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The Social Determinants of Food for Health, Farms, and the Economy

America’s agricultural roots go deep, from the native Patuxet tribe that shared maize with Mayflower settling Pilgrims in southern New England, to biodynamic and organic winemakers in Sonoma County, California, operating today. In 2016, 21.4 million full- and part-time jobs were related to agriculture and food sectors, about 11% of total U.S. employment. Farming is an integral part of a nation’s food system, so the Union of Concerned Scientists developed the 50-State Food System Scorecard to gauge the state of farming and food in the U.S. on several dimensions: diet and health outcomes, farming as an industry and economic engine,

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Healthcare Policies We Can Agree On: Pre-Existing Conditions, Drug Prices, and PillPack – the June 2018 KFF Health Tracking Poll

There are countless chasms in the U.S. this moment in social, political, and economic perspectives. but one issue is on the mind of most American voters where there is evidence of some agreements: health care, as evidenced in the June 2018 Health Tracking Poll from Kaiser Family Foundation. Top-line, health care is one of the most important issues that voters want addressed in the 2018 mid-term elections, tied with the economy. Immigration, gun policy, and foreign policy follow. While health care is most important to voters registered as Democrats, Republicans rank it very important. Among various specific health care factors, protecting

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Consumers Grow to View Food as the Prescription

Taking a page out of Hippocrates, “let food be thy medicine and medicine be thy food,” consumers are increasingly shopping for groceries with an appetite for health, found in research published this week by the International Food Information Center cleverly titled, An Appetite for Health. The top line: over two-thirds of older adults are managing more than one chronic condition and looking to nutrition to help manage disease. Most consumers have that “appetite for health” across a wide range of conditions, with two rising to the top as “extremely important:” heart health and brain function. Other top-ranked issues are emotional/mental

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Doing Less Can Be Doing More for Healthcare – the Biggest Takeaway From ASCO 2018

Less can lead to more for so many things: eating smaller portions, lowering sugar consumption, and driving less in favor of walking or cycling come to mind. When it comes to healthcare utilization, doing less can also result in equal or even better outcomes. Groundbreaking research presented at this week’s ASCO meeting found that some women diagnosed with certain forms of cancer do not benefit from undergoing chemotherapy. The American Society of Clinical Oncology (ASCO) is one of the largest medical meetings annually, and at this huge meeting these research results for the TAILORx trial were huge news with big

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The US Covered Nearly 50% of Global Oncology Medicine Spending in 2017 – a market update from IQVIA

“We are at a remarkable point of cancer treatment,” noted Murray Aitken, Executive Director, IQVIA Institute for Human Data Science, in a call with media this week. 2017 was a banner year of innovative drug launches in oncology, Aitken coined, with more drugs used more extensively, driving improved patient for people dealing with cancer. This upbeat market description comes out of a report on Global Oncology Trends 2018 from the IQVIA Institute for Human Data Science. The subtitle of the report, “Innovation, Expansion and Disruption,” is appropriately put. The report covers these three themes across four sections: advances in therapies,

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Health Care for a Typical Working Family of Four in America Will Cost $28,166 in 2018

What could $28,166 buy you in 2018? A new car? A year of your child’s college education? A plot of land for your retirement home? Or a year of healthcare for a family of four? Welcome to this year’s edition of the Milliman Medical Index (MMI), one of the most important forecasts of the year in the world of the Health Populi blog and THINK-Health universe. That’s because we’re in the business of thinking about the future of health and health care through the health economics lens; the MMI is a key component of our ongoing environmental analysis of the

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Consumers Shop Food for Health, But Cost Is a Barrier to Healthy Eating

One-third of Americans are following a specific eating pattern, including intermittent fasting, paleo gluten-free, low-carb, Mediterranean diet, and Whole 30, among dozens of other food-styles in vogue in 2018. It’s mainstream now that Americans are shopping food for health, with eyes focused on heart health, weight, energy, diabetes, and brain health, according to the 2018 Food & Health Survey from IFIC, the International Food Industry Council Foundation. But underneath these healthy eating intentions are concerns about the cost of nutritious foods, IFIC reports. And this aspect of home health economics can sub-optimize peoples’ health. Consider the first graph on consumers’

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The Gap Between the Trump Administration’s Promise of Reducing Rx Costs for Consumers and What People Really Want

This is what happened to pharma stock prices on Friday after President Trump and Secretary of Health and Human Services Alex Azar outlined their new policies focusing on prescription drug prices. The graph is the Nasdaq U.S. Smart Pharmaceuticals Index (NQSSPH) from May 11, 2018, the date when POTUS and Secretary Azar made their announcement. What this upward driving curve indicates, from the start of stock trading in the morning until the ring of the closing bell, is that the pharma industry players, both manufacturers and PBMs, were quite delighted with what they heard. The blueprint for restructuring the prescription drug industry,

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Americans’ Trust in the Healthcare System Low Compared to Rest-of-World’s Health Citizens

In the U.S., trust in the healthcare industry declined by 9 percentage points in just one year, declining from 62% of people trusting — that’s roughly two-thirds of Americans — down to 53% — closer to one-half of the population. I covered the launch of the 2018 Edelman Trust Barometer across all industries here in Health Populi in January 2018, when this year’s annual report was presented at the World Economic Forum in Davos as it is each year. The Edelman team shared this detailed data on the healthcare sector with me this week, for which I am grateful. Check

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Pharma Spending Gone Bipolar: Generics At One End, Specialty Drugs on the Other

While the use of medicines continues to rise in the U.S., spending grew by only 0.6% in 2017 after accounting for discounts and rebates. In retail and mail-order channels, net spending fell by 2.1%. Prescription drug spending on branded products grew nearly $5 billion less than in 2016; generic drug spending fell by $5.5 billion, according to Medicine Use and Spending in the U.S., a report from the IQVIA Institute for Health Data Science. The report reviews medicines spending in 2017 looking forward to 2022. There were over 5.8 billion prescriptions dispensed in 2017, and generic drugs accounted 90% of

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Food as Medicine Update: Danone Goes B-Corp, Once Upon a Farm Garners Garner, and Livongo Buys Retrofit

As the nation battles an obesity epidemic that adds $$ costs to U.S. national health spending, there are many opportunities to address this impactful social determinant of health to reduce health spending per person and to drive public and individual health. In this post, I examine a few very current events in the food-as-medicine marketspace. Big Food as an industry gets a bad rap, as Big Tobacco and Big Oil have had. In the case of Big Food, the public health critique points to processed foods, those of high sugar content (especially when cleverly marketed to children), and sustainability. But

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How Walmart Could Bolster Healthcare in the Community

Walmart has been a health/care destination for many years. The company that defined Big Box stores in their infancy grew in healthcare, health and wellness over the past two decades, pioneering the $4 generic prescription back in 2006. Today, that low-cost generic Rx is ubiquitous in the retail pharmacy. A decade later, can Walmart re-imagine primary care the way the company did low-cost medicines? Walmart is enhancing about 500 of 3500 stores, and health will be part of the interior redecorating. Walmart has had ambitious plans in healthcare since those $4 Rx’s were introduced. Here’s a New York Times article from

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Livongo and Cambia Allying to Address Chronic Disease Burden and Scale Solutions to Consumers

Chronic diseases are what kill most people in the world. In the U.S., the chronic disease burden takes a massive toll on both public health and mortality, accounting for 7 in 10 deaths in America each year. That personal health toll comes at a high price and proportion of national health expenditures. A new alliance between Livongo and Cambia Health seeks to address that challenge, beginning with diabetes and scaling to other chronic conditions. Livongo has proven out the Livongo for Diabetes program, which has demonstrated positive outcomes in terms of patient satisfaction and cost-savings. The plan with Cambia is

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What Would Healthcare Feel Like If It Acted Like Supermarkets – the 2018 Temkin Experience Ratings

U.S. consumers rank supermarkets, fast food chains, retailers, and banks as their top performing industries for experience according to the 2018 Temkin Experience Ratings. Peoples’ experience with health plans rank at the bottom of the roster, on par with rental cars and TV/Internet service providers. If there is any good news for health plans in this year’s Temkin Experience Ratings compared to the 2017 results, it’s at the margin of “very poor” performance: last year, health plans has the worst performance of any industry (with the bar to the furthest point on the left as “low scoring”). This year, it

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Please Stop Hating on Amazon, Mr. President. It’s Americans’ Favorite Brand.

The most beloved company in America is Amazon, according to the 2018 Harris Poll Reputation Quotient Rankings which were published on 22nd March 2018. This was the third year in a row that Amazon garnered the top position in this corporate reputation poll, which gauges consumers’ views on workplace environment, social responsibility, emotional appeal, financial performance, vision and leadership, and products and services. Mr. President, why pick on Americans’ favorite brand? The brand defines the 2018 consumer’s benchmark for a best-retail experience, which is what people increasingly expect across the various interactions they have throughout a day. [As a sidebar,

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Rx 2018: A New Era of Specialty Drugs, Telehealth, Mobile Apps and Value, IQVIA Reports

In 2018, spending on branded prescription drugs will fall in wealthy countries, while spending on specialty drugs will increase, resulting in flat medicines spending. In the U.S., net spending on medicines will fall in 2018 and remain flat at about $800 per person, according to forecasts in 2018 and Beyond: Outlook and Turning Points, from the IQVIA Institute for Human Data Science. “Concerns about existing medicine costs have captured significant attention,” the introduction warns, setting the stage for slowing growth. Key factors for slow growth include payor concerns about budgets and the consideration of value when deciding on access for new

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How Albertsons Grocery Stores and Rite Aid Can Help Remake Healthcare

Albertsons, the grocery group with popular brands like Acme, Safeway, and Vons, announced a merger with Rite Aid, the retail pharmacy chain. The deal has been discussed as Albertsons’ move to succeed in light of growing competition from Amazon and Whole Foods, the proposed CVS/Aetna merger, and Walgreens’ possible purchase of AmerisourceBergen (finalizing its acquisition of over 1,900 Rite Aid stores). If played out well, the combination could become an important player in the evolving U.S. health/care ecosystem that brings a self-care front-door closer to consumers, patients and caregivers. “The new company is expected to serve more than 40 million

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Heart-Love – Omron’s Holy Grail of Blood Pressure Tracking on the Wrist

It’s February 1st, which marks the first of 28 days of American Heart  Month – a time to get real, embrace, learn about, and engage with heart health. Heart disease kills 610,000 people in the U.S. every year, equal to 1 in 4 deaths in America. It’s the leading cause of death for both men and women in the U.S. Knowing your blood pressure is an important step for managing the risks of heart disease. That hasn’t yet been available to those of us who quantify our steps, weight, sleep, food intake, and other health metrics. In 2017, Hugh Langley

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Sleepless in America: Prescribing Sleep at CES 2018

Las Vegas is known for glitzy neon lights brightly shining along the strip and casinos without clocks reminding us of the time, stimulating us to stay awake at all hours of day or night. But inside the Sands Convention Center are a couple dozen technologies and connected things designed to put us to sleep, which is a growing digital health category at the annual CES. Form factors for sleep-things at CES 2018 include masks, beds, lights, apps, and even a huggable sleep “robot.” Why is sleep seeing such a huge influx on the consumer tech-supply side? Because there’s growing, mainstream

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Nurses Rate Highest for Ethics in American Professions Once Again in Gallup Poll

Nurses working in the U.S. are number one when it comes to ethics and honesty, the Gallup Poll found for the sixteenth year in a row. After nurses, military officers, grade school teachers, medical doctors and pharmacists rank second through fifth in ethical-line behind top-rated nursing. It’s important to note that consumers have ranked pharmacists and doctors in second and third place in this annual survey for many years. This year, both professions fall below the military and teachers. Nurses have been #1 in this study every year since Gallup launched the survey in 1999, except for 2001 when firefighters topped

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Health Consumers Face the New Year Concerned About Costs, Security and Caring – Health Populi’s 2018 Forecast

As 2018 approaches, consumers will gather healthy New Year’s Resolutions together. Entering the New Year, most Americans are also dealing with concerns about healthcare costs, cybersecurity, and caring – for physical health, mental stress, and the nation. Healthcare costs continue to be top-of-mind for consumer pocketbook issues. Entrenched frugality is the new consumer ethos. While the economy might be statistically improving, American consumers’ haven’t regained confidence. In 2018, frugality will impact how people look at healthcare costs. 88% of US consumers are likely to consider cost when selecting a healthcare provider, a Conduent survey found. Physicians know this: 81% of

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CVS + Aetna: An Inflection Point for American Healthcare

The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal is valued at $69 billion. I wrote about this inflection point for U.S. healthcare four weeks ago here in Health Populi. CVS is both the biggest pharmacy and pharmacy benefit manager in the U.S., as the first chart shows. In my previous post, I talked about the value of vertical integration bringing together the building blocks of retail pharmacy and pharmacist care, retail clinics, the PBM (Caremark), along with Aetna’s health plan member base and business. As Amazon and other

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High-Deductibles Do Not Automatically Inspire Healthcare Consumerism

It takes more than enrolling in a high-deductible health plan (HDHP) for someone to immediately morph into an effective health care “consumer.” Research from Dr. Jeffrey Kullgren and his team from the University of Michigan found that enrollees in HDHPs could garner more benefits from these plans were people better informed about how to use them, including how to save for them and spend money once enrolled in them. The team’s research letter was published in JAMA Internal Medicine on 27 November 2017. The discussion details results of a survey conducted among 1,637 people 18 to 64 years of age

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Rx Delivery to the Patient’s Door: Home Is Where the Health/Care Is

Talk about the last mile in healthcare. CVS Pharmacy will deliver prescription drugs to patients’ homes, the company announced this week. “Same-day prescription delivery gives customers the easy option of having the pharmacy they trust deliver right to their front door at no cost,” Helen Foulkes, President of CVS Pharmacy, said in the press release. Rx home delivery may not be “the” last mile to conquer all healthcare access challenges, but it’s nonetheless a signal that healthcare industry suppliers are focusing on helping patients streamline their health-consumer lives. In this case, it’s also CVS morphing towards Amazon’s Prime delivery model. Amazon

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A Health Consumer Perspective on CVS+Aetna

  A response to Amazon’s potential moves in healthcare and pharmacy…strategic positioning for the post-Trump healthcare landscape…vertical integration to better manage healthcare utilization and costs…these, and other rationale have been offered by industry analysts and observers of the discussions between CVS and Aetna, for the former to acquire the latter. “A pharmacy chain buying a health insurance company?” many have asked me over the past few days. These inquiring minds include people who work both inside and outside of health/care. I ask back: in 2017 and in the future, “What is a pharmacy? What is a health plan?” See the

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CVS Health in Talks to Acquire Aetna – The Changing Retail Health Landscape

Just a few days since CVS Health announced the company would be working with mega-health insurer Anthem on a prescription drug management program, the pharmacy chain today is reportedly in talks to buy Aetna, the national health insurance company, according to CNBC and other credible news outlets like the Wall Street Journal. Remember that Aetna’s bid to acquire Humana was scuttled earlier this year after many months of negotiation and positioning, along with FTC scrutiny about antitrust. That insurance merger “died” on one day in February 2017 along with an Anthem-CIGNA deal, covered here by CNN. A deal between CVS

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Four Things We Want in 2017: Financial Health, Relationships, Good Food, and Sleep

THINK: money and love. To find health, working-aged people seek financial stability and good relationships, according to the Consumer Health POV Report from Welltok, meQuilibrium, and Zipongo, featured in their webinar broadcast today. The online consumer survey was conducted among 2,000 full-time working U.S. adults in August 2017, segmented roughly into thirds by Boomers (37%), Gen Xers (32%), and Millennials (31%). Much lower down the priority list for healthy living are managing food, sleep, and stress based on the poll. Feeling stress is universal across most consumers in each of the three generational cohorts, especially related to work and finance.

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President Trump Utters “M” for Murder, and a $1 MM Price Tag for Rx Therapy – an October 2017 Pharma Update

Last week, President Trump once again used the “M” word (“murder”) in a sentence accusing the pharmaceutical industry of too-high priced products for U.S. health citizens. The sentence included the phrase, “Drug companies are getting away with murder.” That week, USA Today published an article on a new FDA-approved specialty drug therapy that could add up to over a $1 mm price tag. There is much to report in the world of pharmaceutical innovation, pricing, and patient Rx coverage this month. The CVS Health – Epic announcement ranks high in Health Populi’s vision for the evolving health/care ecosystem, bringing together two

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2017 Rx Cost Trend Over 5 Times U.S. Inflation, Segal Projects

Driven by price increases, costs for the prescription drug benefit carve-out will increase 11.6% this year, based on Segal Consulting’s survey report, High Rx Cost Trends Projected to Be Lower for 2018, published today. The report is accessible on the Segal Co. website. While the Segal team expects prescription drug (Rx) benefit plan cost trends to be “less severe” in 2018, Rx cost increases is a top priority for many sponsors of health plans as their rate of increase far exceeds those for inpatient hospital claims or physician expense. Drug costs continue to be the fastest-growing line item in health

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Prescription Drug Coverage at Work: Common, Complex, and Costly

Getting health insurance at work means also having prescription drug coverage; 99% of covered workers’ companies cover drugs, based on the 2017 Employer Health Benefits Survey released by the Kaiser Family Foundation (KFF). I covered the top-line of this important annual report in yesterday’s Health Populi post, which found that the health insurance premium for a family of four covered in the workplace has reached $18,764 — approaching the price of a new 2017 small car according to the Kelley Blue Book. The complexities of prescription drug plans have proliferated, since KFF began monitoring the drug portion of health benefits

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Employees Continue To Pick Up More Health Insurance Costs, Even As Their Growth Slows

The average cost of an employer=sponsored health plan for a family reached $18,764 in 2017. While this premium grew overall by a historically relative low of 3.4%, employees covered under that plan faced an increase of 8.3% over what their plan share cost them in 2016, according to the 2017 Employer Health Benefit Survey published today by the Kaiser Family Foundation. [Here’s a link to the 2016 KFF report, which provided the baseline for this 8.3% calculation]. Average family premiums at the workplace rose 19% since 2012, a slowdown from the two previous five-year periods — 30% between 2007 and 2012, and

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Americans and Prescription Drugs: Cost, Misuse, and Self-Rationing

In 2017, Americans’ relationship with prescription drugs can be characterized in three ways: cost-rationing, misuse, and abuse. Three new studies about medicines in America paint this picture, brought to light by the AARP, Truven Analytics, and Quest Diagnostics. First, let’s look at the cost issue covered by AARP. AARP tracks the cost of prescription drugs among its constituents, namely people 50 years of age and over. The data were published in AARP’s Rx Price Watch Report, Trends in Retail Prices of Specialty Prescription Drugs Widely Used by Older Americans, 2006-2015. The average annual cost for one specialty medication used for

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Decline in Pharmacy Reputations Related to Prescription Drug Prices, J.D. Power Finds

Cost is the number one driver among consumers declining satisfaction with pharmacies, J.D. Power found in its 2017 U.S. Pharmacy Study. Historically in J.D. Power’s studies into consumer perceptions of pharmacy, the retail segment has performed very well, However, in 2017, peoples’ concerns about drug prices negatively impact their views of the pharmacy — the front-line at the point-of-purchase for prescription drugs. In the past year, dissatisfaction with brick-and-mortar pharmacies related to the cost of drugs and the in-store experience. For mail-order drugs, consumer dissatisfaction was driven by cost and the prescription ordering process. Among all pharmacy channels, supermarket drugstores

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Transparency in Drug Prices, from OTC to Oncology

While on vacation in Bermuda, I found a box of private label ibuprofen for $2.45 for 20 – 200mg tablets, and one for Advil PM for $10.50 for the same number of pills, same strength. I’ve just returned from a lovely week’s holiday. When I travel, whether for work or vacation, it’s always a sort of Busman’s Holiday for me as I love to seek out health destinations wherever I go. So it was natural for me to spot the Dockyard Pharmacy at the port in Hamilton and wander in. I made my way back to the well-stocked pharmacy counter,

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Patients Want Doctors To Know How Much Their Drugs Cost

  Patients want their doctors to know what their personal costs for medicines are; 42% of patients also believe their doctor is aware of how much they spend on prescription drugs. However, 61% of these people have not talked with doctors about drug prices. Nor do most doctors have access to this kind of information at the individual patient level. One important tactic to addressing overall healthcare costs, and managing the prescription drug line item in those costs, is discussed in Doctors and Pharmacists: An Underused Resource to Manage Drug Costs for Older Adults, a report on a survey sponsored

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Note to Mooch: The ER is Not Universal Health Care

I quote directly from the Twitter feed of Anthony Scaramucci, @scaramucci: “@dhank2525 agree. We already have Univ Health Care, we made decision long ago to treat everyone that enters an emergency room.” Mr. Scaramucci is President Trump’s Communications Chief, replacing Sean Spicer. Mr. Scaramucci is neither veteran journalist nor healthcare policy wonk. He’s a successful businessman, which I respect for his savvy and ability to build a fund, attract investors, and create a media persona which he has telegenically broadcast on CNBC and elsewhere over the past decade. He’s got a engaging public personality, and goes by the moniker, “Mooch.” But

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Pharmacies Morph Into Primary Care Health Destinations

The business and mission of pharmacies are being re-shaped by several major market forces, most impactful being uncertain health reform prospects at the Federal level — especially for Medicaid, which is a major payor for prescription drugs. Medicaid covered 14% of retail prescriptions dispensed in 2016, according to QuintilesIMS; Medicare accounted for 27% of retail prescriptions. “But if affordability, accessibility, quality, innovation, responsiveness and choices are among the standards that will be applied to any future changes, pharmacy has strong legs to stand on,” Steve Anderson, president and CEO of the National Association of Chain Drug Stores, said in the PoweRx Top 50

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Patients Switch Doctors Based on Service, Not Just Care or Costs – Think “Text”

There’s more evidence of shopping behavior among patients: there’s new data showing that patients-as-consumers switch healthcare providers not due to quality of care or costs, but because of lack of service. I discovered one key verb and feature patient-consumers expect from doctors: it’s the ability to text, for appointment reminders, alerts, treatments, and communicating with the practice. SolutionReach, in the business of patient engagement, conducted a survey among 500 consumers asking about primary care providers, communication experience and satisfaction levels. The company presented the research results in a webinar on 29 June 2017. The research was also written up in

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Shopping Food for Health: the 2017 U.S. Grocery Shopper Trends

Wellness is at the grocery store, the vast majority of U.S. health citizens say. 8 in 10 U.S. shoppers are concerned about the nutritional content in the food they eat. As grocery shoppers look for more fresh and less processed foods, grocery stores are seen as trusted allies for meeting wellness needs. Grocers are coupling the growth of more healthy packaged foods in the middle of the store with more fresh and prepared food options that consumers see as healthier than restaurant meals, according to U.S. Grocery Shopper Trends 2017 from FMI (the Food Marketing Institute) and Hartman Group. While

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Global Drug Sales Forecasts Fall For Next Five Years

Total prescription drug sales have been trimmed, based on calculations of EvaluatePharma which forecasts a $390 bn drop in revenues between 2017 and 2022. “Political and public scrutiny over pricing of both new and old drugs is not going to go away,” EvaluatePharma called out in its report. The intense scrutiny on pharma industry pricing was fostered by Martin Shkreli in his pricing of Daraprim (taking a $13.50 product raising the price to $750), Harvoni and Sovaldi pricing for Hepatitis C therapies, and last year’s EpiPen pricing uproar. A May 2017 analysis of prescription drug costs by AARP judges that, “Nothing

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Helping People On A Path to Better Health with CVS @Retail

“Helping people on their path to better health” is the mission-mantra of CVS Health. Re-branded from its previous identity as CVS/pharmacy, the organization convened a Health Innovation Summit with its vendor partners whose products fill the front-of-store shelves to empower, inspire and support consumers to manage health and wellness for themselves and their families. I was grateful for the opportunity to provide the first talk for the day, setting the context for the evolving retail health/care landscape with the consumer at the center. The consumer is, at any point in a 24-hour day: a person wearing many hats (a worker,

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Amazon’s Health Care Building Blocks

In the past few weeks, two announcements from Amazon point to a strategy, whether intended or my dot-connecting, that the ecommerce leader has the health of its customers in its sights. In late May, CNBC first published the news that Amazon was seeking out a candidate to be a general manager for a pharmacy business. Here’s the video telling the story. Getting into the retail pharmacy channel is in itself a huge message to this health industry segment, which is very competitive between chain pharmacies (led by CVS, Walgreens, and Rite-Aid), grocery pharmacies (the largest of which are Kroger and

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Shopping Food for Health is Mainstream, But Nutrition Confusion is Super-Sized

Americans are overwhelmingly keen to use food for their health, and overwhelmed by the amount of nutrition information they face to make good shopping and eating decisions. Welcome to “food confusion,” a phenomenon gleaned from the 12th Annual Food and Health Survey conducted by the International Food Information Council Foundation (IFIC). This 12th annual survey from IFIC finds that most Americans take many steps to be healthy. In the past year, the most popular health-steps include drinking more for hydration, making small changes to achieve a healthier diet, consuming smaller portions, eating more fruits and vegetables, and eating more whole grains.

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So Far, Food and Nutrition Aren’t Baked Into President Trump’s Health Policies

The FDA is delaying the public posting of calorie counts, a policy that President Obama’s administration had pioneered for public health and wellness. Menu labeling has applied to grocery stores, gas stations, convenience stores, movie theaters and sports stadiums that sell prepared food. “Health and Human Services Secretary Tom Price said the menu labeling requirements would be ‘unwise and unhelpful’ as currently written, and added that the FDA is looking for ways to make the rules ‘more flexible and less burdensome.'” Former FLOTUS Michelle Obama took on the issue of healthy food and fitness for America’s children. Except for keeping her White

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Medicines in America: The Half-Trillion Dollar Line Item

Prescription drug spending in the U.S. grew nearly 6% in 2016, reaching $450 billion, according to the QuintilesIMS Institute report, Medicines Use and Spending in the U.S., published today. U.S. drug spending is forecasted to grow by 30% over the next 5 years to 2021, amounting to $610 billion. In 2016, per capita (per person) spending on medicines for U.S. health citizens averaged $895. Specialty drugs made up $384 of that total, equal to 43% of personal drug spending, shown in the first chart. Spending on specialty drugs continues to increase as a proportion of total drug spending: traditional medicines’ share

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The Power of Joy in Health and Medicine – Learning From Dr. Regina Benjamin

Former Surgeon General Dr. Regina Benjamin was the first person who quoted to me, “Health isn’t in the doctor’s office. It’s where people live, work, play and pray,” imparting that transformational mantra to me in her 2011 interview with the Los Angeles Times. I wrote about that lightbulb moment here in Health Populi. Dr. Benjamin was the 18th Surgeon General, appointed by President Obama in 2009. As “America’s Doctor,” she served a four-year term, her mission focused on health disparities, prevention, rual health, and children’s health. Today, Dr. Benjamin wears many hats: she’s the Times Picayune/NOLA.com professor of medicine at

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Diet, Surgery and Pharmacy – The Pillars of Healthcare for 500 Years

Healthcare was based on three pillars in 16th century Florence, Italy: diet, surgery, and pharmacy. Five centuries later, not much has changed in Italy or the U.S. But how healthcare gets funded and delivered in the context of these pillars significantly varies between the two countries, and impacts each nation’s health. To put this in context, visiting the Biblioteca Medicea Laurenziana (the Medici’s Laurentian Library) today in Florence was a trip through medical-surgical history, starting in the second half of the 16th century. The design of this magnificent library’s foyer and reading room was initially conceived by Michelangelo. The reading room

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The Pharmacy as Herbalist – An Italian Prescription

CNN called it, “the ancient perfume store you never heard of,” but the Officina Profumo-Farmaceutica di Santa Maria Novella had its literal roots in medicinal herbs. With scents wafting onto a 13th century Florence piazza, the Farmacia now operates as a pharmacy storefront for homeopathic and herbal supplements, along with perfumes and home scents. A visit to the pharmacy today is a journey into medicinal time-travel, back to the year 1221. I spent time in the pharmacy today to learn about the literal roots of the shop in medicinal herbs cultivated in a monastery garden and reformulated by monks into

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The Healthcare Reform Issue Americans Agree On: Lowering Rx Costs

Yesterday, the Tweeter-in-Chief President Donald Trump tweeted, “I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!” Those 140 characters sent pharma stocks tumbling, as illustrated by the chart for Mylan shares dated 7 March 2017. This is one issue that Americans across the political spectrum agree on with the POTUS. The latest Zogby poll into this issue, conducted for Prescription Justice, found 3 in 4 Americans agree that pharmaceutical companies are “getting away with murder,” as President Trump said in a TIME magazine interview

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Marketing Medicines: Going Boldly and Accessibly for Rx

Over the past two weeks, we see two marketing campaigns emerge to market medicines: first, from the branded pharmaceutical association PhRMA, the #GoBoldly initiative with a theme of innovation and personalized medicine. Second, there’s a campaign from the Generic Pharmaceutical Association (GPhA), rebranding the organization as the Association for Accessible Medicines with the tagline, “keep medicines in reach.” What’s this all about? To put these marketing initiatives in context, let’s start with the publication of Express Scripts 2016 Drug Trend Report. “Drug trend” is short-hand for growth in prescription drug spending, year on year. The first graph illustrates the price index

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Americans Far More Likely to Self-Ration Prescription Drugs Due To Cost

Americans are more than five times more likely to skip medication doses or not fill prescriptions due to cost than peers in the United Kingdom or Switzerland. U.S. patients are twice as likely as Canadians to avoid medicines due to cost. And, compared with health citizens in France, U.S. consumers are ten-times more likely to be non-adherent to prescription medications due to cost. It’s very clear that more consumers tend to avoid filling and taking prescription drugs, due to cost barriers, when faced with higher direct charges for medicines. This evidence is presented in the research article, Cost-related non-adherence to prescribed

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Pharma’s Branding Problem – Profits Over Patients

Nine in 10 U.S. consumers think pharma and biotech put profits above patient interests, according to the latest Harris Poll studying reputation equity across organizations serving health care. Notice the relatively low position of the green bars in the first chart (with the exception of the impression for “strong financial performance); these are the pharma/biotech consumer impressions. The health industry stakeholders consumers believe would more likely place them above making money are health care providers, like doctors and nurses, hospitals, and pharmacists. Health insurance companies fare somewhat better than pharma and biotech in this Poll, although rank low on social

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More Consumers Use Retail Health Clinics for Healthcare Management, Harris Finds

1 in 5 U.S. adults used a retail clinic in 2016. Increasingly, health consumers seek care from retail clinics for more complex healthcare services beyond flu shots and pre-school exams, according to the Harris Poll’s survey, One in Five Adults Turn to Retail Health Clinics for Treatment, Prevention, and More, published January 5, 2017. Additional points the poll revealed are worth attention for public health policy purposes: Twice as many people who identify as LGBT turn to retail clinics than others (35% vs. 18%) Older people frequent retail clinics for flu vaccines more than younger people do More younger men

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Nursing Is Seen As The Most Ethical Profession in America; Congress Members, Least

Nurses rank, by far, the top profession for honest and ethics in the U.S. in the 2016 version of the annual Gallup poll on ethics in professions, Americans Rate Healthcare Providers High on Honest, Ethics, published this week. Since 1999, nurses have been #1 in this survey except for the year 2001, when firefighters scored the top spot in light of the 9/11 attack. Another consistency in this survey among U.S. consumers is that pharmacists and physicians top the list once again, after nurses, and the most-trusted professions in America. At the bottom of the roster, as in 2015, are Members

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Retail Trumps Healthcare in 2017: the Health Populi Forecast for the New Year

Health citizens in America will need to be even more mindful, critical, and engaged healthcare consumers in 2017 based on several factors shaping the market; among these driving forces, the election of Donald Trump for U.S. president, the uncertain future of the Affordable Care Act and health insurance, emerging technologies, and peoples’ growing demand for convenience and self-service in daily life. The patient is increasingly the payor in healthcare. Bearing more first-dollar costs through high-deductible health plans and growing out-of-pocket spending for prescription drugs and other patient-facing goods and services, we’re seeking greater transparency regarding availability, cost and quality of

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You Better Watch Out, You Better Not Cry, Pharma: Donald Trump is Coming to Town

Based on a TIME magazine interview conducted today with President-Elect Donald Trump, the pharmaceutical and life science industries may expect to find coal in their Christmas stocking, and tougher pricing constraints in 2017. “I’m going to bring down drug prices,” Mr. Trump said, quoted on the TIME website naming him Person of the Year. “I don’t like what’s happened with drug prices.” As CNN put it, “Trump put the entire drug industry on notice on Wednesday in an interview with Time.” In fact, Donald Trump’s campaign website talked about drug importation as one potential tactic consumers could potentially use to

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A Growing Medicines Bill for Global Health Consumers to 2021

The global market for spending on medicines will high $1.5 trillion by 2021, according to the latest forecast from QuintilesIMS. Drug spending grew about 9% in the past two years, and is expected to moderate to 4 to 7 percent annually over the next five years. That dramatic 9% growth was heavily driven by new (expensive) specialty drugs to treat Hepatitis C (e.g., Harvoni and Sovaldi) and cancer therapies that hit the market in the past couple of years. There will be a “healthy level” of new innovative meds coming out of the drug pipeline in the next several years

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Fighting Cancer with Hormel Vital Cuisine – Food as Medicine Update

Think “Hormel,” and you may have visions of SPAM, Chi-Chi’s salsa, Skippy peanut butter, and Dinty Moore corned beef hash. So what’s Hormel doing in the title of a Health Populi post, anyway, you might ask? Like many food companies, Hormel is broadening its product portfolio expanding with health. The company isn’t just moving to healthy eating for wellness’s sake, but boldly going where most food companies haven’t yet gone: developing products for people battling cancer. Vital Choices, a well-titled line of frozen meals, was developed by Hormel in collaboration with the American Cancer Society, Cancer Nutrition Consortium, the Culinary Institute

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See Me, Feel Me, Touch Me, Heal Me – What The Who’s Tommy Can Teach Healthcare

“See me, feel me, touch me, heal me,” is the lyrical refrain from The Who’s Tommy. These eight words summarize what Deloitte has learned from the firm’s latest look into healthcare consumers, published in the report, Health plans: What matters most to the health care consumer. U.S. consumers’ demands for health care are for: Personalization from doctors, hospitals, and other care providers — the most important priority; Economically rational coverage and care choices; Convenience-drive access and care experience; and, Digitally connected care. Personalization is Job 1: “Consumers want to be heard, understood, and given clear directions through a personalized health care

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Self-Care Is the Best Healthcare Reform

The greater a person’s level of health engagement, the better their health outcome will be. Evidence is growing on the return-on-investment for peoples’ health activation and how healthy they are. That ROI is both in survival (mortality) and quality of life (morbidity), as well as hard-dollar savings — personally bending-the-healthcare-cost-curve. But people are more likely to engage in “health” than “healthcare.” We’d rather ingest food-as-medicine than a prescription drug, use walking in a lovely park for exercise, and laugh while we’re learning about how to manage our health insurance benefits. Thus, Campbell’s Soup Company and Hormel are expanding healthy offerings,

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Consumers Feel More Respect from Personal Care and Grocery Brands Than Pharma or Insurance

People feel like get-no-respect Rodney Dangerfield when they deal with health insurance, government agencies, or pharma companies. Consumers feel much more love from personal care and beauty companies, grocery and fitness, according to a brand equity study by a team from C Space, published in Harvard Businss Review. As consumer-directed health care (high deductibles, first-dollar payments out-of-pocket) continues to grow, bridging consumer trust and values will be a critical factor for building consumer market share in the expanding retail health landscape. Nine of the top 10 companies C Space identified with the greatest “customer quotient” are adjacent in some way to health:

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43% of Americans Worry About How They’ll Pay for Health Care

4 in 10 Americans are worried about how they’ll pay for health care, according to Americans’ Views on Current Trade and Health Policies, a poll conducted jointly between the Harvard T.H. Chan School of Public Health and Politico. There are no significant party differences between Democrats and Republicans regarding peoples’ worrying about their ability to pay medical costs in the next year. But there are differences in geography, with 53% of people in the South significantly more worried about health care costs compared with other regions of the U.S. Who’s to blame for the high costs of health care that

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Healthcare Stakeholders’ Kumbaya Moment at Walmart’s Retail Health Summit

Walmart is already in the healthcare business, serving 140 million customer visits weekly, millions of whom fill prescriptions at the store pharmacy, seek personal care in the health and beauty aisles, track blood pressure using a Higi health kiosk, and shop for healthier foods in the grocery aisles. The world’s largest company on the Global Fortune 500 list hosted a Retail Health Summit in June, the details of which have been published in a special report by Drug Store News. The Summit, produced by Dan Mack’s Mack Elevation Forum and Drug Store News, convened stakeholders from across the retail health landscape: including

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7 Signs of the Retail Health Revolution

There are many signposts in the marketplace pointing the way toward the new retail health/care for consumers. They include: Food and exercise as the new medicine Loneliness as the new smoking as a health risk Prevention as the new sustainability Home as the new long-term care locus Balancing humanity and technology, the analog and the digital, and Retail as a center of the new healthcare ecosystem. Read more about the 7 Signs of the Retail Health Revolution,  published by Drug Store News. This graphic-rich publication was based on a speech I gave at a recent retail health summit convened with healthcare’s

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Naloxone in Retail Health – Helping The Opioid Epidemic at Pharmacies and Grocery Stores

The ranks of pharmacies making available the overdose reversal medication naloxone without a prescription or seeing a doctor, is fast-growing. These announcements from retail pharmacy chains and grocery stores is a collective retail health-response to the opioid epidemic, a mainstream public health challenge across America. Naloxone is used in the event of an overdose. It can reverse the impacts of opioids, administered by injection or nasal spray. The statistics on opioid overdoses in the U.S. are chilling. Mortality (death rate) from opioid overdose in the U.S. grew 200% since 2000. Deaths have been higher among people between 25 and 44 years of

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Most US Doctors Say They Ration Patients’ Healthcare

Rationing has long been seen as a common practice in national, single-payer health systems like the UK’s National Health Service and Canada’s national health insurance program (known as “Medicare”).  However, over half of U.S. physicians say they ration care to patients. In a peer-reviewed column in the Journal of General Internal Medicine published in July 2016, Dr. Robert Sheeler and colleagues at the Mayo Clinic, University of Iowa, and University of Michigan, found that 53% of physicians surveyed personally “refrained” in the past six months from using specific clinical services that would have provided the “best patient care” due to cost.

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The Future of Retail Health in 2027

As consumers gain more financial skin in the game of paying for health care, we look for more retail-like experiences that reflect the Burger King approach to consuming: having it our way. For health are, that means access, convenience, transparency and fair costs, respect for our time, and a clear value proposition for services rendered. That doesn’t happen so much in the legacy health care system — in hospitals and doctors’ offices. It has already begun to happen in retail health settings and, especially, in the changing nature of pharmacies. Retail Health 2027, a special supplement to Drug Store News

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The Drug Epidemic-Testing and Data Arm the Battle

More than 40 Americans die every day from prescribed opiate overdoses, Dr. Tom Frieden of the CDC has recognized. The harms of pain-killing drugs have been substantial: Dr. Frieden observed, “the prevalence of opioid dependence may be as high as 26% among patients in primary care receiving opioids for chronic non-cancer-related pain.” There were more deaths due to drug overdoses in 2014 than in any previous year, 61% of which involved opioid pain relieving medications such as oxycodone and hydrocodine, and heroin which has grown in use over the past few years. The CDC has recommended that healthcare providers do

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Retail Clinics Continue to Shape Local Healthcare Markets

Retail clinics are a growing source of primary care for more U.S. health consumers, discussed in a review of retail clinics published by Drug Store News in July 2016. There will be more than 2,800 retail clinics by 2018, according to Accenture’s tea leaves. Two key drivers will bolster retail clinics’ relevance and quality in local health delivery systems: Retail clinics’ ability to forge relationships with legacy health care providers (physicians, hospitals); and, Clinics’ adoption and effective use of information technology that enables data sharing (e.g., to the healthcare provider’s electronic health records system) and data liquidity (that is, securely moving

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PwC’s “Behind the Numbers” – Where the Patient Stands

The growth of health care costs in the U.S. is expected to be a relatively moderate 6.5% in 2017, the same percentage increase as between 2015 and 2016, according to Medical Cost Trend: Behind the Numbers 2017, an annual forecast from PwC. As the line chart illustrates, the rate of increase of health care costs has been declining since 2007, when costs were in double-digit growth mode. Since 2014, health care cost growth has hovered around the mid-six percent’s, considered “low growth” in the PwC report. What’s driving overall cost increases is price, not use of services: in fact, health care

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Love, Mercy and Virtual Healthcare

Virtual healthcare – call it telemedicine, remote monitoring, or the umbrella term, telehealth – is coming of age. And it’s a form of healthcare that a growing percentage of consumers in the U.S. want. I’m in Branson, Missouri, today, meeting with the State’s Hospital Association to talk about consumers in the growing DIY health/care economy. So “telehealth,” broadly defined, is part of my message. This week Xerox announced its survey results focused on consumers’ interests in telehealth. “Xerox helps healthcare providers serve patients anytime, anywhere,” the press release starts. Convenience, cost-savings, and the ability to consult physicians quickly and get e-refills are

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Financial Toxicity: The High Cost of Cancer Drugs in the U.S.

Two news items published in the past week point to the yin/yang of cancer survivorship and the high prices of cancer drugs. The good news: a record number of people in the US are surviving cancer, according to the American Cancer Society. That number is 15.5 million Americans, according to a study in the cancer journal CA. Note the demographics of cancer survivors: One-half are 70 years of age and older 56% were diagnosed in the past ten years, and one-third in the past 5 years Women were more likely to have had breast cancer (3.5 mm), uterine cancer (757,000),

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Finding Affordable Care In a Deductible World: The Growing Role of Alternative Therapies

Faced with the increasing financial responsibility for healthcare payments, and a desire to manage pain and disease via “natural” approaches, more U.S. consumers are seeking and paying for non-conventional or naturopathic therapies — complementary and alternative medicine (CAM). Health and Healing in America, The Harris Poll conducted among U.S. adults, learned that two in three Americans see alternative therapies as safe and effective. 1 in 2 people see alternative therapies as reliable. And most people believe that some of these treatments, like chiropractic and massage therapy, should be reimbursed by health insurance companies. Seven in 10 Americans have used alternative

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Control Drug Costs and Regulate Pharma, Most Older Americans Say

The top reason people in America over 50 don’t fill a prescription is the cost of the drug, according to the AARP 2015 Survey on Prescription Drugs. Eight in 10 people 50+ think the cost of prescription drugs is too high, and 4 in 10 are concerned about their ability to afford their medications. Thus, nearly all people over 50 think it’s important for politicians (especially presidential candidates) to control Rx drug costs. Older consumers are connecting dots between the cost of their medications and direct-to-consumer prescription drug advertising: 88% of the 50+ population who have seen or heard drug

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The Hospital of the Future Won’t Be a Hospital At All

In the future, a hospital won’t be a hospital at all, according to 9 in 10 hospital executives who occupy the c-suite polled in Premier’s Spring 2016 Economic Outlook. Among factors impacting their ability to deliver health care, population health and the ACA were the top concerns among one-half of hospital executives. 1 in 4 hospital CxOs think that staffing shortages have the biggest impact on care delivery, and 13% see emerging tech heavily impacting care delivery. Technology is the top area of capital investment planned over the next 12 months, noted by 84% of hospital execs in the survey.

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Expect Double-Digit Rx Cost Growth to 2020 – Implications for Oncology

In the U.S., spending on prescription medicines reached $425 bn in 2015, a 12% increase over 2014. For context, that Rx spending comprised about 14% of the American healthcare spend (based on roughly $3 trillion reported in the National Health Expenditure Accounts in 2014). We can expect double-digit prescription drug cost growth over the next five years, according to forecasts in Medicines Use and Spending in the U.S. – A Review of 2015 and Outlook to 2020 from IMS Institute of Healthcare Informatics. The biggest cost growth driver is specialty medicines, which accounted for $151 bn of the total Rx spend

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Digitizing Self-Healthcare with Google, Pfizer, Under Armour, Walgreens and WebMD

How can digital technologies enable self-healthcare in novel ways? This was the theme of a meeting sponsored by Pfizer Consumer Healthcare and hosted by Google, with the title, “Advancing Consumer Health through New Technology and Next Generation OTC Healthcare” held on 12th April 2016 at Google offices in Manhattan’s Chelsea neighborhood. Pharmaceutical brand drugs switching to over-the-counter packaged goods, the Cellscope Otoscope used by parents checking their young children’s earaches, connected shoes and earbuds for athletic enhancement, and omni-channel retail shopping….these are a few of the signals we see emerging to enable consumers’ to drive healthy behaviors, wellness and self-healthcare. Speakers

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Consumers’ Growing Use of New Retail Health “Doors”

In the growing era of consumer-driven health, a growing list of options for receiving care are available to consumers. And people are liking new-new sites of care that are more convenient, cheaper, price-transparent, and digitally-enabled. Think of these new-new sites as “new front doors,” according to Oliver Wyman in their report, The New Front Door to Healthcare is Here. The traditional “doors” to primary and urgent care have been the doctor’s office, hospital ambulatory clinics, and the emergency room. Today, the growing locations for retail clinics and urgent care centers are giving consumers more visible and convenient choices for seeking

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What Retail Financial Services Can Teach Healthcare

“Banks and insurance companies that cannot keep pace will find their customers, busy pursuing flawless service models and smart solutions, have moved on without them and they are stranded on the wrong side of the digital divide — from which there will be no return,” according to a report on The Future of Retail Financial Services from Cognizant, Marketforce, and Pegasystems. You could substitute “healthcare providers” for “banks and insurance companies,” because traditional health industry stakeholders are equally behind the consumer demand for digital convenience. This report has important insights relevant to health providers, health plans and suppliers (especially for

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The Rise and Rise of (Specialty) Prescription Drug Prices

Prices for the most commonly used branded prescription drugs grew from a base index of $100 in 2008 to to $264 in 2015, based on the Express Scripts 2015 Drug Trend Report. This is illustrated by the upwardly-sloping blue line in the chart. In contrast, the market basket of the most commonly used generic drugs fell from the $100 index in 2008 to $29.73, shown by the declining black line in the graph. The $112.05 is calculated from a market basket of commonly purchased household goods which cost $100 in 2008, a relatively flat line which puts the 264% rise in

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Prescription Drugs Will Exceed 17% of US Healthcare Spending in 2016

Spending on prescription drugs in America in 2015 hit nearly one-half trillion dollars, some 16.7% of national health spending. The latest report on Observations on Trends in Prescription Drug Spending was published this week by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation (ASPE). For over a decade in the U.S., the prescription drug component of national health spending was relatively flat, about 10% of overall health costs. In the past couple of years, the proportion of healthcare costs allocated to Rx medications is fast-increasing, as the line chart shows: while

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The New-New Health Fair – Care Goes Shopping

As consumers’ growing financial skin in the health care game compels them to seek care in lower-cost settings, the pharmacy business recognizes the opportunity to provide healthcare services beyond the core business of filling prescriptions. This month, Drug Store News (DSN) published a special section called Health Event Horizon which profiles several pharmacy companies’ expanding reach into retail health – in particular, re-defining the concept of the “health fair.” A health fair is “an educational and interactive event designed for outreach to provide basic prevention and medical screening to people in the community,” according to the latest Wikipedia definition. But the

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Beauty Meets Pharma in Retail Health – At Coin in Florence

All over the world, people define their health and wellness across many dimensions…physical, mental, financial, and appearance. In Florence, Italy, I happened upon a riff on this last component on “look good, feel good” at the Coin Department store located on Via Del Calzaiuoli in central Firenze. Welcome to Coin’s Health&Beauty Store. The two photos tell a story about health, where we live, work, play, and shop, the mantra for public health focused on the social determinants of health beyond healthcare. Here at Coin, adjacent to the holistic brands of Clarins and other luxury labels, is a pharmacy along with

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A Growing Market for DIY Digital Health for Sleep and Pain

Sleeplessness and chronic pain are two epidemics that are mutually-enforcing, as the chart shows. The 2015 Sleep in America Poll found that pain is a key factor in Americans’ “sleep debt:” 21% of people have experienced chronic pain and lose 42 minutes of sleep due to it; 36% have experience acute pain, resulting in 14 minutes of lost sleep each night. People dealing with both conditions project-manage their health in numerous ways, multitasking with over-the-counter meds, prescription drugs (from “lite” to narcotic), meditation, yoga, homeopathic remedies, aural relaxation, Mozart, and more. There are a growing number of digital health tools now

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Retailers will morph into health destinations in 2016

Retailers in the U.S. are morphing into health destinations in 2016. Members of Target’s management team attended the 2016 Consumer Electronics Show (CES) and shared their perspectives in the company blog. Among the Target teams observations came from the Chief Marketing Officer, Jeff Jones, who observed, “A tidal wave of newness is coming to fitness technology and many companies are on the cusp of changing the game. From nutrition and sleep to how you exercise, it’s all going to be measured, linked and tracked. Wearables are here to stay and getting smarter every year.” The Senior Vice President for Hardlines,

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The 2016 THINK-Health Health/Care Forecast

It’s time to get the tea leaves out and mash up trends in my world of health, health care, technology, policy and people for 2016. We’ll start with the central player: people, consumers, patients, caregivers all. Health consumerism on the rise.  People – call us patients, consumers, caregivers – will take on even more financial and clinical decision making risk in 2016. Growing penetration of high-deductible and consumer-driven health plans will push (not just nudge) people into the role of health care consumers, and the emerging businesses and programs serving the transparency market for price and quality will gain traction

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Prescription Drug Costs Will Be In Health Benefits Bullseye in 2016

Prescription drug costs have become a front-and-center health benefits cost issue for U.S. employers in 2015, and in 2016 the challenge will be directly addressed through more aggressive utilization management (such as step therapy and prior authorization), tools to enable prescription intentions like DUR, and targeting fraud, waste and abuse. Consumers, too, will be more financially responsible for cost-sharing prescription drugs, in terms of deductibles and annual out-of-pocket limits, as described in the PBMI 2015-206 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda. The Pharmacy Benefit Management Institute has published this report for 15 years, which provides neutral, detailed survey

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Americans Like Generic Drugs Over Brands

“What’s in a name?” Juliet asked in Shakespeare’s play. For medicines consumers in the U.S., not much. Most Americans prefer generics products, according to The Harris Poll’s survey. 7 in 10 U.S. adults choose generics over brands when given a choice. 3 in 10 people say they would “always” choose generics, whether a prescription drug or an over-the-counter product (store brand, private label). While most people across all age groups would choose generics over brand ames for meds, parents with children in the households would more likely choose a brand  name (36% with vs. 28% without kids). Still, 66% of

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The U.S. Will Cover the Bulk of Medicines Spending in 2020

U.S. spending on medicines will approach $590 billion in 2020, increasing 34% over 2015, IMS Institute for Healthcare Informatics projects in its forecast, Global Medicines Use in 2020. Growth in spending will be attributable to innovation (new products), price increases and some patent losses of exclusivity (e.g., branded drugs going generic). The U.S. will cover the bulk of drugs spending in 2020 at 41% of the world medicines market, shown in the first pie in the first chart. U.S. medicines spending dwarfs any other country or region in the world, including China which is expected to account for 11% of

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Walgreens Extends Telehealth On Your Smartphone

In the U.S., if you walk 3 miles in any direction, there’s a 3 in 4 chance you’ll find yourself in front of a Walgreens pharmacy. The company often says that 75% of people in the America live within 3 miles of a Walgreens storefront. What’s a pharmacy storefront anymore? Both Walgreens and CVS are re-defining that with a dizzying pace of new announcements. The latest for Walgreens: people in 25 states will be able to use the Walgreens app on their smartphones to access physicians virtually. Consumers living in Alabama, Arizona, California, Colorado, Connecticut, Florida, Indiana, Illinois, Iowa, Maryland,

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Health Care Costs Are #1 Pocketbook Issue, and Drug Prices Top the Line Items

Consumers are most concerned about health care costs among their kitchen table issues, above their ability to afford the utility bill, housing, food, or gas and transportation costs. The October 2015 Kaiser Family Foundation Health Tracking Poll finds 4 in 10 Americans finding it difficult to afford health care, including 16% of people earning $90,000 a year or more. Underneath that worrying healthcare cost umbrella are the price of prescription drugs, which the majority of Democrats, Independents, and Republicans all agree need to be “limited” by government regulation. Ensuring that the public have affordable access to high-cost drugs for chronic conditions

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The Fast-Growing Consumer Digital Health Ecosystem – Health 2.0 Day 2

The fastest-growing category of products and services at Health 2.0 is consumer-facing digital health, and a panel of companies demonstrated various flavors of the New Retail Health. One of the most prominent companies featured in Health 2.0’s conferences from the inception has been MyFitnessPal (MFP), a long-time helpful tool I’ve used to manage my own health-life. Under Armour acquired MFP earlier this year, which I covered here in Health Populi. Under Armour’s original mission was to make all athletes better. With the company’s acquisition of MyFitnessPal, Under Armour continued its morphing from a textile and sports gear company to a

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Wellness Is In Target’s Bullseye

Health is where we live, work, play, pray, learn, and increasingly, shop. The new Retail Health goes well beyond the pure-play pharmacy. Part of Target’s re-imagined market positioning is in this expanding sweet-spot as healthcare morphs from institutional providers like hospitals and doctors’ offices to the community. Don’t think pharmacy’s not important: it will remain a core business and revenue center in retail health. But that business is fast-changing, as the role of pharmacy benefits management companies change, more (expensive) specialty drug benefits come out of pipeline and into the market, and health insurance continues to shift financial risk to

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What Retail Telemedicine Means For Healthcare Providers

Direct-to-consumer retail health options are fast-growing in the U.S. health ecosystem. CVS Health brought three telemedicine vendors to its pharmacy brick-and-mortar stores. CVS also acquired Target’s pharmacies, expanding its retail health footprint. Rite Aid has added HealthSpot kiosks to its pharmacies, while Walgreens expanded its relationship with MDLive. And, Cox Cable acquired Trapollo to bring remote health monitoring into subscribers’ homes, along with the cable company’s venture with Cleveland Clinic, Vivre Health. Coupled with the growing supply side of telemedicine vendors, the latest National Business Group on Health survey found that most large employers plan to expand the telemedicine services they

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U.S. Consumers’ View of Pharma Goes Negative in 2015

Americans’ views of the pharmaceutical industry have fallen in the past year, with negative perceptions outweighing positive ones, shown in the line graph from the Gallup Poll. Pharma’s low-lying reputation among consumers sits among others including the legal field, healthcare, oil and gas, and the Federal government which ranked lowest across all 25 sectors Gallup analyzed. Gallup surveyed 1,011 U.S. adults in in the first week of August 2015 via telephone. Since 2003, Gallup notes, the pharma industry has consistently ranked in the bottom third of industries operating in the U.S. Pharma respect is in the eye of the consumer-beholder

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Happy 1st Anniversary to CVS Going Tobacco-Free

CVS quit selling cigarettes and tobacco products in 2014, made $139 bn, and saved 65,000 lives. That’s the best kind of retail health there is. It’s been a year since CVS quit selling cigarettes, I’m reminded by a one-page ad in today’s Wall Street Journal on page B5. This is a big investment in an ad for a business strategy that’s had a huge return-on-investment. The ad reads: “One year ago, we took a deep breath and quit selling cigarettes in our pharmacies. Now we’re working to create a tobacco-free world. We just want to help everyone, everywhere, breathe easier,”

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Wegmans tops pharmacy satisfaction – and it’s not even a pharmacy

Think of the word “pharmacy,” and what names come to your mind? CVS Health, Walgreens, Rite-Aid, perhaps. But it’s Wegmans who’s #1 across all pharmacy brands and types, according to the 2015 J.D. Power Pharmacy Study. The big improvement in pharmacy satisfaction in 2015 has been among supermarket drug stores, up to an index score of 851 (of 1,000), the highest consumer score. The satisfaction score for chain pharmacies increased a small 2 points, whereas satisfaction for two other channels for pharmacies — mass merchandisers and mail order — both fell from 2014. It may come as no surprise to Health

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People Like Physicians, Food and Banks. Pharma? Not much.

Most consumers think favorably when they picture doctors, food manufacturers, banks, and airlines. But the pharma industry continues to be lumped with Big Oil and health insurance in the minds of U.S. consumers, industries for which more than 50% of people in America share unfavorable impressions. The August 2015 Kaiser Family Foundation Health Tracking Poll focuses a lot on the pharmaceutical industry. The link to the poll is here: http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-august-2015/ Key findings from the survey tell a story about a health citizenry highly suspicious of pharma: 72% of Americans think that drug costs are unreasonable 74% of people think patients in

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Dr. Watson comes to retail health

IBM’s Watson joins CVS Health to bring Big Data to people managing chronic conditions through the retail pharmacy channel. Welcome to the mainstreaming of predictive analytics for health in the community. Or, as PC magazine put it, “CVS, IBM’s Watson Wants to Prevent You From Getting Sick.” The core of the program would, in the words of CVS’s press release, “enable health care practitioners to quickly and easily gain insights from an unprecedented mix of health information sources such as medical health records, pharmacy and medical claims information, environmental factors, and fitness devices to help individuals stay on track with

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It’s My Body And I’ll Test If I Want To

While health consumers in America have more skin in the game in terms of paying more via high-deductible health plans and out-of-pocket costs, they are largely unempowered when it comes to diagnostic testing in labs. Theranos is working to change that and empower consumers to access convenient lab testing and get results quickly and online. Describing the lab-disempowerment story in a Wall Street Journal op-ed dated July 28, Elizabeth Holmes writes about How to Usher In a New Era of Preventive Health Care. Holmes is the founder and CEO of Theranos (named by joining the words “therapy” and “diagnosis”), a health technology company

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