The move to an outcomes model in pharma is real. However, how pharma companies will get there is much less clear.
Part of the challenge is that many factors drive outcomes. While the molecule itself is important, so are factors like real-world evidence and social health determinants along with better compliance, monitoring and screening.
In fact, in determining overall social health, medical care gets only about 10% of the responsibility, said ad agency exec Prodeep Bose, who heads growth and innovation for The Bloc. Patients' choices are much more influential at 40%, followed by genetics (30%), social factors (15%) and environment (5%).
So what can pharma companies do?
Bose has devised an alliterative list of issues pharma should already be exploring—prevention, prediction, precision medicine and people-centered care—when it comes to outcomes and the future of healthcare.
“For any product that comes to market today, the question should not be, ‘Should we have a value-added service on top of the molecule?’ The question should be ‘Is there any reason to not have it?’” he said.
For many pharma companies, that will mean partnering with advocacy groups, hospital systems or technology partners to create value adds like targeted screening, personalized diagnostic testing and real-time monitoring, for instance.
Another avenue some “high-science” pharma companies are taking is a more narrow focus, he said. They are developing precision medicine with companion diagnostics that deliver better outcomes because they predict exactly which patients will respond best to certain therapies. Bose called it a “very specific tactic” to evolve beyond the molecule, but one already being explored in oncology, cardiology and rare diseases.
“The big question is what is pharma’s orientation to owning, enhancing or partnering in the entire value chain system of driving real-world outcomes? That’s what every pharma company is grappling with,” he said.
“If outcomes are what society, the financial model (and) the compensation framework want, how does pharma adapt? How do manufacturers of molecules who are used to bringing to market a data point that was captured in highly controlled circumstances, also known as clinical trials, how do they adapt culturally in terms of their business model and their commercialization process to an outcomes-based model?” he added.