---Terri Bernacchi, PharmD, MBA, President, Cambria Health Advisory
Professionals, and FOUNDER, SME Systems (this blog also posted on www.smehealthsystems.com)
This is the inaugural post for SME Systems and I will be
linking it to others that I post on the web; the issue (especially given my
background as a pharmacist with experience in both the clinical and business
world in the US) is clear to me: how
will branded pharma and device companies continue to bring value under a
retooled US Health Care system?
The critical changes are removing the traditional parties
(doctor and patient) from the buffered world where “someone else will pay for
this”. Risks are being spread, insurance
rates are going up and providers are being penalized for what is perceived as
“over spending”.
The new Accountable Care Organization (because it is taking
on transferred risk) is unlikely to allow “business as usual” with the
pharmaceutical sales machines that have been so successful in the past.
So how does one INNOVATE and then MARKET in such a different
environment?
In a word, I believe, you can only do these things if you
shift your own perspective and become willing to prove value in different
ways. That may be the key mission of SME
Systems: proving Safety as part of
compliance and VALUE as part of Medical Effectiveness.
Tim Norton published a brilliant commentary about the fact
that now about 70% of the market is government backed, the meaning of
competition, the success of the Medicare Part D program and HHS’ recent attempt
to break what worked in that program, too.
HHS has backed off on their most recent plans but the threat to the
bounties of a competitive marketplace are clear. (See the link:
http://blog.pharmexec.com/2014/03/12/close-call-for-american-rx-marketers-on-medicare-part-d/ )
Since I cannot say it better than he did, I hope you read
this for yourself. Here is the most
critical part of his commentary and his clarion call to be alert:
“I believe it’s clear that as the U.S. progresses farther
and farther down the road of expansive public healthcare, U.S. pharmaceutical
companies are going to face many battles with public entities that will attempt
to close their free market channels.
Hopefully, this recent “close call” with Part D is not a
foreshadowing of what’s to come. But frankly, as the inevitable cost pressures
develop in all these public programs, I would not be surprised to see more of
the same, and soon.
In any case, the wise American Rx marketer would do well to
fully understand and appreciate the developing mindset of all the new public
programs now coming online…A mindset that is definitely not free enterprise
oriented.”
Terri is the Founder of SME Health Systems and Cambria
Health Advisory Professionals. She is a
Senior Partner at Valiant Health, LLC.
The thoughts put forth on these postings are not necessarily reflective
of the views of her employers, clients nor other colleagues. Terri has had a
varied career in health related settings including: 9 years in a clinical
hospital pharmacy setting, 3 years as a pharmaceutical sales rep serving
government, wholesaler, managed markets and traditional physician sales, 3
years working for the executive team of an integrated health system working
with physician practices, 4 years as the director of pharmacy for a large BCBS
plan, 12 years of experience as founder and primary servant of a health
technology company which was sold to IMS Health in late 2007. She has both a BS and a PharmD in Pharmacy
and an MBA.