Editor’s Notice: Within the fall of 2022, GreenBook’s IIEX Well being occasion occurred in Philadelphia, bringing each helpful and inspiration content material to insights and analytics professionals spanning the healthcare, pharmaceutical, medical, and wellness industries. Attendees discovered the content material so helpful that we needed to make a lot of it accessible to all who couldn’t attend this in-person occasion. Earlier than even studying this publish, know this: You possibly can view all of the classes on-demand now!
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Take pleasure in our On-Demand Video
Be part of New York College Professor Steve Andrzejewski with a chat concerning the altering panorama within the healthcare business. Discover the continually evolving business and the way pharmaceutical firms can take part on this altering panorama. Click on to view the video (courtesy of Civicom).
View extra 2022 IIEX Well being content material on-demand!
Whether or not you had been in a position to attend, or you weren’t, be part of us on-line to see what was shared by among the greatest manufacturers, the latest startups, and expert-level researchers throughout healthcare, pharma, and shopper expertise. Right here’s simply two of the wonderful classes you’ll discover on-demand:
- Greg Hewitt and James Bauler converse to the innovation course of behind Fuse Oncology, a spin-out of Cone Well being, after a essential examination of the lag between a affected person’s prognosis and begin of remedy.
- Zach Hebert speaks to how the Covid-19 pandemic has made it extra vital than ever to ship the suitable message and the way the suitable message may also help ease the thoughts of vaccine hesitant mother and father.
On-line you’ll discover different incredible classes by audio system from Pierre Fabre Group, Novartis, Hinge Well being, and extra! If you wish to keep on prime of the developments within the healthcare business — one of many largest spends in market analysis — you received’t need to miss IIEX Well being On-Demand!
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What begins right here will change our world!
Transcript
(Transcript courtesy of TranscriptWing)
Alexine Tranquada: All proper. For our final presentation for the day, we’re so lucky to have Prof. Steve Andrzejewski with us to speak concerning the altering panorama in healthcare. As we all know, issues are evolving so shortly, and the way can pharma take part on this altering panorama. So thanks very a lot, Professor.
Steve: Thanks very a lot. Good afternoon, everybody. Oh, return one. There we go, “The Altering Panorama of Healthcare,” There’s loads occurring, and on the finish we’ll speak about how pharmaceutical firms will work together with that altering healthcare panorama.
Simply actually shortly on myself, I went to Hamilton Faculty and performed ice hockey. You’ll perceive why I’m telling you that on the finish of the presentation. Then I went to NYU Stern a few years in the past. I’ve been an adjunct professor there. I train a course known as the Enterprise of Well being and Medical Care to the Economics Division. I spent my complete profession within the pharma/biotech market. Healthcare represents, as you in all probability know, 20% of the gross home product. One of many issues I inform my college students proper upfront is it’s clearly very difficult, however within the six-week course, one night time every week, so there’s not a whole lot of time to cowl a whole lot of floor. Listed here are among the issues which have both arrived or rising that you need to keep in mind. As you go into the course, take into consideration this stuff.
The primary one, it shouldn’t be a shock, “Comply with the greenback and reveal worth.” It’s not solely prescribed drugs. A lot of you, I’m certain, are taking a look at digital well being and all of the exercise that’s occurring there. We all know there was some huge cash that went into the digital well being popping out of the pandemic. It was a development that was accelerated. Nonetheless, the final six months or so, clearly, broader financial points, there’s a whole lot of the digital well being investments gone method down. For those who learn about it, one of many issues they need to do is that they need to reveal worth, proper? All people does. If the digital platform sounds actually good, in the event that they’re not enhancing the present scenario, it’s going to be difficult.
Consolidation. We’ve clearly seen that over time with drug change, distributors. We see CVS and Aetna, and Cigna and CSI coming collectively. One of many issues when consolidation happens in any business, you see the value factors begin to go up. We’ve clearly seen that in healthcare usually and, clearly with, extra lately, inflation. Training. Clearly, the web during the last 10-plus years has been an enormous assist because it pertains to training. Individuals can get info at their fingertips rather more shortly than they used to. Clearly, we get bombarded with issues like food regimen and train, food regimen and train, food regimen and train, however there’s much more that goes past that and different essential element to healthcare.
We simply heard slightly bit about consumer-driven healthcare and affected person duty. All people has a job within the general system. One of many issues that I received’t cowl immediately however that we speak about in my class is we evaluate the US system to different nations and the way they deal with healthcare. In socialized programs, every thing is roofed, however there are professionals and cons to that, proper? In Canada, you might have to attend six months to get an MRI. There’s this idea of affected person duty within the system. I’m not fairly certain all people in the USA thinks that method, but it surely’s vital and we’ll see extra of that particularly as extra of the cash, an increasing number of sufferers or persons are given the selection to do excessive deductible well being plans today the place you’re not paying as a lot by way of the premium popping out of your month-to-month wage, however then you could have a much bigger chunk of cash to undergo your out-of-pocket bills earlier than your insurance coverage actually kicks
1.A part of that’s the customers have extra management over the place they’re going to make use of these {dollars}. Then, clearly, you could have well being spending accounts and versatile spending accounts. I got here up with the phrase electronization of healthcare. It’s not all that straightforward to pronounce. Nonetheless, digital medical data, everyone knows, have performed a a lot greater position in drugs. It’s not that way back that we had the manila folders, proper? Ten-plus years in the past, once you stroll in a physician’s workplace, manila folders in every single place. The Obama Administration gave incentives for medical doctors to modify to EMRs. For those who talked to any medical doctors, as I’m certain you could have, they’ll complain to this day how painful that was. I feel it’s a greater downside, EMR, than all of the manila folders as a result of I feel there’s a greater likelihood of measuring impression in healthcare.
Clearly, past EMR, we have now a whole lot of digital well being alternatives and locations on the web and different methods wherein it’s impacting healthcare. Ethics is all the time vital because it pertains to healthcare and making selections simply to what will be reimbursed or not. There are all the time tradeoff selections. Not every thing goes to be paid. Then a giant bucket on the backside there, and I’m going to speak much more about that is new healthcare fashions. Massive organizations like Amazon, Berkshire
Hathaway, and JP Morgan, I feel you in all probability know, got here collectively beneath Haven. Three main organizations in our nation, and what occurred? It’s disbanded. It’s one other indication of how difficult healthcare is and the incentives will not be all the time aligned throughout the system. Normal Motors with Henry Ford Healthcare System labored slightly bit higher. We simply had the election about a few days in the past, and folks say politics are all native, proper? The identical factor to an extent with healthcare, it is a good instance of it. It might be slightly bit simpler to ship healthcare as a result of it’s extra regional.
Denmark is all the time excessive on the checklist by way of how a lot cash they spent in healthcare and what outcomes they ship. Properly, it’s a smaller, extra homogeneous group of individuals than we have now by far than the USA. So one other instance that regionalization does make a distinction. Hospitals began their very own generic drug firms, Civica Rx. That’s been very profitable. A lot of hospitals felt they had been paying an excessive amount of cash. So how do you get extra leverage within the market? It applies in healthcare as properly. You get extra quantity and negotiate on worth. It’s basically what they did by creating their very own drug firm. A couple of of the others I’m going to get in right here, concerned right here as we transfer ahead.
So I’m going to go over plenty of offers that occurred within the final couple of years within the healthcare area and attempt to provide you with slightly sense as to why they doubtlessly are doing this, however it should result in the top of, “Okay. How does pharma slot in to all of this stuff which are occurring in healthcare?” So, $13.5 billion UnitedHealthcare and Change Healthcare, UnitedHealthcare needed entry to Change Healthcare’s analytics and fee platforms and Change clearly is a part of Optum. Clearly knowledge, AI alternatives exist. FTC challenged this on a few of that foundation, but it surely has since handed. This occurred a few yr in the past.
Oracle and Cerner. Oracle will get entry to a trove of healthcare data from Cerner. They didn’t have entry to that earlier than, $28.3 billion. Clearly, they see an alternative right here to repair among the inefficiencies in our system. Once more, that was from December of final yr. Amazon. They’ve been quoted as saying, “Healthcare is excessive on the checklist of experiences that want reinvention.” I don’t suppose that ought to come as a shock to anyone on this room. On the similar time, we all know Amazon has been fairly good at reinventing issues, possibly not so nice in healthcare. They put a bunch of effort ahead. They haven’t all essentially labored out. For them, the $3.9 billion is in all probability small within the huge scheme of issues. They purchased One Medical. Clearly, that gives buyer 24/7 entry to digital care. That occurred in July of this yr.
Earlier this week, you could have seen that Walgreens, particularly, their VillageMD group, purchased Summit Well being. For these of you who don’t know, Summit Well being is Summit Medical Group, which is an built-in supply community mainly within the New Jersey space and in addition CityMD. That, I feel, was round $9 billion as introduced earlier. So, issues proceed to alter, and all these totally different organizations are taking a look at the place can they doubtlessly add worth and get a aggressive benefit. Google. One other huge identify in enterprise, proper? They need to play in healthcare, too. $2.1 billion, that’s not that huge of an funding for Google, however they’re investing in Fitbit. Can they make healthcare extra accessible? Clearly, Fitbit is a wearable. You hear much more about wearables. Can they gather the suitable info that’s going to have an effect shifting ahead? That was introduced in late ’19 however closed in early ’21.
You in all probability clearly have heard of 23andMe, they usually went forward and purchased Lemonaid for $400 million. They need to make personalised healthcare a actuality. Clearly, it’s genetics area for 23andMe. As an alternative of constructing a digital platform, they went out and purchased one in Lemonaid. There’s a telemedicine element of that. We’re speaking about that earlier immediately. That was October of final yr. This one doubtlessly is likely one of the huge granddaddies of all of them, $18.5 billion {dollars}. Teladoc purchased Livongo, and Livongo is targeted in diabetes. For those who’re a pharmaceutical firm, to me, you’d need to actually be actually learning the way you match into the diabetes equation given the place this complete effort could also be going. Chances are you’ll know that Glen Tullman was the CEO of Livongo. He began Transcarent the place he’s attempting to coordinate pharmacy care to have one-stop purchasing, particularly in diabetes. Individuals get their insulin from one place. They get their different drug from some place else. A variety of this has to do with enhancing the shopper journey, and which will trump the standard of a drug. If somebody goes on-line they usually’re having fun with and are in a position to get by way of what’s perceived and the difficulties of purple tape in healthcare proper now and may get to a degree the place they’ll get care and a drug that makes a distinction, they might simply be going with the generic drug. It doesn’t matter that there’s a brand new drug within the market that’s considerably higher in a way, form, or kind.
Lately, USA Right this moment did a survey; 68% of individuals need know-how to play a much bigger position in sharing real-time medical info with their doctor. Fifty-six % of individuals surveyed used a digital assortment device to observe well being. I feel a whole lot of us in all probability monitor our steps on our iPhones. Clearly, it’s going method past that shifting ahead, once more, one other indication that customers are going to manage extra of their healthcare shifting ahead. Psych Hub is only one instance of many digital well being platforms which are on the market. They lately raised a good quantity of cash. They’ve over 800 companions together with J&J. It’s an academic useful resource for psychological well being, and it connects you to a physician for a seek the advice of. To me, should you’re a pharmaceutical firm in psychological well being, I’d attempt to actually perceive what’s going on in Psych Hub and lots of, many different psychological well being platforms which are on the market.
Healthcare is altering drastically. You shouldn’t be stunned by something that you just see up there. It’s catching as much as the remainder of the world from a digital perspective, healthcare, however clearly with the pandemic, the tempo of change has accelerated. We talked about knowledge and the way the simulation of that from an AI standpoint might actually have an effect. Clearly, the extra know-how advances are enhancing issues extra shortly however will complicate issues from a reimbursement standpoint as properly.
Shortly, traditionally, once you take a look at the healthcare mannequin, it was once vertical: physician, affected person, pharmacy hospital. It moved to a extra distributed healthcare throughout plenty of totally different sectors, some which are famous right here: imaging, behavioral well being, rehab. Now, it’s actually shifting to a extra related mannequin. Integration, I discussed built-in supply networks earlier. Built-in supply networks are growing their affect within the market. In my experiences in pharmaceutical roles, they’re very troublesome to kind of penetrate and get to the suitable decision-makers because it pertains to what their efforts are so one thing to remember.
A extremely vital half is extra proactive than reactive, proper? As an alternative of treating sick care, how can we get forward of the sport and deal with sufferers from a well-care perspective to extend worth. I discussed know-how earlier. We all know wearables, digital well being. All of the issues that you just see up there, genomics, robots, 3D-printing are all proceed to advance know-how. It’s an analogous query of how do they slot in?
Much like a pharmaceutical, how do they slot in to the system, and the place are they going to have the ability to add worth and have a aggressive benefit? One factor that I suppose is vital to level out. You hear the phrase digital well being again and again and over once more. Is it actually digital well being or is it simply well being, proper? I imply, can we name it like digital looking out? Can we name it digital expense monitoring on-line? No. We simply name it what it’s. So, it’s indicative that healthcare is behind the remainder of the world because it pertains to the digital platform and ultimately, I feel it’s merely going to be known as well being.
While you take a look at prescribed drugs, once you look traditionally, everyone knows considered one of the primary thresholds for achievement is you need to reveal efficacy and security. Clearly, in more moderen occasions, demonstrating worth from an financial standpoint or nonetheless you needed to seek out that, particularly with payers and managed care organizations, to get reimbursement is essential. I’m going so as to add now one other threshold: is how do you are taking each of these and the place do you play in that healthcare area given all of the developments and adjustments which are taking place?
This slide is right here as a result of, in my expertise, the pharmaceutical business tends to transfer very slowly. I feel you’ve seen that even from a digital well being standpoint, a contributing issue to why it’s nonetheless possibly known as digital well being as a substitute of well being versus different industries. It’ll be attention-grabbing to see how issues change over time, however I actually suppose the pharma business has to determine the place do they need to play. That is the place the hockey analogy is available in, and why I discussed that I performed hockey in school a very long time in the past. How will pharma slot in? One piece of recommendation from the well-known hockey participant, Wayne Gretzky, “I skate to the place the puck goes to be not the place it has been.” I feel that’s an excellent piece of recommendation for the pharma business to be fascinated about on this speedy altering panorama of healthcare. Thanks very a lot. When you have any questions, blissful to take them. [Applause]
Alexine Tranquada: It’s so cool. Sure. We’ve a query within the again?
Feminine 2: May you give your ideas on how blockchain and EAOs will match into this enterprise that you’ve got?
Steve: Properly, I imply, I feel it’s one other type of know-how that’s going to hurry issues up, however as issues get sped up, you bought to seek out the place that puck goes as opposed to the place it’s been. There are such a lot of issues altering so quickly. While you take a look at the pharma and biotech business, Boston, what number of biotech firms are there? A few of them are possibly very properly utilizing blockchain of their efforts, however simply attending to that Section 3 trial after which approval isn’t going to find out success on its personal, clearly. If there’s unmet wants, nice, but it surely’s going to go away past that. I simply see it as one other type of know-how that speeds issues up.
Feminine 2: Can I simply elaborate?
Steve: Sure. Please do.
Feminine 2: Do you suppose that pharma will find yourself adopting blockchain, or do you’re feeling prefer it’s going to be an business that’s going to finish up being very resistant on this explicit case prefer it has with every thing else? Or do you see that there’s going to be a development that you just gravitate in the direction of this decentralized, democratized knowledge?
Steve: What Jonathan, I feel, mentioned in his presentation earlier was one thing alongside the traces of change occurs, and possibly it’s gradual at first then impulsively it takes off. Pharma is, I feel traditionally, glacial change, they usually’re in all probability in that boat because it pertains to blockchain. Perhaps you’re doing extra at Novartis and possibly there’s extra exercise there. I feel all of this turns into a aggressive benefit, and I feel in some instances, particularly should you’re a smaller firm that doesn’t have the assets to determine a whole lot of this stuff, they might be left behind shifting ahead. While you say blockchain, is it going to be some small to midsized pharma firm that will get concerned in blockchain to assist them? Unlikely. It’s going to be the massive pharma that has the assets to attempt to determine that out and perceive the place issues are heading and the way they match into it.
Feminine 2: It’s okay.
Steve: Certain. Thanks for the query. Sure?
Male 1: You introduced up a whole lot of the acquisitions that occurred lately. Do you suppose that that’s a part of a higher development of issues turning into an increasing number of centralized within the healthcare business, like in a number of years it’s going to be huge tech firms which are simply operating your e mail account and your healthcare and that form of factor? Or do you suppose that there is likely to be has a small [Unintelligible] entry and small [Unintelligible] would there be an inflow of extra aggressive – being that modern and coming into that [Unintelligible] alternative the place it’s going to be very centralized?
Steve: Sure. I feel it’s too complicated and there are too many alternatives within the area for it to grow to be ultra-centralized. I feel there’ll all the time be a need of competitors to maintain that market forces going. So FTC seems to be in any respect these offers, they usually’re not solely taking a look at them. They’re wanting on the one which I discussed earlier with Amazon. They’re not solely taking a look at it from a standpoint of healthcare. As a result of One Medical doesn’t symbolize that many sufferers within the huge scheme of issues, however they’re wanting from knowledge as properly and the way a lot knowledge does any person have entry
1. I do suppose although these individuals which are forward of the sport in knowledge and are studying from it are going to have the ability to make selections which are going to place them for higher progress than possibly firms have carried out. Sure?
Feminine 3: I want to return to the opposite query. With reference to Amazon and their buy of One Medical, earlier than they did the acquisition, they’d a special measure of the place they form of utilized their Amazon-y form of strategy to every thing that they do. “We’re going to repair healthcare,” they usually regularly did a whole lot of stuff that ended up failing as a result of they didn’t have the reference to healthcare suppliers, with sufferers. They didn’t actually perceive the complexity of the connection which led to the primary group of [Unintelligible]. Provided that and on condition that Amazon has been so profitable from the areas [Unintelligible] surprising failure, if Amazon can’t do it, if they’ll’t are available in and actually innovate within the area, what hope does anyone else have? In the event that they’re not doing good there, what’s one factor that any person can do to really make enhancements, or is it actually all the time going to be inside the place the alliance now could be pharma firms working, the hospital and payers, and it needs to be a [Unintelligible] working altogether to make the change internally. Or can any person exterior are available in and try this?
Steve: Properly, a few issues. Amazon, clearly, has some huge cash make investments and healthcare is clearly a part of their technique just by 20% of GDPs in healthcare. I suppose they’re going to maintain attempting. They’re in all probability getting nearer now that they have a supplier element, however they’re not going to cease, proper? They’re going to maintain attempting to determine it out. With that mentioned, I don’t suppose they’re going to be like discovered so properly that they grow to be healthcare, proper? I imply, it’s simply there are too many elements to it. It might be nice for among the programs. I feel IDNs are a part of that to possibly accomplice with a few of these organizations. I feel a whole lot of persons are afraid of Amazon, too, although, proper? I imply, they suppose that they’re so sturdy that they’re going to determine one thing that any person else couldn’t, after which that group can be at a aggressive drawback. I inform my college students once I train this class is, “You’re getting your MBA. You need to become involved in enterprise. What an ideal place to go in healthcare.” It’s actually difficult. It’s fragmented and it’s inefficient. What does that spell? Alternative, proper? Heaps and many alternative. For those who go backwards 10 years, we’ve discovered loads, and take a look at how far we’ve come even by way of ordering issues on-line and them having shipped – medicine on-line after a seek the advice of with a physician had been needed and having it shipped to our home. The data that we study on-line, oh my gosh. “My aunt has most cancers. Okay. Let’s instantly go surfing.” You simply take into consideration how far even from 10, 15 years in the past the place we at the moment are. We’ve made a whole lot of progress. Nonetheless a whole lot of inefficiencies and there are a whole lot of causes for that. Personally, I feel there’s discrimination in healthcare. I feel there are clearly all the time entry points in healthcare. We’re rather more difficult. Our society relies on freedom and capitalism, and others aren’t all the time in that scenario. We’re not a homogeneous inhabitants. We’re treating a whole lot of different ailments, and we’re all the time seeking to get the perfect know-how, a minimum of, a element of {the marketplace}. I feel it spells alternative even that I’m kind of in my speak right here difficult the pharma business, “Okay. How are you going to slot in?”
Even like one huge, huge pharma firm isn’t going to go in and alter the world, however the place do they slot in? The place is your spot in shifting ahead foundation the place you’re going to seek out success and aggressive benefit? Thanks very a lot.
Alexine Tranquada: Thanks a lot. [Applause] Actually, I’m so grateful. That’s our program for the day. I hope you all loved it. I hope you all are taking dwelling one thing that’s actionable or inspiring or just insightful. We might be downstairs for the foreseeable future, so we are going to see you down there. Once more, thanks all. On behalf of Greenbook and all people on IIEX occasion group thanks a lot for being right here. [Applause] Oh and thanks to Lexi for being my trusted co-chair on this monitor. It’s nice. Thanks. Excellent. [Applause]
