Pharmaguy's Insights Into Drug Industry News
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Pharmaguy's Insights Into Drug Industry News
Pharmaguy curates and provides insights into selected drug industry news and issues.
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Make American Medicine Great Again: #Pharma Should Offer Payers "Money Back Guarantees" as in UK

Make American Medicine Great Again: #Pharma Should Offer Payers "Money Back Guarantees" as in UK | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Drug companies have started offering 'money back guarantees' in their treatments to make eye-wateringly expensive therapies more attractive.

 

This week British pharmaceutical giant GlaxoSmithKline (GSK) said it would include a warranty for its cutting-edge new gene therapy for ‘Bubble Boy syndrome’, a rare disorder which leaves suffers with such a compromised immune system that they are advised to live in a completely sterile environment.

 

GSK gained European approval for gene therapy Strimvelis in May but healthcare providers have been reluctant to pay for it, as it costs around £500,000 per patient, making it one of the most expensive treatments in the world.

 

The deal is thought to represent a new era in healthcare pricing, where drug companies will be responsible for continued success rates and allows treatments for very rare diseases, with low take-up, to come to market.

 

Such ‘money-back’ deals have only been made a four times in Britain in the past. The first was approved in 2002 for the treatment of multiple sclerosis with interferon beta or glatiramer where drug prices were adjusted according to outcomes.

 

In 2007 the NHS agreed a risk-sharing scheme with Johnson & Johnson after the National Institute for Health and Care Excellence (Nice) rejected its cancer drug Velcade.

 

Under the terms if a patient achieved complete or partial response, greater than 50 per cent within four cycles or treatment then the NHS would pay up. If not Johnson & Johnson agreed to pick up the entire bill.

 

Since then Merck Serono has reimbursed the health service for patients who failed to respond to its metastatic colorectal cancer drug Erbitux within six weeks. And GSK has a refund deal with its drug Votrient for Adcanced renal cell carcinoma.

Pharma Guy's insight:

I assume that in the U.S. scenario, patients would also get back their co-pays. Not that this would help patients who have died (like in this Opdivo case: http://sco.lt/5OSoXR). But at lest insult would not be added to injury.

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Craig DeLarge Leaves Pharma to Pursue New Career in Digital Mental Health Outcomes

Craig DeLarge Leaves Pharma to Pursue New Career in Digital Mental Health Outcomes | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Craig DeLarge, until yesterday, Global Leader, Multichannel Marketing Strategy & Innovation at Merck, announced his departure from the pharmaceutical industry on his Facebook timeline.

"Yesterday," said Craig, 'was my last day as ‪#‎Global‬ Leader, MCM ‪#‎Strategy‬ & ‪#‎Innovation‬ at ‪#‎Merck‬. It has been a good, highly developmental & productive 2 years at the '‪#‎leadership‬ school', I have fondly come to refer to Merck as. I am grateful for the leaders who brought me in, and the colleagues I co-developed and co-created with during my tenure.

"Moving on, I am furthering my practice in the areas of ‪#‎digitalhealthcare‬, ‪#‎changeleadership‬ and ‪#‎mentalhealth‬ outcomes. I will be taking time to explore how I can best contribute my leadership, ‪#‎creativity‬ and management in these areas in either freelance, ‪#‎consulting‬ or organizational leadership contexts.

"In particular, I will be focusing on a ‪#‎sabbatical‬ research project to map 'digital mental health' over the next 4 months as this brings together my expertise in digital health and my interest in mental health, related to my ‪#‎NAMI‬ Board work. I offer my best wishes to my management and colleagues I am leaving behind. I welcome the good wishes and assistance of any who know of opportunities for me to contribute in the three areas I mention above."

Craig has influenced countless people in his nearly 25 years within and outside the pharmaceutical industry. Let me tell you how he has influenced me. Read more about that here.

Pharma Guy's insight:


Now Craig can focus all his efforts on making a difference in the mental health arena through the confluence of his experience with digital health, change management, and outcomes. I wish him great success in his new career!

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Who, What Determines Physician Effectiveness? Just as Tough as Measuring Teacher Performance, Says JAMA

Who, What Determines Physician Effectiveness? Just as Tough as Measuring Teacher Performance, Says JAMA | Pharmaguy's Insights Into Drug Industry News | Scoop.it

Opinion from JAMA — Who Determines Physician Effectiveness?


It is a paradox. Although physicians do not control patient behavior, physician effectiveness is increasingly determined by patient behavior. There is a trend toward physician ratings being based on specific metrics related to the management of chronic illness. Such markers include glycosylated hemoglobin levels, blood pressure, body mass index, and smoking rates, along with other factors known to affect risk of morbidity and mortality. However, the physician contribution to changing the actual outcomes is limited.


Population analyses of health outcomes suggest that medical care accounts for only 10% of the variance in outcomes, whereas approximately 50% can be attributed to behavioral and social factors.1 With respect to the chronic conditions that receive the largest proportion of health care attention, such as cardiovascular disease and diabetes, physicians identify risk factors, diagnose disease, prescribe treatments, and educate patients regarding relevant lifestyle factors. The result of these efforts, however, is ultimately determined by patient adherence to prescribed treatment regimens and recommended health behaviors (eg, diet, exercise, smoking cessation).


Extensive physician time and effort is devoted to determining what medications and dosages patients need to take for their chronic conditions, but nonadherence to medication regimens for the treatment of chronic illness has been estimated to be 50%.2 Primary nonadherence (not ever filling or picking up the prescription) is estimated to be approximately 30%.3 Outcomes of surgical interventions (eg, bariatric surgery) also largely depend on patient behavior over the long term (ie, changes in eating patterns must be maintained by patients for sustained weight management).


Other variables associated with health outcomes are not directly affected by physicians. Educational attainment affects life expectancy, such that individuals with an advanced degree can expect to live approximately a decade longer than individuals with less than a high school education, although childhood adversity can attenuate the advantage of education.4 There is a similar gradient for other socioeconomic indicators. Positive affectivity, that is, a trait-like tendency to experience positive emotions and to be actively engaged with other people, is associated with a life expectancy of approximately 4 to 10 more years compared with more negative affectivity.5 Although physicians are not held accountable for life expectancy, these traits influence overall health and well-being.


Because so many variables beyond physician control affect patient outcomes, relying solely on outcome data (or proxies for outcomes) to determine physician effectiveness may be both inaccurate and unjustified. There is a parallel with public school teachers who are increasingly evaluated using student outcomes, even though student achievement is affected by many variables other than the teacher’s qualifications and skills, such as socioeconomic factors. However, until better measures of overall physician effectiveness are identified, physicians, like teachers, must do their best to affect outcomes in the face of performance measures that are influenced by circumstances outside their control.

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Keith McGuinness's curator insight, October 13, 2014 6:53 PM
Summary:  Physician effectiveness often depends on behavior and lifestyle, things that physicians struggle, often without success, to influence.  Solution: motivational interviewing.  


Conspicuous by its absence from this article is the mention of apps.


Dilemma and opportunity: Patients are turning to apps to help with behavior and lifestyle challenges that their physicians leave virtually untouched. And app developers promise behavior change to patients but fail to monitor the health outcomes that both the physician and the patient use to measure success.


As soon as #behavioralhealth apps begin to monitor the outcomes that physicians and patients alike target, they will become useful and trustworthy. Then they will be adopted by physicians, recommended to patients, offered to consumers at large, and proliferate.