The more things change, the more they stay the same. Will this adage hold true for healthcare?
With the historic passage of healthcare reform legislation, the question on everyone's mind is what will really change? The principles of reform began with expanding coverage, improving quality and reducing costs. While the law provides clearly for expanded coverage, the issue of improved quality and reduced costs remain to be seen. What is certain is that health insurers and pharmas are at the center of changes under the new healthcare reform.
Pharma manufacturers have been targeted on multiple fronts that will reduce profitability in the short term: Industry fees; coverage in the Medicare donut hole and Medicaid rebate expansion; and specified patent exclusivity for biologics. In the longer term, the increasing number of patients with insurance coverage may offset some of these losses. Healthcare insurers also are heavily impacted by changes that affect their ability to selectively insure members and their exemption to antitrust regulations around competition.
However, for better or for worse, it is safe to say that patients will play a larger role in the healthcare of tomorrow. For example, our pharmacy data shows the increasing power of the patient in deciding whether or not to use a doctor-prescribed and health plan-approved drug. More frequently in 2009 than in 2008, patients opted to leave a prescription at the pharmacy. In turn, they are asserting pressure on the market due to these decisions.
The future of healthcare is changing, but in the end, the patient will be a key driver in these changes.Dea Belazi, PharmD, MPH, is consulting practice leader, managed markets, for Wolters Kluwer Pharma Solutions