More medicine, more problems
IQVIA report puts value, costs at center of outlook
Perennial readers of the healthcare industry’s tea leaves, IQVIA — née QuintilesIMS — is once again looking into what the future holds for the healthcare market. The IQVIA Institute for Human Data and Science recently released its report on where the global health market is headed in the next five years.
“Global health is poised to meet a series of key turning points, and changes seen in 2018 will mark the key in directions that drive the outlook for the next five years and beyond,” the report said. “The types of medicines being developed, the way technology contributes to health and how the value of health care is calculated are all changing, markedly.”
Most of the projected trends have to do with two factors that increasingly are in focus — and that the report suggested will continue to be the object of scrutiny in the coming years — namely, cost and value. The report noted that with regard to innovation, the Food and Drug Administration’s access to robust, real-world data on treatments will continue to improve, health apps will make their way into treatment guidelines as an increasing number of studies validate their impact on outcomes, and telehealth use will expand, taking in some of the roughly 400 million visits to the emergency room, urgent care facilities and primary care doctors that can be shifted to lower cost sites of care.
Also among the innovative changes IQVIA projects in the next five years is the increased adoption of biotherapeutic drugs that have heretofore been niche products. These treatments, which include cell-based therapies, gene therapies and regenerative medicine, are expected to see between five and eight drugs join their ranks every year. And while this is promising for patients, gene therapies are something of a harbinger of the ways that reimbursement will need to change to match innovation.
The report also noted that curative treatments offer the ability to be billed at time of treatment, creating a possibly prohibitive cost density, which, coupled with small patient populations, could cause difficulty for payers. “While the flow of Next Generation Biotherapeutics is increasing, payment models have been slow to adapt. In the future, governments, insurers and patients will not be able to afford Next Generation Biotherapeutics without some mechanism to adjudicate which patients are eligible for treatments, negotiate payment based on outcomes or to amortize costs over time.”
An uptick in costly next-generation medication will come as IQVIA projects that, while branded medication spending will fall in developed markets, specialty medication will be the principal driver of spending growth. Branded medication prices are set to drop due to a confluence of factors, not the least of which is a patent expiry impact projected to be 37% larger from 2018 to 2022 than the previous five years. Additionally, new drug launches are expected to slow as most developed markets — save the United States — are expected to see branded drug price levels drop in the next five years.
“The steady level of spending will provide opportunities for payers to focus on addressing outstanding healthcare disparities, to increase access or to invest in approaches to address system inefficiencies,” the report stated.
Among the aspects that will need to be addressed will be the fact that, by 2022, specialty medications’ share of spending will surpass 50%. In 2018, IQVIA said that it will make up 41% of developed market spending — compared with $172 billion in 2013.
A focus on value will increase alongside this growth, and IQVIA highlighted outcomes-based contracts as playing a role in containing costs, though it noted that “the administrative burden on all parties will escalate and become prohibitive unless the outcomes are designed in measurable ways.” And biosimilar drugs also will see new potential in the coming years, with the report noting that by 2022, 77% of current biotech spending will be subject to some form of competition in the developed market. The only hurdle will be biosimilars makers pursuing the products that are difficult to manufacture.
“Clearly the greater the number of competitors, the greater the competition-indued savings for payers, but only time will tell how much savings biosimilars will generate,” the report said.
Q&A: FlavoRx’s Recipe for success
Stuart Amos, CEO of FlavoRx, shares why customization is key to a memorable pharmacy experience
Sometimes it takes a personal moment for a great idea to click into someone’s head. According to Stuart Amos, the CEO of FlavoRx, that is exactly what happened at his company. Drug Store News sat down with Amos to talk about FlavoRx, its start and where the company sees itself in the marketplace today and in the future.
Drug Store News: Tell us about Flavorx and its history.
Stuart Amos: Like many great ideas, FlavoRx was born of necessity. It’s no secret, getting kids to take medicine can be a monumental task. About 24 years ago, the inventor of FlavoRx, whose father happened to be a pharmacist, was struggling to get his daughter to take phenobarbital for her seizure disorder. She couldn’t, or wouldn’t, keep it down, and she was not getting better. After much testing and tweaking, they came up with a recipe that helped her swallow her medicine and reduce her seizures. That was the ‘aha’ moment. Since then, our company has expanded into 45,000 retail locations, both domestic and international. We also have a line of flavors for pets, which is utilized by both veterinary clinics and compounding pharmacies to help pets take their medicine as well. Also, we joined forces with Fillmaster Systems to help optimize pharmacy workflow.
DSN: What makes the company unique?
SA: We are the fun side of pharmacy. There aren’t many, if any, services available behind the counter that elicit an emotional response with customers like FlavoRx. Letting kids choose the taste of their medicine is empowering. It gives them a sense of ownership and excitement at a time when they feel little control or joy. Additionally, because we make medicine time easier, parents don’t stress as much when it’s time for that dose of amoxicillin or Tamiflu. Taking care of their children and reducing their stress levels is a surefire way to gain parents trust and affinity.
Our partnership with Fillmaster is another differentiator. By combining reconstitution and flavoring into one automated step via the new Fillmaster Auto, we’re able to eliminate several minutes from the dispensing process. No other company has a solution like the Fillmaster Auto — not even close.
DSN: How does this help retailers in terms of sales or marketing?
SA: FlavoRx drives customer loyalty and new business. Offering to customize the taste of a child’s medicine demonstrates to customers a level of care for their family’s health that is both relevant and unexpected. This creates a memorable pharmacy experience, which leads to brand devotion and great word-of-mouth marketing. As we’re now seeing on social media, the FlavoRx experience is highly shareable. Moms and dads (but mainly moms) don’t have many reasons to get on Facebook and talk with their friends and followers about the trip they just took to the pharmacy. Executing at a high level with the FlavoRx service is a proven way to start the conversation and build enthusiasm.
DSN: What does the retailer need to do?
SA: The simple answer is to get technicians to ask about flavoring whenever they see a prescription for a liquid antibiotic. Nothing is more effective than asking. This does require a certain level of commitment from the retailer. In a perfect world, every technician or pharmacist would ask, ‘How would your daughter like her medicine to taste?’ with every liquid prescription because it’s the right thing to do for the customer. But everyone has a ton on their plate. They get distracted. They forget. Sometimes they don’t want to flavor medications because it takes time. Pharmacy teams need motivation from their leaders to do well with the flavoring service. Setting goals, sharing best practices, communicating success stories, investing in automated dispensing equipment — these are all great ways pharmacies can maximize the programs potential and win more business.
DSN: Finally, what are your plans for the near future?
SA: We are highly motivated to help retailers maximize the potential of the flavoring service and optimize their pharmacy workflow. The new Fillmaster Auto helps accomplish that, so we are focused on getting as many of these machines into pharmacies as possible, plain and simple. We’re also working with strategic marketing partners to drive the flavoring conversation on social media and generate buzz for our customers.
Stuart Amos is the CEO of FlavoRx.
Q&A: Service stands out at Ascend Labs
John Dillaway, executive vice president, Ascend Labs, shares how the pharmacy company looks to make its mark in a crowded field
Generics maker Ascend Labs has been in business since 2000, when it was conceived as a product development company. In the years that followed, it acquired a marketing company and hit the market with three products in 2009. Today, the company is a wholly owned subsidiary of Indian generic drug giant Alkem, with more than $200 million in annual revenue and nearly 40 molecules on the market.
Drug Store News talked to Ascend Labs executive vice president John Dillaway about how the Parsippany, N.J.-based company stands out in a crowded market, and what it has in store for the future.
Drug Store News: How does Ascend Labs differentiate itself in the generics space?
John Dillaway: In a word, service. Ascend recognizes that there is little that it sells that cannot be purchased elsewhere. To this end, Ascend has invested in what it believes is one of the industry’s top sales teams. It has hired experienced sales executives who come with knowledge of the industry and strong relationships that can determine quickly if we have opportunity or not. We have balanced that with bright, younger individuals who can learn from their more experienced peers and offer a longevity that will serve the company and its customers well for many years. Beyond our investments in people, Ascend also has invested in its products.
We recognize that being in an in-stock position is extremely important, and we have beefed up on-hand inventory in an effort to be in a position to say yes when customers come calling. We have also implemented an extended dating stability program looking to move the dating on our products from the standard two years to three years and beyond. This allows us to hold more inventory on hand without fear of it going short dated, and allows customers longer times to sell through. At the end of the day, Ascend aspires to be a reliable supplier, and these investments have allowed us to become just that.
DSN: How are you educating pharmacies and patients about your products and their benefits?
JD: In several ways. Ascend has increased its presence at trade events and has developed a larger presence at national shows over the past few years. We also visit customers at their headquarters, where we can continue this process in a more private environment.
We are also very close to launching a new website, which will provide physicians, retailers and consumers much more information on our products, including allergen information, that will make getting these answers much faster with much less hassle for all. Finally, we are one of the only generic manufacturers that has an actual practicing primary care physician on our staff whose job it is to field calls from other physicians, pharmacists and even patients who have any questions about our products. This service is one that gets quite a bit of usage with our physicians — with response time typically less than 30 minutes.
DSN: What’s in store for Ascend Labs in the future? Any new products on the horizon?
JD: Ascend currently markets about 40 molecules — 125 SKUs when you consider various strengths and sizes. We have about 50 more molecules fully developed and awaiting FDA approval, and another 100 or so at various stages of development. We have invested heavily in infrastructure, with two FDA-approved manufacturing campuses in India, one in St. Louis and an API manufacturing plant in California. We are in the process of adding capacity in India by more than doubling our size in our Damon facility, and have broken ground in central India on what will be our third and largest facility for the U.S. market. We expect this to come online by 2020, and it will essentially quadruple our output from where we are today.
Unlike many companies that are currently paring back their lines and focusing on only the most profitable items, we view ourselves as a healthcare company. Instead of abandoning items, we are adding capacity to ensure we are not only supplied well today, but will be supplied well tomorrow as these additional molecules are approved and enter our line.
John Dillaway is the executive vice president of Ascend Labs.