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PHILADELPHIA — The changing healthcare environment and the challenges and opportunities of specialty pharmacy were the biggest themes at Acro Pharmaceutical Services' sixth annual Payer and Managed Care Symposium in Philadelphia last Thursday.
Representatives from drug makers and across the specialty pharmacy space met at the Hyatt at the Bellevue to discuss a wide variety of topics related to specialty pharmacy.
Following opening remarks by Acro president Sajid Syed, Philadelphia-based Independence Blue Cross SVP and chief medical officer Richard Snyder took the stage to talk about the shift to accountable care and its effects on payer and provider relations.
Afterward, Gorman Health Group chairman John Gorman provided the view from Washington, talking about such topics as the election and its implications for government health programs and Medicare.
"We've got to all collaborate to deliver better value to the member, the payer and ultimately to the customer, the federal government," Gorman said. The implications of healthcare reform were huge, he said.
"We are on a lightning path toward the biggest reform of our health system we've seen maybe since Medicare and Medicaid," he said.
Accountable care organizations are set to "explode," he said, predicting a leap forward in the health system that he compared to Turkey's sudden embrace of mobile phones in the 1990s that skipped the development of land lines. Healthcare delivery could become similar to public utilities: heavily regulated, with mandated expense margins and a need for organizations to provide unique value as middlemen or else "you're toast."
Gorman also spoke of dual eligibles — people who are eligible for Medicare savings programs or Medicaid benefits. They are an important group for specialty, he said, and will be in need of services like medication therapy management.
Following Gorman's presentation, Specialty Pharmacy Solutions founder Bill Sullivan briefly talked about trends in the drug pipeline and biosimilars, noting that specialty made up about 20% of drug spend in 2010, totaling $100 billion, despite accounting for only 1% of the population. Today, that figure is 25%, expected to reach 40% by 2015, while specialty drugs represent about 50% of the drug-development pipeline.
Afterward, PerformRx president Mesfin Tegenu spoke about topics like the budget crisis and what high-priced specialty drugs could add to it. "I don't think anyone understands what to do when a drug comes out with a $100,000 cost and extends a cancer patient's life by three months," Tegenu said.
Following a brief introduction to the National Association of Specialty Pharmacy by president Gary Cohen, University of the Sciences president emeritus Philip Gerbino moderated a panel discussion that included representatives from several payers who discussed topics like the value of specialty drugs and the need to manage coverage and opportunities and challenges from the Patient Protection and Affordable Care Act.
"We need pharma to come up and show us the value of some of these therapies," Syed told Drug Store News. "We want to hear how pharma is showing value and openign access to pharmacies so the patient gets the right drug at the right time."