Future of Pharma Reimbursement and Health Care Trends, Treatment Access and Funding Approval - why health care rationing will dominate pharma funding - impact on patients and pharma profits

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Notes on pharma trends keynote for Roche Pharmaceuticals on Drug Treatment Access.

In the past, the major challenge for a pharma company was to develop a new drug therapy, prove excellent health care impact in clinical trials, show patient safety with few side effects, and get licience approval for the drug to enable the product to be sold commercially. Typically the process could take up to 15 years, and cost up to $1.2 billion, which all had to be recouped in 10 years of sales before the patent ran out.  

But today there is a massive additional hurdle: how does a pharma company persuade cash-strapped governments and insurers to fund a new therapy for patients?

Health care budgets are very limited, so every additional cost of a new drug therapy has to be saved from cuts in some other part of the health service. It is no longer enough to prove the therapy works, saves lives, has less side effects and so on.  

Every pharma company has to make the case that their new drug therapy offers good value for money compared to other treatments for the same condition.  

Health rationing is complex and highly controversial but is taking place every day in almost every government-funded hospital around the world.  

Life-and-death decisions are being made by health care economists and by government administrators, who are in turn being lobbied by sick patients and their worried families, as well as by activist groups, medical researchers and hospital clinicians.

The truth about the future of pharma:

1) Pharma companies will need to offer far more sophisticated data about cost benefits – not only things like cure rates, but also measures of improvement of quality of life for those with chronic conditions.  Measures of impact on human life and wellbeing may also include estimates of lower numbers of working days lost because of ill health, fewer days spent in hospital and so on.

2) Data is not enough: human stories are also powerful and necessary.  Decision-makers are ordinary people with their own families and close friends.  They may be swayed by a story of extraordinary success in treatment of a very distressing condition, that someone they know well is also suffering from.  As Stalin himself once said:  “A million deaths is a statistic.  A single death is a tragedy.”  Pharma companies will need to communicate the personal tragedies as well as the health statistics.

3) Pharma companies need to work together with government decision-makers to help resolve these complex questions in a collaborative rather than adversarial way.

4) Most important of all, the most compelling approach will always be where the pharma team member sees themselves as a patient advocate, helping sick people fight for the very best treatments available.  And as part of advocacy, working closely with patient groups to help make our world a better place.  

The moment a pharma team member is positioned as a mere commercial agent trying to maximize pharma drug sales and profits for shareholders, the person rissk losing credibility in the eyes of those who hold responsibility for government health care budgets.

5) As part of this there are important ethical questions to be asked about what a reasonable price is for a new drug therapy, given the huge risks of failure in early studies and clinical trials.  Society has a strong interest in a profitable pharma industry, because without it, research funding for clinical trials will rapidly dry up.  The rate of innovation for new health therapies is very slow for many different types of illness.  It is shocking to me that a doctor who completed training this year is using a large number of identical medicines to those I was trained to use as a doctor over 30 years ago.

Here is the key: only “sell’ what you really believe in.  

It is not enough to say a drug works.  You need to be certain deep inside yourself that the benefit of the pharma therapy you are promoting, at the agreed price per treatment, is a really good use of public money, compared to the other types of medical treatments what will need to be cut back, in order to pay for it.  Anything else is just overselling, and lacks integrity.

And always keep in mind how tough the job is of the decision-makers “on the other side” who may well have sleepless nights after agonizing health care decisions, chosing between different therapies for different groups of people, all of whom would benefit in some way from some extra health budget, which cannot easily be found.

Need a world-class pharma keynote speaker for your event? Phone or e-mail Patrick Dixon now.


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