first chart from the report. These include self-rationing prescription drug

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Ten In Ten: Manatt’s Healthcare Priorities to 2031

The coronavirus pandemic has exposed major weaknesses in the U.S. health care system, especially laying bare inequities and inertia in American health care, explained in The Progress We Need: Ten Health Care Imperatives for the Decade Ahead from Manatt Health. The report details the ten objectives that are central to Manatt’s health care practice, a sort of team manifesto call-to-action and North Star for the next decade. Their ten must-do’s for bending the cost curve while driving constructive change for a better health care system are to: Ensure access Achieve health equity Stability the safety net and rebuild public health

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Addressing Lives and Livelihoods with a Whole-of-Government Approach – The First Wave of Biden Health Policy

President Biden’s first few days on the job gave us a very clear view on how he sees conquering COVID: through a whole-of-government approach to public policies that bolster directly addressing the virus, along with the many forces shaping how we got here and how to come out of the pandemic era stronger. I cover this first wave of Biden health policy in my latest post for the Medecision Liberation blog titled, “Top Priorities for President Biden: COVID-19, Then Everything Else.” The plotline goes… On the day of inauguration, January 20, 2021, Joseph R. Biden was installed as the 46th

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The 2021 Shkreli Awards: Lown Institute Counts Down the Top 10 Healthcare Industry Abuses in the Coronavirus Pandemic

The first year of the coronavirus pandemic in America was a kind of stress test on the U.S. health care system, revealing weak links and opportunities for bad behavior. “These are not just about individual instances or bad apples,” Dr. Vikas Saini, President of The Lown Institute, explained, referring to them as “cautionary tales” of the current state of U.S. health care. Dr. Saini and his colleague Shannon Brownlee released the annual Lown Institute 2020 Shkreli Awards this week, highlighting their ten most egregious examples of the worst events in U.S. health care that happened in the past year —

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The Fastest-Growing Brands of 2020 Are All About the Pandemic and Health

Staying home, being clean, staying entertained, eating well, and self-caring for healthcare….these are the major factors underpinning the twenty fastest-growing brands of 2020, based on Morning Consult’s annual look at the topic. Let’s look into these categories by brand, and connect the dots for health, medical care, and well-being… Connectivity as a social determinant of health. Zoom was the fastest-growing brand of the year, with 26% of U.S. consumers saying they would consider purchasing the service in November compared with 11% in January. Zoom morphed from a business meeting platform to a consumer and family-connecting service spiking on holidays like

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Will 2021 Be the Year of Sicker Americans? Pondering Late 2020 Data from IQVIA

Yesterday, IQVIA presented their end-of-year data based on medical claims in the U.S. health care system tracking the ups, downs, and ups of the coronavirus in America. IQVIA has been tracking COVID-19 medical trends globally from early 2020. The plotline of patient encounters for vaccines, prescribed medicines, foregone procedures and diagnostic visits to doctors begs the question: in 2021, will Americans be “sicker,” discovering later-stage cancer diagnoses, higher levels of pain due to delayed hip procedures, and eroded quality of life due to leaky guts? Here are a few snapshots that paint a picture for greater morbidity and potentially more “excess

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U.S. Health Consumers’ Growing Financial Pressures, From COVID to Cancer

Before the coronavirus pandemic, patients had been transforming into health care payors, bearing high deductibles, greater out of pocket costs, and financial risk shifting to them for medical spending. In the wake of COVID-19, we see health consumers-as-payors impacted by the pandemic, as well as for existing diagnoses and chronic care management. There is weakening in U.S. consumers’ overall household finances, the latest report from the U.S. Bureau of Economic Analysis (BEA) asserted (published 25 November 2020). In John Leer’s look into the BEA report in Morning Consult, he wrote, “Decreases in income, the expiration of unemployment benefits and increased

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The Pandemic, Amazon, Pharmacy, and the Digital Transformation of Health Consumers

As the COVID-19 pandemic emerged in the U.S., Americans were already Primed for ecommerce — even in health care. The coronavirus accelerated the digital transformation on people as consumers — and consumers as health consumers. Today, Amazon announced the company’s launch of Amazon Pharmacy. Watch for earth-shaking (negative) impacts on the incumbent pharmacies like CVS, Rite-Aid, Walgreens, as well as discount and ecommerce players such as GoodRx. [Sidebar: as of 10 am this morning, the announcement “sunk” the retail pharmacy stocks, according to TheStreet.com]. Some context: this announcement builds on Amazon’s previous major move into pharmacy with its acquisition of

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Will We See A Field of Dreams for the COVID-19 Vaccine in the U.S.?

“If you build it, he will come,” the voice of James Earl Jones echoes in our minds when we recall the plotline of the film, Field of Dreams. A quick summary if you don’t know the movie: the “it” was a baseball field to be built in a rural cornfield. The “he” was a baseball player, ultimately joined by a dream-team of ball players who would convene on that dreamy field to play an amazing game. Today, the day after Pfizer announced a 90% benefit for its coronavirus vaccine, bolstering Wall Street returns on 9th November 2020, two new consumer

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Voting for Health in 2020

In the 2018 mid-term elections, U.S. voters were driven to polls with health care on their minds. The key issues for health care voters were costs (for care and prescription drugs) and access (read: protecting pre-existing conditions and expanding Medicaid). Issue #2 for 2018 voters was the economy. In 2020, as voting commences in-person tomorrow on 3rd November, U.S. voters have lives and livelihoods on their minds. It’s the pandemic – our physical lives looming largest in the polls – coupled with our fiscal and financial lives. Health is translating across all definitions for U.S. voters in November 2020: for

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Americans Worry About Medical Bankruptcy, As Prescription Drug Costs Play Into Voters’ Concerns

One in two people in the U.S. are concerned that a major health event in their family would lead to bankruptcy, up 5 percent points over the past eighteen months. In a poll conducted with West Health, Gallup found that more younger people are concerned about medical debt risks, along with more non-white adults, published in their study report, 50% in U.S. Fear Bankruptcy Due to Major Health Event. The survey was fielded in July 2020 among 1,007 U.S. adults 18 and older. One of the basic questions in studies like these is whether a consumer could cover a $500

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Pharma’s Future Relevance Depends on Empathy, Messaging, Partnering, and Supporting Patients and Providers

COVID-19 is re-shaping all industries, especially health care. And the pharma industry is challenged along with other health care sectors. In fact, the coronavirus crisis impacts on pharma are especially accelerated based on how the pandemic has affected health care providers, as seen through research from Accenture published in Reinventing Relevance: New Models for Pharma Engagement with Healthcare Providers in a COVID-19 World. For the study, Accenture surveyed 720 health care providers in general practice, oncology, immunology, and cardiology working in China, France, Japan, the United Kingdom, and the U.S., in May and June 2020. Top-line, Accenture points to four

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Pharmacies Grow for Primary Care On-Ramps – And J.D. Power Says Consumers Like That

The use of health and wellness services delivered in retail pharmacies is growing, and health consumers’ satisfaction increases with use. That’s the headline for J.D. Power’s 2020 U.S. Pharmacy Study. This is the 12th year of J.D. Power’s U.S. Pharmacy Study, this year based on a survey of 13,378 pharmacy customers who filled a prescription between June 2019 and February 2020. The study assessed four retail prescription drug channels for consumers: brick and mortar chain drug stores, brick and mortar mass merchandisers, supermarket pharmacies, and mail order. The top ranked brands were: For brick and mortar chains, Good Neighbor Pharmacy

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The Racial Divide Due to COVID-19 Also Applies to Healthcare and Pharma Costs

Into the sixth month of the coronavirus pandemic in the U.S., it’s clear that COVID-19 has wreaked a greater mortality and morbidity impact on people of color than on white adults. A new Gallup-West Health poll found that the coronavirus also concerns more non-white Americans than whites when it comes to the cost of health care and medicines to deal with the effects of COVID-19. Considering the cost of COVID-19 treatment, across all U.S. adults, 40% of people are concerned (extremely/concerned), and 41% are “not at all concerned.” Broken down by race, there is a stark difference in levels of

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Americans Across Political Party Worry About Prescription Drug Prices – Especially to Deal with COVID-19

Nine in ten Americans is concerned about the price of prescription drugs in the wake of the coronavirus pandemic, Gallup and West Health found in their survey on the cost of healthcare, published today. A majority of people across political party share this concern: overall, 88% of U.S. adults are concerned about rising drug prices in response to COVID19, split across party ID with: 94% of Democrats, 86% of Independents, and 84% of Republicans. By demographics, more women than men are concerned about rising costs for the three health care spending categories the survey studied: drug prices, insurance premiums, and

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Americans’ Concerns About the US Healthcare System Loom Larger Than Worries About Their Own Care

The coronavirus pandemic has further opened the kimono of the U.S. healthcare system to Americans: four months into the COVID-19 outbreak, most consumers (62%) of people in the U.S. are more concerned about other people not having access to high quality health care versus themselves. This is a 16 point increase in concern in May 2020 compared with the response to the same question asked in February in a poll conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research (the AP-NORC Center). The AP-NORC Poll found more of this

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Health Care In the COVID-19 Era – PwC Finds Self-Rationing of Care and Meds Especially for Chronic Care

Patients in the U.S. are self-rationing care in the era of COVID-19 by cutting spending on health care visits and prescription drugs. The coronavirus pandemic’s impact on health consumers’ spending varies depending on whether the household is generally a healthy family unit, healthy “enthusiasts,” dealing with a simple or more complex chronic conditions, or managing mental health issues. PwC explored how COVID-19 is influencing consumers’ health care behaviors in survey research conducted in early April by the Health Research Institute. The findings were published in a May 2020 report, detailing study findings among 2,533 U.S. adults polled in early April

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How COVID-19 Has Re-Shaped Health Care Delivery So Far

COVID-19 is re-shaping health care in America across many dimensions. In Shifts in Healthcare Demand, Delivery and Care During the COVID-19 Era, IQVIA presents a multi-faceted profile of the early impacts of the pandemic on U.S. health care. In the report, published in April 2020, IQVIA mined the company’s many data bases that track real-time data, including medical claims, flu data, sales data, oncology medical and pharmacy claims, formularies, among other sources. Top-line, IQVIA spotted the following key shifts in U.S. health care since the start of the coronavirus pandemic: Patients’ use of health services Impacts on medicine use, influenced

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Americans’ Top 2 Priorities for President Trump and Congress Are To Lower Health Care and Rx Costs

Health care pocketbook issues rank first and second place for Americans in these months leading up to the 2020 Presidential election, according to research from POLITICO and the Harvard Chan School of Public Health published on 19th February 2020. This poll underscores that whether Democrat or Republican, these are the top two domestic priorities among Americans above all other issues polled including immigration, trade agreements, infrastructure and regulations. The point that Robert Blendon, Harvard’s long-time health care pollster, notes is that, “Even among Democrats, the top issues…(are) not the big system reform debates…They’re worried about their own lives, their own

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Come Together – A Health Policy Prescription from the Bipartisan Policy Center

Among all Americans, the most popular approach for improving the health care in the U.S. isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. It would be to improve the current health care system, according to the Bipartisan Policy Center’s research reported in a Bipartisan Rx for America’s Health Care. The BPC is a truly bipartisan organization, co-founded by Former Democratic Senate Majority Leaders Tom Daschle and George Mitchell, and Former Republican Senate Majority Leaders Howard Baker and Bob Dole. While this political week in America has revealed deep chasms between the Dems and

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The State of the Union for Prescription Drug Prices

Tonight, President Trump will present his fourth annual State of the Union address. This morning we don’t have a transcript of the speech ahead of the event, but one topic remains high on U.S. voters’ priorities, across political party – prescription drug prices. Few issues unite U.S. voters in 2020 quite like supporting Medicare’s ability to negotiate drug prices with pharmaceutical companies, shown by the October 2019 Kaiser Family Foundation Health Tracking Poll. Whether Democrat, Independent, or Republican, most people living in America favor government intervention in regulating the cost of medicines in some way. In this poll, the top

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A Uniting Issue in the United States is Lowering Prescription Drug Costs

Health care continues to be the top-ranked voting issue in the U.S. looking to the November 2020 Presidential and Congressional elections. The Kaiser Family Foundation conducts the monthly poll which gauges U.S. adults’ perspectives on health care, and this month’s January 2020 Kaiser Health Tracking Poll explores Americans’ views on broad healthcare reform plans and specific medical policy issues. Overall, Americans point to prescription drug costs and the preservation of the Affordable Care Act’s protections for people with pre-existing conditions, the first chart tells us. Third and fourth on voters’ minds are protecting patients from surprise medical bills and better

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Most Americans Regardless of Income Say It’s Unfair for Wealthier People to Get Better Health Care

In America, earning lower or middle incomes is a risk factor for having trouble accessing health care and/or paying for it. But most Americans, rich or not, believe that it’s unfair for wealthier people to get better health care, according to a January 2020 poll from NPR, the Robert Wood Johnson Foundation and Harvard Chan School of Public Health, Life Experiences and Income Equality in the United States. The survey was conducted in July and August 2019 among 1,885 U.S. adults 18 or older. Throughout the study, note the four annual household income categories gauged in the research: Top 1%

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In 2020, PwC Expects Consumers to Grow DIY Healthcare Muscles As Medical Prices Increase

The new year will see a “looming tsunami” of high prices in healthcare, regulation trumping health reform, more business deals reshaping the health/care industry landscape, and patients growing do-it-yourself care muscles, according to Top health industry issues of 2020: Will digital start to show an ROI from the PwC Health Research Institute. I’ve looked forward to reviewing this annual report for the past few years, and always learn something new from PwC’s team of researchers who reach out to experts spanning the industry. In this 14th year of the publication, PwC polled executives from payers, providers, and pharma/life science organizations. Internally,

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Despite Greater Digital Health Engagement, Americans Have Worse Health and Financial Outcomes Than Other Nations’ Health Citizens

The idea of health care consumerism isn’t just an American discussion, Deloitte points out in its 2019 global survey of healthcare consumers report, A consumer-centered future of health. The driving forces shaping health and health care around the world are re-shaping health care financing and delivery around the world, and especially considering the growing role of patients in self-care — in terms of financing, clinical decision making and care-flows. With that said, Americans tend to be more healthcare-engaged than peer patients in Australia, Canada, Denmark, Germany, the Netherlands, Singapore, and the United Kingdom, Deloitte’s poll found. Some of the key behaviors

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Social Determinants of Health – My Early Childhood Education and Recent Learnings, Shared at the HealthXL Global Gathering

My cousin Arlene got married in Detroit at the classic Book Cadillac Hotel on July 23, 1967, a Sunday afternoon wedding. When Daddy drove us back out to our suburban home about 30 minutes from the fancy hotel, the car radio was tuned to WWJ Newsradio 950, all news all the time. As soon as Daddy switched on the radio, we were shocked by the news of a riot breaking out in the city, fires and looting and gunshots and chaos in the Motor City. Two days later, my father, who did business with Mom-and-Pop retail store owners in the

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Great Expectations for Health Care: Patients Look for Consumer Experience and Trust in Salesforce’s Latest Research

On the demand side of U.S. health care economics, patients are now payors as health consumers with more financial skin in paying medical bills. As consumers, people have great expectations from the organizations on the supply side of health care — providers (hospitals and doctors), health insurance plans, pharma and medical device companies. But as payors, health consumers face challenges in getting care, so great expectations are met with frustration and eroding trust with the system, according to the latest Connected Healthcare Consumer report from Salesforce published today as the company announced expansion of their health cloud capabilities. This is

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Will Consumers Cross the Cost-and-Trust Chasm Between Prescription Drugs and Hospitals?

People in the U.S. rank prescription drugs, lab tests, emergency room visits, dental and vision care, preventive services, chronic disease management and mental health care as the “most essential” health care services, according to the 2019 Survey of America’s Patients conducted by The Physicians Foundation. When asked what factors contribute to rising health care costs in America, most consumers cite the cost of prescription drugs. Taken together, these two data points demonstrate the potent political import of prescription drug prices as the U.S. approaches the 2020 Presidential election. The Physicians Foundation surveyed 2,001 U.S. adults between 27 and 75 years

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Americans’ Top Sources of Stress are Money, Money, Money and Family

ABBA sang the song “Money Money Money” back in 1976. The lyrics feel, sadly, spot-on when thinking about health care costs, job-lock and Americans’ home economics in 2019. “Work all night, I work all day, to pay the bills I have to pay Ain’t it sad And still there never seems to be a single penny left for me That’s too bad… Money, money, money must be funny In the rich man’s world.” That year, ’76, wasn’t just the U.S. bicentennial — it was a year when the U.S. allocated 8.6% of the nation’s Gross Domestic Product for health care.

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Patients Growing Health Consumer Muscles Expect Digital Services

Patients’ experiences with the health care industry fall short of their interactions with other industries — namely online retail, online banking and online travel, a new survey from Cedar, a payments company, learned. Survata conducted the study for Cedar among 1,607 online U.S. consumers age 18 and over in August and September 2019. These study respondents had also visited a doctor or hospital and paid a medical bill in the past year. One-third of these patients had a health care bill go to collections in the past year, according to Cedar’s 2019 U.S. Healthcare Consumer Experience Study. Among those people

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Wasted: $1 of Every $4 Spent on Health Care In America

A study in JAMA published this week analyzed research reports that have measured waste in the U.S. health care system, calculating that 25% of medical spending in America is wasted. If spending is gauged at $3.8 trillion, waste amounts to nearly $1 trillion. If spending is 18% of the American gross domestic product (GDP), then some 4.5% of the U.S. economy is wasted spending by the health care system and its stakeholders. In “Waste in the US Health Care System,” a team from Humana and the Univrsity of Pittsburgh recalibrated the previous finding of 30% of wasted spending to the 25%,

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The Pharma Industry Hits Bottom of Consumers’ Industry Rankings, and Healthcare Is Only Marginally Higher on the List

from Gallup’s 2019 survey into Americans’ Views of U.S. Business Industry Sectors. Since reaching a relative high regard in 2015, the pharma industry reputation among consumers has declined each year since to the low this year with 58% of Americans having a negative view. This was a 31 percentage point drop in reputation in one year. This is one negativity point above peoples’ low regard for the Federal government. Gallup notes that Americans are over two times more likely to rank the pharmaceutical industry negatively (58%) as positively (27%). The healthcare industry, apart from pharma, didn’t fare well this year in

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Talking “HealthConsuming” on the MM&M Podcast

Marc Iskowitz, Executive Editor of MM&M, warmly welcomed me to the Haymarket Media soundproof studio in New York City yesterday. We’d been trying to schedule meeting up to do a live podcast since February, and we finally got our mutual acts together on 6th August 2019. Here’s a link to the 30-minute conversation, where Marc combed through the over 500 endnotes from HealthConsuming‘s appendix to explore the patient as the new health care payor, the Amazon prime-ing of people, and prospects for social determinants of health to bolster medicines “beyond the pill.” https://www.pscp.tv/MMMnews/1eaJbvgovBYJX Thanks for listening — and if you

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Health Care and Consumers in 2030: A Profile from KPMG

A “one layered delivery network through which patients can move seamlessly as they age and their needs evolve” will be the new health care platform to meet patients’ demands by 2030, according to a forecast from KPMG’s Healthcare and Life Sciences Institute. In Healthcare 2030: The consumer at the center, the KPMG team explores the demographic shifts and market drivers that will challenge the health care industry in the current U.S. delivery and financing system. The lens on that 2030 future is a consumer-centric delivery model that KPMG believes will be a solution to dealing with a demographic divide between

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On Amazon Prime Day, What Could Health Care Look Like?

Today is July 15, and my email in-box is flooded with all flavors of Amazon Prime’d stories in newsletters and product info from ecommerce sites — even those outside of Amazon from beauty retailers, electronics channels, and grocery stores. So I ask on what will probably be among the top ecommerce revenue generating days of all time: “What could health care look like when Amazon Prime’d?” I ask and answer this in my book, HealthConsuming, as chapter 3. For context, this chapter follows two that explain how patients in the U.S. have been morphing into health consumers based on how health

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The New Drug Companies Aren’t Drug Companies At All

The health/care ecosystem continues to morph as the stakeholder groups themselves are blurring across and outside of their core businesses. Today’s example of this is Clover Health, which launched Clover Therapeutics this week. This research organization will develop medicines targeting older adults — which makes sense because Clover Health’s target consumer market is Medicare Advantage beneficiaries. “Clover Therapeutics was created to address the significant unmet needs in chronic progressive diseases in the Medicare population,” Cheng Zhang, Head of Clover Therapeutics, is quoted in the press release. The company will first collaborate with Genentech (Roche) to research and develop therapies based

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Prescription Drugs Are Becoming A Luxury Good in America – Join the #HCLDR Chat Tonight

“Drugmakers Push Their Prices Higher” is the top story under the Business & Finance banner in today’s Wall Street Journal. That’s in terms of drugs’ list prices, which most patients don’t pay. But drug costs to patients are in the eye of the beholder, who in a high-deductible plan or Medicare Part D donut hole becomes the first-dollar payer. Patients continue to face rising drug costs, pushing them into what I’ve been thinking about as luxury-goods territory. The economic definition of a luxury good is a product for which demand increases more than proportionally as income rises, so that spending

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A Matter of Trust, Perception, Risk, and Uncertainty – The Big Issues Raised by the Acquisition of PatientsLikeMe and Other Patient Data Transactions

By Susannah Fox, Jane Sarasohn-Kahn and Lisa Suennen I’ve lived long enough to have learned The closer you get to the fire the more you get burned But that won’t happen to us Cause it’s always been a matter of trust           A Matter of Trust, by Billy Joel If you’re in health care and don’t live under a rock, you have probably heard that United Health Group (UHG) has acquired PatientsLikeMe (PLM).  After the announcement, there was a lot of sound and fury, some of which signified nothing, as the saying goes, and some which signified a lot.

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Health Care and the Democratic Debates – Round 2 – Battle Royale for M4All vs Medicare for All Who Want It – What It Means for Industry

Looking at this photo of the 2020 Democratic Party Presidential candidate debater line-up might give you a déjà vu feeling, a repeat of the night-before debate. But this was Round 2 of the debate, with ten more White House aspirants sharing views — sometimes sparring — on issues of immigration, economic justice, climate change, and once again health care playing a starring role from the start of the two-hour event. The line-up from left to write included: Marianne Williamson. author and spiritual advisor John Hickenlooper, former Governor of Colorado Andrew Yang. tech company executive Pete Buttigieg, Mayor of South Bend,

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Health Care and the Democratic Debates – Part 1 – Medicare For All, Rx Prices, Guns and Mental Health

Twenty Democratic Presidential candidates each have a handful of minutes to make their case for scoring the 2020 nomination, “debating” last night and tonight on major issues facing the United States. I watched every minute, iPad at the ready, taking detailed notes during the 120 minutes of political discourse conducted at breakneck speed. Lester Holt, Savannah Guthrie, and Jose Diaz-Balart asked the ten candidates questions covering guns, butter (the economy), immigration, climate change, and of course, health care — what I’m focusing on in this post, the first of two-debate-days-in-a-row. The first ten of twenty candidates in this debate were,

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IKEA Garners the Top Health & Wellness Award at Cannes Lions 2019 – the Expanding Health/Care Ecosystem

“Health is now everyone’s business,” Shaheed Peera, Executive Creative Director of Publicis LifeBrands, said this week at the 2019 Cannes Lions awards. Shaheed also led the Health & Wellness jury at Cannes Lions 2019, the mission of which is to, in the words of the award’s portal, “celebrate creativity for personal wellbeing.” The Grand Prix Lions award for Health & Wellness went to IKEA for the company’s ThisAbles campaign. ThisAbles is a project pioneered by IKEA’s team in Israel, looking to improve everyday living for people with special needs through  well-designed IKEA products. IKEA collaborated with non-profit organizations to develop

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Americans Could Foster a Health Consumer Movement, Families USA Envisions

Employers, health care providers, unions, leaders and — first and foremost, consumers — must come together to build a more accessible, affordable health care system in America, proposes a call-to-action fostered by a Families USA coalition called Consumers First: The Alliance to Make the Health Care System Work for Everyone. The diverse partners in this Alliance include the American Academy of Family Physicians, AFSCME (the largest public service employees’ union in the U.S.), the American Benefits Council (which represents employers), the American Federation of Teachers (AFT), First Focus (a bipartisan children’s advocacy organization), and the Pacific Business Group on Health

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Two-Thirds of Americans Say Healthcare Doesn’t Work Well, in RealClear Politics Poll

Health care is the top issue facing the U.S. today, one in three Americans says, with another one-fourth pointing to the economy. Together, health care + the economy rank the top issues for 62% of Americans. Health care and the economy are, in fact, intimately tied in every American’s personal household economy I assert in my book, HealthConsuming: From Health Consumer to Health Citizen. This poll from RealClear Politics, conducted in late April/early May 2019, makes my point that the patient is the consumer and, facing deductibles and more financial exposure to footing the medical bill, the payor.   Fully

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Prescription Drug Costs In America Through the Patient Lens, via IQVIA, GoodRx and a New $2 Million Therapy

Americans consumed 17.6 prescriptions per person in 2018, two in three of which treated chronic conditions. Welcome to Medicine Use and Spending in the U.S. , the annual review of prescription drug supply, demand and Rx pricing dynamics from the IQVIA Institute for Human Data Science. In a call with analysts this week in which I participated, the Institute’s Executive Director Murray Aitken discussed the report which looks back at 2018 and forward to 2023 with scenarios about what the U.S. prescription drug market might look like five years from now. The report is organized into four sections: medical use

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Across All Political Parties, Likely Voters Over 50 Favor Cutting Prescription Drug Prices

People over 50 in the U.S. that are likely to vote in the 2020 Presidential election are keenly interested in lowering the cost of prescription drugs, according to a survey conducted by AARP in February and March 2019. Most people over 50 take prescription drugs daily; one-third take two or three Rx’s regularly, and one in five older people take six or more prescription medicines regularly. Thus, prescription drugs are part of most older Americans’ daily life-flows and household spending considerations. About two-thirds of older people who are likely to vote say that Rx prices are “unreasonable,” including 67% of

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Americans’ Trust in U.S. Healthcare Lags Tech — and Women Are Particularly Cynical

The 2019 Edelman Trust Barometer measured the biggest gap in trust for the healthcare industry between the U.S. “informed public” and the mass population. Fewer American women, too, trust the healthcare industry than men do. “This inequality of trust may be reflective of the mass population continuing to feel left behind as compared to others, even as they recognize the advances that are being made that could benefit them. Given tone and tenor of the day, and particularly among mass population, healthcare may continue to see increasing demands for change and regulation,” Susan Isenberg, Edelman’s head of healthcare, notes in

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Listen Up, Healthcare: Hear The Patient’s Voice!

Consider the voice of a patient before the advent of the Internet in the digital 1.0 world, and then the proliferation of social networks in v 2.0. One patient could talk with another over their proverbial neighborhood fence, a concerned parent at the PTA meeting with others dealing with a children’s health issue, or a recovering alcoholic testifying in person at an AA session. Today, the voice of the patient is magnified one-to-many, omnichannel and multi-platform — via video, blogs, podcasts, social networks, listservs….and, yes, still in live forums like AA meetings, church basements, Y-spaces, and the Frazzled Cafe meet-ups

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The United States of Diabetes: a $1,240 Tax on Every American

Pharmaceutical company executives are testifying in the U.S. Congress this week on the topic of prescription drug costs. One of those medicines, insulin, cost a patient $5,705 for a year’s supply in 2016, double what it cost in 2012, according to the Health Care Cost Institute. Know that one of these insulin products, Lilly’s Humalog,  came onto the market in 1996. In typical markets, as products mature and get mass adoption, prices fall. Not so insulin, one of the many cost components in caring for diabetes. But then prescription drug pricing doesn’t conform with how typical markets work in theory.

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Most Americans Blame Drug Companies, Insurers, and Hospitals for High Health Care Costs

There’s little agreement between Democrats and Republicans on a plethora of issues in American public life. But one issue that brings U.S. citizens together is agreement that the cost of health care is too high in the country, and that pharma, health plans, and providers are to blame. Welcome to health politics in America as of March 2019, according to The Public and High U.S. Health Care Costs, a poll conducted by POLITICO and the Harvard T.H. Chan School of Public Health. The first chart illustrates the common ground shared by Americans by party affiliation, with vast majorities across parties playing

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Most Americans Across Party ID Favor U.S. Government Negotiation to Lower Rx Drug Costs

There’s little Americans, by political party, agree upon in 2019. One of the only issues bringing people together in the U.S. is prescription drug prices — that they’re too high, that the Federal government should negotiate to lower costs for Medicare enrollees, and that out-of-pocket costs for drugs should be limited. The Kaiser Family Foundation has been tracking this topic for a few years, and this month, their March 2019 Health Tracking Poll shows vast majorities of Democrats, Independents and Republicans all share these sentiments. It’s not that patients who take prescription drugs don’t appreciate them – most (58%) say medicines

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National Health Spending Will Reach Nearly 20% of U.S. GDP By 2027

National health spending in the U.S. is expected to grow by 5.7% every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth, published yesterday by Health Affairs. For context, note that general price inflation in the U.S. was 1.6% for the 12 months ending January 2019 according to the U.S. Bureau of Labor Statistics. This growth rate for health care costs exceeds every period measured since the high of 7.2% recorded in 1990-2007. The bar chart illustrates the

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The Cost of Prescription Drugs, Doctors and Patient Access – A View from HIMSS19

Most patient visits to doctors result in a prescription written for a medicine that people retrieve from a pharmacy, whether retail in the local community or via mail order for a maintenance drug. This one transaction generates a lot of data points, which individually have a lot of importance for the individual patient. Mashed with other patients’, prescription drug utilization data can combine with more data to be used for population health, cost-effectiveness, and other constructive research pursuits. At HIMSS19, there’s an entire day devoted to a Pharma Forum on Tuesday 12 February, focusing on pharma-provider-payor collaborations. Allocating a full

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In 2023, the U.S. Will Still Be the #1 Prescription Drug Spender in the World, IQVIA Forecasts

Today, as Congress kicks off hearings about the cost of prescription drugs in the United States, IQVIA published its 2019 report on The Global Use of Medicine in 2019 and Outlook to 2023. The top-line of the research is the robust pharma market growth will be driven by two factors, and limited by two others: spending in the U.S. and emerging markets (coined “pharmerging” by IQVIA) will push up spending, while limiting factors on growth will be increasing generics and expiration of brand patents. The U.S. will continue to be the number 1 prescription drug spender in the world to

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The Consumer as Payor – Retail Health at CES 2019

All health/care is retail now in America. I say this as most people in the U.S. who have health insurance must take on a deductible of some amount, which compels that insured individual to spend the first dollar on medical services up until they meet their financial commitment. At that point, health insurance kicks in, and then the insured may have to spend additional funds on co-payments for general medicines and services, and coinsurance for specialty drugs like injectables and high-cost new therapies. The patient is a consumer is a payor, I asserted today during my talk on the expanding

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Costs, Consumerism, Cyber and Care, Everywhere – The 2019 Health Populi TrendCast

Today is Boxing Day and St. Stephens Day for people who celebrate Christmas, so I share this post as a holiday gift with well-wishes for you and those you love. The tea leaves have been brewing here at THINK-Health as we prepared our 2019 forecast at the convergence of consumers, health, and technology. Here’s our trend-weaving of 4 C’s for 2019: costs, consumerism, cyber and care, everywhere… Health care costs will continue to be a mainstream pocketbook issue for patients and caregivers, with consequences for payors, suppliers and ultimately, policymakers. Legislators inside the DC Beltway will be challenged by the

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Healthcare Is Local: Channeling Tip O’Neill in the 2018 Midterm Election Results

As Tip O’Neill’s mantra goes, “All politics is local.” In the U.S. 2018 midterm elections, healthcare voting seems to have translated as a local issue, falling into O’Neill’s axiom. In this election, healthcare was the most important voting issue for consumers, PwC found, ranking above the economy, national security, and education. On this morning after 2018 midterm election results are (mostly) out, it looks like healthcare was a local and state issue for U.S. 2018 midterm voters. The Democrats flipped more than 23 seats in the U.S. House of Representatives to gain control of that chamber. The Senate is up

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Koen Kas, the Gardener of Health Tech Delights

The future of healthcare is not about being sick, Prof. Dr. Koen Kas believes. Having spent many years in life sciences in both research and as an entrepreneur, Koen now knows that getting and staying healthy isn’t about just developing medicines and med-tech: optimally, health requires a tincture of delight, Koen advises in his breakthrough, innovative book, Your Guide to Delight. Healthcare must go beyond traditional user-centered design, Koen’s experience has shown, and aspire toward design-to-delight. The concept of “delight” in healthcare, such as we experience in hospitality, grocery stores, and entertainment, is elusive. I’ve observed this, too, in my

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CVS + Aetna: Inflection Point in US Healthcare, Merger Approved Update

    CVS Health’s acquisition of Aetna was approved this week by U.S. Federal regulators after months of scrutinizing the antitrust-size-market control implications of the deal. I wrote this post on the deal as an inflection point in American healthcare on 3rd December 2017 when CVS and Aetna announced their marriage intentions. This post updates my initial thoughts on the deal, given the morphing US healthcare market on both the traditional health services front and fast-evolving retail health environment. The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal

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Prescription Drugs: From Costs and Bad Reputation to Civica Rx and Amazon to the Rescue

The prices of medicines prescribed in outpatient settings rose, on average, 10.3% in 2018. Wages increased about 2.6%, and consumer prices, 1.3%, based on the 2019 Segal Health Plan Cost Trend Survey. Segal forecasts that medical cost trends will moderate for 2019, lower than 2018 rates. But to the patient, now feeling like a consumer dealing with high-deductibles and the growing sticker shock of specialty drug prices, a so-called “moderate” trend still feels like a big bite in the household budget. Specifically, specialty drug trend is expected to be 14.3% in 2019, compared with 17.7% in 2018 — still several

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Consumers Changing the Channel on Where They Shop for Health

Consumers who have long purchased over-the-counter medicines, anti-dandruff shampoo, whitening toothpaste, and cosmetics-with-benefits at food, drug and mass merchant retailers are switching to other places to shop for health, new data from AT Kearney and GMDC have found. The two organizations have collaborated to launch a new  benchmarking study into health-beauty-wellness (HBW) sales, launched this weekend at the GMDC HBW Conference in Orlando. Overall, 2017 to 2018 year-on-year, HBW sales were flat-to-no growth, notwithstanding the consumer and influencer buzz around the categories.       This study uncovered some very important trends underneath the macro numbers that tell a story

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Self-Care is Healthcare for Everyday People

Patients are the new healthcare payors, and as such, taking on the role of health consumers. In fact, health and wellness consumers have existed since a person purchased the first toothpaste, aspirin, heating pad, and moisturizing cream at retail. Or consulted with their neighborhood herbalista, homeopathic practitioner, therapeutic masseuse, or skin aesthetician. Today, the health and wellness consumer can DIY all of these things at home through a huge array of products available in pharmacies, supermarkets, Big Box stores, cosmetic superstores, convenience and dollar stores, and other retail channels – increasingly, online (THINK, of course, of Amazon — more on

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Pharmacies Continue to Earn Consumer-Love

Among industries that consumers frequent, one continues to delight people more than most: pharmacies. J.D. Power’s 2018 ratings on U.S. pharmacies finds that consumers do indeed still love their pharmacies after ten years of rating customer satisfaction with brick-and-mortar and mail order channels. “U.S. consumers love their pharmacies,” J.D. Power asserts in its first study finding. In terms of total points across all pharmacies, Wegmans pharmacy was the overall top-ranked Rx retail channel with a total ranking of 906 out of 1,000 points. J.D. Power evaluated four categories of pharmacy: Brick-and-mortar chain drug stores, ranking Good Neighbor Pharmacy number one.

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Surprise, Surprise: Most Americans Have Faced a “Surprise” Medical Bill

Most Americans have been surprised by a medical bill, a NORC AmeriSpeak survey found. Who’s responsible? Nearly all Americans (86% net responsible) first blame health insurance companies, followed by hospitals (82%). Fewer U.S. patients blamed doctors and pharmacies, although a majority of consumers still put responsibility for surprise healthcare bills on them (71% and 64% net). Most of the surprise bills were for charges associated with a physician’s service or lab test. Most surprise charges were not due to the service being excluded from a health plans provider network. The poll was conducted among 1,002 U.S. adults 18 and over

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Americans Growing Health Consumer Muscles and Knowledge: McKinsey

Most Americans are healthcare cost-conscious, concerned about various kinds of healthcare expenses, data from McKinsey’s research has found presented in Healthcare consumerism 2018: An update on the  journey. McKinsey’s consumer research identified four themes: affordability as a pressing consumer concern; lack of continuity of care for many consumers; growing demand for digital convenience and access; and, greater willingness to partake in health care programs that lower costs, if made available. Personal and household concerns about healthcare costs is top-of-mind for U.S. consumers, as I’ve pointed out in previous studies such as Kaiser Family Foundation’s look at top “pocketbook issues,” here on

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Employers Take on Health Activism, Embracing Behavioral Health, Virtual Care, AI, and Transparency

More U.S. employers are growing activist roles as stakeholders in the healthcare system, according to the 2019 Large Employers Health Care Strategy and Plan Design Survey from the National Business Group on Health (NBGH). Consider the Amazon-Berkshire Hathaway-JPMorgan Chase link up between Jeff Bezos, Warren Buffet, and Jamie Dimon, as the symbol of such employer-health activism. The NBGH report is based on survey results collected from 170 large employers representing 13 million workers and 19 million covered lives (families/dependents). This annual survey is one of the most influential such reports released each year, providing a current snapshot of large employers’ views

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Healthcare’s Profits Will Be Dramatically Redistributed as Care Shifts to Consumers: Accenture

All sectors who are stakeholders in the healthcare ecosystem aren’t created equal, Accenture explains in their report, Healthcare’s future winners and losers. Observing the influx of new flavors of entrants like Amazon and Google, start-ups like Iora Health, Oscar and FetchMD, begs the question: how will legacy healthcare system players fare? Who will survive, and what will be the success factors that bolster long-term viability? To answer that question, Accenture points to three market trends that set “new rules” in healthcare: Blurred lines, which are the grey areas and adjacencies between technology, service, finance, and retail The middle of nowhere,

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