ACHP Live Interview —

High-Cost Drugs: Challenges and Opportunities

Date: Monday, June 15

  • Kavita Patel, M.D., Managing Director, Clinical Transformation, Brookings Institution Center for Health Policy (Moderator)
  • Ceci Connolly, Managing Director, PwC’s Health Research Institute
  • Leslie Fish, Vice President of Clinical Programs, Fallon Health
  • Eileen Wood, Vice President of Clinical Integration and Chief Pharmacy Officer, Capital District Physicians’ Health Plan

The Alliance of Community Health Plans (ACHP) facilitated a conversation about high-cost drugs and the effect of these high prices on patients, insurers, providers and state and federal governments. The discussion focused on drug pricing trends; how new drugs are helping patients; strategies for ensuring patients have access to appropriate drugs; and emerging specialty drugs, such as the PCSK9 inhibitors for control of high cholesterol.

Included among the key takeaways from the conversation offered by the panelists:

  • There is a need to use alternative financing models and think about the high-cost drug issue in the context of alternative payment models as care delivery continues to evolve. The separation of pharmaceuticals and the delivery of care needs to end.
  • All sectors of health care, not just pharmacy, are being asked to deliver a high rate of service with fewer resources. As this trend continues, there is a need to begin pilot programs testing alternative financing models.
  • Consumers and health care providers continue to be inundated with drugs introduced to the market as the priority for particular disease states. There is a need to weigh the risks and benefits of these drugs to other drugs and alternative treatments.
  • High cost is not only an issue with specialty drugs; all drug prices are increasing.
  • There is a need to unify value messaging around the drug cost issue and use organizations with which we are associated to disseminate the message to the public.

Additional information is available in PwC’s Medical Cost Trend: Behind the Numbers 2016 report, the webinar slide presentation and the webinar recording.