IntelliQHealth Blog

Early last year industry experts anticipated that 2012 would be challenging for the largest global pharmaceutical firms. . . a year of transition as they digested lost revenues due to the patent cliff, and adjusted to growing governmental scrutiny and regulation as well as a poor economic climate.

The pharmaceutical industry, according to First Word's Pharma Outlook Q1 2013 report, will continue to face many of the same challenges during 2013.  Even though the FDA approved 39 new chemical entities during 2012, the highest number in 16 years, overcoming the sizeable revenue declines due to patent expirations and generic competition will be considerable.  Furthermore, an evolving market landscape with new 'generic" competition from biosimilars and a growing demands from payers and providers to demonstrate value, creates additional hurdles.

During the next five years, pharmaceutical manufacturers are likely to overcome the patent cliff and other industry challenges with a broad range of new products.

According to a recently released Robert Wood Johnson Foundation study, rising premiums have driven a steady decline in employer-sponsored health insurance since 2000.

In 2011, the number of non-elderly Americans with employer-sponsored insurance stood at 159 million, a decline of 11.5 million from 2000 (69.7% in 1999/2000 vs. 59.5% in 2010/2011). According to the report, 47 states had a statistically significant decline in employer-sponsored coverage from 2000-2011, with 22 states experiencing declines of at least 10 percentage points.

Employers Offering Coverage, 2010/2011

Source:  State Health Access Data Assistance Center, 2013.  "State-Level Trends in Employer-

Sponsored Health Insurance."  SHADAC Report, Minneapolis MN, University of Minnesota.

Other key findings:

• While most states saw “significant declines” in employer provided coverage, the range was wide (e.g., New Hampshire with 73.8% coverage vs. New Mexico with 48% coverage).
• The largest decline occurred in Michigan with a 15.2% drop.
• As might be expected, higher income populations experienced less of a decline than lower income populations.
• Annual premiums for single coverage more than doubled while family coverage increased 125%.

For a full copy of this report, click HERE.

For the first time in over 20 years, spending on traditional prescription drugs among those with commercial insurance declined 1.5% in 2012, according to latest Drug Trend Report just released by Express Scripts.

Much of this decrease can be attributed to broader availability, growing use, and lower prices of generic medications.  While spending for brand name drugs rose 12.5% in 2012, this increase was more than offset by a spending decline of 24% for generic medicines.

* 2012 = January – December 2012 vs. same period, 2011,   Q4 = October – December, 2012 vs. same period, 2011

Source, Express Scripts 2012 Drug Trend Report

Spending on specialty medications on the other hand continued to increased during 2012, jumping 18.4%, and contributed to an overall annual prescription drug upward spending trend of 2.7%.  With the Food and Drug Administration approval of 22 new specialty medications in 2012, many of them with very high price tags, this trend is likely to continue.

In total, specialty medications accounted for 24.5% of total per member per year (PMPY) spending on prescription drugs in 2012.   Increased usage and significantly higher costs for new hepatitis C therapies, drugs for inflammatory conditions such as rheumatoid arthritis, and unique cancer treatments were key contributors.

It is also worthwhile to note that spending for diabetes prescription drugs accounted for the single biggest share of spending on any treatment class, rising 11% in 2012 versus a 7% increase in 2011.  With diabetes diagnosis increasing dramatically, according to a new study by the Centers for Disease Control and Prevention (CDC), it is likely the proportional share of overall drug spending for diabetes drugs will continue to rise in the coming years.

A great deal of more in-depth information on these prescription drug spending topics and trends can be found on the Drug Trend Report 2012 web site.

In recent months the subject of Telehealth has generated steadily increasing interest and "buzz" in the media, industry circles and among politicians. Will all this "buzz" and attention finally translate into what Jonathan Linkous, CEO of the American Telemedicine Association (ATA) characterized as a "banner year" for Telehealth in 2013?   Is Telehealth "ready for prime time at last?

Both Information Week and Computerworld cite reports that project a six-fold increase in home-based health monitoring and a nearly five-fold growth in the number of in-home monitoring devices between now and 2017.  A new InMedica study projects remote patient monitoring use to grow from 300,000 patients today to 1.8 million worldwide by 2017, while Berg Insight predicts the volume of home-based remote monitoring devices to increase from 2.8 million to 9.4 million connections by 2017.

World Telehealth Patients (thousands by disease state)

Source:  InMedica - World Market for Telehealth

Telehealth growth is being fueled primarily by the efforts of governments worldwide to curb increasing healthcare costs.  As a result, the majority of patients using remote monitoring devices are post-acute patients with long-term chronic conditions such as congestive heart failure, COPD, diabetes, hypertension and mental health issues.

The use of these devices is increasingly being viewed as critical for reducing hospital readmission rates, tracking disease progression to improve outcomes and quality of care, as well as an efficient and cost effective solution for care access in rural and remote areas.

According to the ATA, growth is also being facilitated by a flurry of legislation mandating coverage for telemedicine services similar to the way in-person visits are covered, resulting in  more and more payers (most recently Wellpoint) including remote monitoring coverage in their plans.  At the same time, research shows that payers are recognizing that they can increase their competitiveness and reduce in-patient payouts by working with Telehealth suppliers.

"After 40-plus years of development, telemedicine has finally come of age," ATA CEO Linkous writes, and argues that demonstration grants, projects and experimental research are giving way to Silicon Valley, private payers and consumer groups embracing the technology to transform the delivery and quality of care.  Linkous sums it up nicely when he says, "Whether you call it telehealth, mHealth or remote monitoring, the deployment of telemedicine is galloping."

30-day Readmissions Reduction: An Imperative for Hospitals

Faced with potential reimbursement penalties starting this month, the need for hospitals to address reductions in 30-day preventable readmissions has become an economic, as well as a quality of patient care/outcomes, imperative.

The stakes are high. Cost estimates range between $17 billion to $31 billion annually, according to the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ) respectively, and hospitals are facing potential penalties of as much as 1% of their total Medicare billings for higher than permitted readmission rates.

Even though the readmissions problem has been studied extensively, and substantial investments in technology such as clinical systems have been made, the root causes are not well understood and the average 30-day readmission rate has remained fairly constant around 16% in the United States. While this lack of understanding may be attributed to variability in data from hospital to hospital as well as disease states, geography, demographic and socio-economic characteristics, progress has been made in identifying certain disease states more likely to result in readmissions as well as interventions that are positively impacting readmission rates.

There are a variety of prevention programs and interventions best practice hospitals have implemented that center around patient education, and pre-, and post-discharge coordination of care procedures. Even a simple follow-up call with patients positively impacts readmission rates.

A recent Strategic Solutions for the Readmissions Challenge provides an excellent overview of the key role proactive care and care transition best practices can play in reducing preventable readmissions. Featuring case studies from four leading health systems, the report provides valuable insights into various approaches used by these leading institutions to attack the readmissions challenge.

Post-Launch Customer Acceptance Analysis Maximizes New Product Development ROI

IntelliQ Health recently launched a new service that provides a research framework and methdology intended to measure market acceptance of new products and services following their initial introduction.

IntelliQ Health's Customer Acceptance Analysis is a formal early market feedback mechanism to identify new product and service program deficiencies, provide insight into needed corrective actions and uncover additional market and future product and services opportunities.    Its ultimate objective is to maximize the return on organizations' new product and services development investments.

For more information, please click here for access to IntelliQ Health's Customer Acceptance Analysis White Paper.

Cincinnati, Ohio, June 26, 2011

A spirited debate has been ongoing for a number of years about the roles of medical professionals in the patient-centered medical home (PCMH). While the conventional wisdom and current practice has had the lead role reserved for primary care physicians, other medical professionals, and especially advanced practice nurses, along with their advocacy groups, are increasingly challenging the status quo as they jockey for position and a more significant role in the medical home.

Although the patient-centered medical home concept has been around for some time, it has regained visibility since the implementation of the Affordable Care Act of 2010. Originally mandated by the Tax Relief and Health Care Act of 2006 and the Medical Homes Act of 2007, the PCMH is about understanding a patient’s needs, coordinating and providing evidence-based preventative, acute and chronic care through shared decision making between the patient and a multi-disciplinary team of providers.

Most of the medical home demonstration and pilot projects under way today are physician-led and most physicians, along with the four biggest physician advocacy organizations, prefer to keep it this way. While other medical professionals, such as nurse practitioners, pharmacists, social and case workers are certainly welcome to be part of the care team, the position of physicians is that PCMH’s should be physician directed and led.

In light of the significant shortage of primary care physicians expected in 15 years, the efforts by other medical professionals and especially nurse practitioners (NPs), advanced practice nurses and pharmacists, to secure more significant roles in PCMH’s appear to make good sense. Furthermore, with the contributions of NPs, advanced practice nurses, and pharmacists in the delivery of accessible, affordable, high quality and safe care well documented, the time might be right to give serious consideration to exploring expanded roles for them as primary care providers and leads in the PCMH model.

As a start, medical home demonstration projects should allow for nurse practitioner-, advanced practice nurse-, and perhaps pharmacist-led PCMH’s utilizing the same standards and scoring mechanisms applied to physician led PCMHs. The outcomes and results will speak for themselves. It is interesting to see progress in this direction being made at the state level, especially in states where nurse practitioners are already authorized to provide independent primary care. In addition, adjustments in the definition of medical homes as “clinician-,” rather than physician-led also open the door to this possibility.

For more information about the latest patient-centered medical home developments, please contact Bert Kollaard at 513-605-3633 or via email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

About IntelliQ Health

IntelliQ Health is a full service market research and intelligence consulting firm exclusively focused on the healthcare industry. Since 1983, IntelliQ Health has completed well over 4,000 studies across the healthcare continuum of care. During this time, we have helped countless healthcare organizations improve and accelerate their most critical decisions with meaningful information and actionable insights.

Cincinnati, Ohio, May 12, 2011

In a recent report entitled, The Use of Medicines in the United States - Review of 2010 the IMS Institute for Healthcare Informatics reports slowing growth of spending on prescription medicines and declines in doctor office visits and new chronic therapy treatment intiations. More specfically. . .

• Overall, spending on prescription medicines in the US in 2010 increased by 2.3% to $307 Billion, considerably lower than the 5.1% spending growth during 2009.
• The number of visits to doctors' offices declined by 4.2% in 2010, while new therapy starts declined by 3.4 million during 2010 versus 2009.

IMS attributes these declines and slowing spending growth to a convergence of factors, including continued high unemployment levels, more people losing their healthcare coverage, greater use of generics, rising healthcare costs, and more careful healthcare spending.

Other noteable findings:

• The average patient co-payment declined 20 cents to $10.73 in 2010 primarily due to the growing use of generics, which now account for 78% of all retail prescriptions.
• Consumers are increasingly turning to chain drugstores for their prescriptions. increasing their share by 0.5%.

For additional insights about the changing healthcare landscape and its impact on the use of medicines, simply This e-mail address is being protected from spambots. You need JavaScript enabled to view it and we will send a FREE copy of the report to you.

Contact:

Bert Kollaard, MS
Vice President Client Services
IntelliQ Research & Strategy
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Tel:(513) 605-3633

Washington, DC, September 21, 2011

New Study Finds Use of Generic Prescription Drugs Saved Consumers and the U.S. Health Care System $931 Billion Over Past 10 Years

Savings Reached $158 Billion in 2010, Averaging $3 Billion Weekly

The Generic Pharmaceutical Association (GPhA) today released an independently conducted analysis showing that the use of generic prescription drugs in the U.S. has saved consumers and the health care system $931 billion over the last 10 years (2001-2010).

The analysis, conducted for GPhA by the IMS Institute for Healthcare Informatics and IMS Health, shows that in 2010 alone generic drug use generated nearly $158 billion in savings, an average of $3 billion every week.

“These findings could not have come at a more critical time,” said Ralph G. Neas, GPhA President and CEO. “The analysis shows beyond doubt that savings achieved through the use of safe and effective generics deliver a huge win to consumers looking to hold down their health care costs. Moreover, the savings provide a winning solution to those in Washington trying to address the sustainability of the nation’s health care system, as well as the national economy.”

Noting that the Congressional Budget Office recently pointed to the rising cost of health care as the greatest threat to our fiscal future, Neas said, “It is significant that the savings delivered by generics are system-wide and not the result of simply cost shifting. As such, the savings gained through the use of generic medicines benefit both the public and private sectors.”

The analysis also pointed to the extraordinary savings delivered by newer generics, those introduced since 2001. The majority of these new generics entered the market before the patents on the counterpart brand drugs expired thanks to patent litigation settlements between the generic and brand companies. “A ban on patent settlements would have the unintended consequence of delaying patient access to lower cost generics, costing consumers, payers and the government billions of dollars,” Neas said.

The study also reports that the Medicaid system could save more than $1.3 billion annually by increasing generic use by just two percentage points. Nationally, generics account for only about 70 percent of total Medicaid prescriptions. But outside of Medicaid, generics account for 78 percent of all prescriptions. With Medicaid paying on average 80 percent less for a generic prescription compared to the brand drug, federal and state governments could save more than $600 million for each one percentage point increase in generic usage.

“When the generic drug industry was established by Congress in 1984, it was predicted that generic drugs would save our country $1 billion a year,” Neas said. “As this analysis shows, the savings generated by generic prescription drugs are now three times that amount every week. As a result, millions of Americans are able to get the medicine they need at an affordable cost."

GPhA represents the manufacturers and distributors of finished generic pharmaceuticals, manufacturers and distributors of bulk pharmaceutical chemicals, and suppliers of other goods and services to the generic industry. Generic pharmaceuticals fill 78 percent of the prescriptions dispensed in the U.S. but consume just 25 percent of the total drug spending. Additional information is available at gphaonline.org.

Cincinnati, Ohio, March 15, 2011 – Cooper Research Announces New Corporate Identity and Name Changes for Its Two Operating Divisions

New operating division names more accurately reflect its longstanding industry focus and expertise.

Dr. Robert Miller, CEO Cooper Research, Inc. today announced the launch of its new corporate identity, IntelliQ Research and Strategy, Inc., as well as IntelliQ Health and IntelliQ B2B as the new names for its two operating divisions, Cooper Research and Diagnostics Plus.

State College, Pennsylvania, March 15, 2011 - Diagnostics Plus Announces New Corporate Identity and Name Changes for Its Two Operating Divisions

New operating division names more accurately reflect its longstanding industry focus and expertise.

Dr. Paul Weener, CEO of Diagnostics Plus, today announced the launch of its new corporate identity, IntelliQ Research and Strategy, Inc., as well as IntelliQ B2B and IntelliQ Health as the new names for its two operating divisions, Diagnostics Plus and Cooper Research.

Cincinnati, Ohio, February 21, 2011 – IntelliQ Research and Strategy, a full service global provider of market research and intelligence for the healthcare and business to business markets, announced today that Mr. Bert Kollaard has joined its IntelliQ Health division, formerly Cooper Research, as Vice President, Client Services.