Editor’s Be aware: Within the fall of 2022, GreenBook’s IIEX Well being occasion happened in Philadelphia, bringing each helpful and inspiration content material to insights and analytics professionals spanning the healthcare, pharmaceutical, medical, and wellness industries. Attendees discovered the content material so invaluable that we needed to make a lot of it obtainable to all who couldn’t attend this in-person occasion. Earlier than even studying this put up, know this: You’ll be able to view all of the periods on-demand now!
Should you aren’t in these industries … how may you apply the training inside your individual? At GreenBook, we consider that IIEX is greater than a convention collection. It’s a mindset. These are the boards by which an important insights improvements are revealed, demonstrated, debated, and championed. What begins on the occasions drive change in our world. It’s in that spirit that we convey you, instantly, among the poignant content material we heard at IIEX Well being.
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Get pleasure from our On-Demand Video
Be part of New York College Professor Steve Andrzejewski with a chat in regards to the altering panorama within the healthcare trade. Discover the continuously evolving trade and the way pharmaceutical corporations can take part on this altering panorama. Click on to view the video (courtesy of Civicom).
View extra 2022 IIEX Well being content material on-demand!
Whether or not you have been in a position to attend, or you weren’t, be a part of us on-line to see what was shared by among the greatest manufacturers, the latest startups, and expert-level researchers throughout healthcare, pharma, and client expertise. Right here’s simply two of the superb periods you’ll discover on-demand:
- Greg Hewitt and James Bauler communicate to the innovation course of behind Fuse Oncology, a spin-out of Cone Well being, after a essential examination of the lag between a affected person’s prognosis and begin of remedy.
- Zach Hebert speaks to how the Covid-19 pandemic has made it extra vital than ever to ship the appropriate message and the way the appropriate message might help ease the thoughts of vaccine hesitant mother and father.
On-line you’ll discover different implausible periods by audio system from Pierre Fabre Group, Novartis, Hinge Well being, and extra! If you wish to keep on high of the traits within the healthcare trade — one of many largest spends in market analysis — you received’t need to miss IIEX Well being On-Demand!
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If there was one thing new to our trade — an organization, methodology, or platform — that didn’t exist 10 years in the past and is now thought of a “finest apply” … effectively, you most likely noticed it first at an IIEX occasion.
What begins right here will change our world!
Transcript
(Transcript courtesy of TranscriptWing)
Alexine Tranquada: All proper. For our final presentation for the day, we’re so lucky to have Prof. Steve Andrzejewski with us to speak in regards to the altering panorama in healthcare. As we all know, issues are evolving so rapidly, and the way can pharma take part on this altering panorama. So thanks very a lot, Professor.
Steve: Thanks very a lot. Good afternoon, everybody. Oh, return one. There we go, “The Altering Panorama of Healthcare,” There’s so much occurring, and on the finish we’ll discuss how pharmaceutical corporations will work together with that altering healthcare panorama.
Simply actually rapidly on myself, I went to Hamilton School and performed ice hockey. You’ll perceive why I’m telling you that on the finish of the presentation. Then I went to NYU Stern a few years in the past. I’ve been an adjunct professor there. I train a course known as the Enterprise of Well being and Medical Care to the Economics Division. I spent my whole profession within the pharma/biotech market. Healthcare represents, as you most likely know, 20% of the gross home product. One of many issues I inform my college students proper upfront is it’s clearly very sophisticated, however within the six-week course, one night time every week, so there’s not numerous time to cowl numerous floor. Listed here are among the issues which have both arrived or rising that you must bear in mind. As you go into the course, take into consideration these items.
The primary one, it shouldn’t be a shock, “Comply with the greenback and display worth.” It’s not solely prescribed drugs. Lots of you, I’m positive, are taking a look at digital well being and all of the exercise that’s occurring there. We all know there was some huge cash that went into the digital well being popping out of the pandemic. It was a pattern that was accelerated. Nonetheless, the final six months or so, clearly, broader financial points, there’s numerous the digital well being investments gone means down. Should you learn about it, one of many issues they need to do is that they need to display worth, proper? All people does. If the digital platform sounds actually good, in the event that they’re not bettering the present scenario, it’s going to be difficult.
Consolidation. We’ve clearly seen that over time with drug change, distributors. We see CVS and Aetna, and Cigna and CSI coming collectively. One of many issues when consolidation happens in any trade, you see the worth factors begin to go up. We’ve clearly seen that in healthcare usually and, clearly with, extra not too long ago, inflation. Training. Clearly, the web over the past 10-plus years has been an enormous assist because it pertains to schooling. Individuals can get data at their fingertips rather more rapidly than they used to. Clearly, we get bombarded with issues like eating regimen and train, eating regimen and train, eating regimen and train, however there’s much more that goes past that and different essential element to healthcare.
We simply heard a little bit bit about consumer-driven healthcare and affected person duty. All people has a job within the general system. One of many issues that I received’t cowl as we speak however that we discuss in my class is we evaluate the US system to different nations and the way they deal with healthcare. In socialized methods, every thing is roofed, however there are execs and cons to that, proper? In Canada, you might have to attend six months to get an MRI. There may be this idea of affected person duty within the system. I’m not fairly positive everyone in america thinks that means, but it surely’s vital and we’ll see extra of that particularly as extra of the cash, increasingly sufferers or individuals are given the selection to do excessive deductible well being plans today the place you’re not paying as a lot when it comes to the premium popping out of your month-to-month wage, however then you may have an even bigger chunk of cash to undergo your out-of-pocket bills earlier than your insurance coverage actually kicks
1.A part of that’s the customers have extra management over the place they’re going to make use of these {dollars}. Then, clearly, you may have well being spending accounts and versatile spending accounts. I got here up with the phrase electronization of healthcare. It’s not all that simple to pronounce. Nonetheless, digital medical information, everyone knows, have performed a a lot larger function in medication. It’s not that way back that we had the manila folders, proper? Ten-plus years in the past, whenever you stroll in a physician’s workplace, manila folders in all places. The Obama Administration gave incentives for medical doctors to modify to EMRs. Should you talked to any medical doctors, as I’m positive you may have, they’ll complain to this day how painful that was. I believe it’s a greater downside, EMR, than all of the manila folders as a result of I believe there’s a greater likelihood of measuring impression in healthcare.
Clearly, past EMR, we’ve got numerous digital well being alternatives and locations on the web and different methods by which it’s impacting healthcare. Ethics is at all times vital because it pertains to healthcare and making selections simply to what will be reimbursed or not. There are at all times tradeoff selections. Not every thing goes to be paid. Then a giant bucket on the backside there, and I’m going to speak much more about that is new healthcare fashions. Large organizations like Amazon, Berkshire
Hathaway, and JP Morgan, I believe you most likely know, got here collectively underneath Haven. Three main organizations in our nation, and what occurred? It’s disbanded. It’s one other indication of how difficult healthcare is and the incentives usually are not at all times aligned throughout the system. Basic Motors with Henry Ford Healthcare System labored a little bit bit higher. We simply had the election about a few days in the past, and folks say politics are all native, proper? The identical factor to an extent with healthcare, this can be a good instance of it. It might be a little bit bit simpler to ship healthcare as a result of it’s extra regional.
Denmark is at all times excessive on the checklist when it comes to how a lot cash they spent in healthcare and what outcomes they ship. Properly, it’s a smaller, extra homogeneous group of individuals than we’ve got by far than america. So one other instance that regionalization does make a distinction. Hospitals began their very own generic drug corporations, Civica Rx. That’s been very profitable. A lot of hospitals felt they have been paying an excessive amount of cash. So how do you get extra leverage within the market? It applies in healthcare as effectively. You get extra quantity and negotiate on worth. It’s basically what they did by creating their very own drug firm. A couple of of the others I’m going to get in right here, concerned right here as we transfer ahead.
So I’m going to go over a lot of offers that occurred within the final couple of years within the healthcare house and attempt to provide you with a little bit sense as to why they probably are doing this, however it can result in the top of, “Okay. How does pharma slot in to all of these items which can be occurring in healthcare?” So, $13.5 billion UnitedHealthcare and Change Healthcare, UnitedHealthcare needed entry to Change Healthcare’s analytics and cost platforms and Change clearly is a part of Optum. Clearly knowledge, AI alternatives exist. FTC challenged this on a few of that foundation, but it surely has since handed. This occurred a few yr in the past.
Oracle and Cerner. Oracle will get entry to a trove of healthcare information from Cerner. They didn’t have entry to that earlier than, $28.3 billion. Clearly, they see an alternative right here to repair among the inefficiencies in our system. Once more, that was from December of final yr. Amazon. They’ve been quoted as saying, “Healthcare is excessive on the checklist of experiences that want reinvention.” I don’t suppose that ought to come as a shock to anyone on this room. On the similar time, we all know Amazon has been fairly good at reinventing issues, possibly not so nice in healthcare. They put a bunch of effort ahead. They haven’t all essentially labored out. For them, the $3.9 billion is most likely small within the large scheme of issues. They purchased One Medical. Clearly, that gives buyer 24/7 entry to digital care. That occurred in July of this yr.
Earlier this week, you could have seen that Walgreens, particularly, their VillageMD group, purchased Summit Well being. For these of you who don’t know, Summit Well being is Summit Medical Group, which is an built-in supply community mainly within the New Jersey space and in addition CityMD. That, I believe, was round $9 billion as introduced earlier. So, issues proceed to alter, and all these completely different organizations are taking a look at the place can they probably add worth and get a aggressive benefit. Google. One other large title in enterprise, proper? They need to play in healthcare, too. $2.1 billion, that’s not that large of an funding for Google, however they’re investing in Fitbit. Can they make healthcare extra accessible? Clearly, Fitbit is a wearable. You hear much more about wearables. Can they accumulate the appropriate data that’s going to have an effect transferring ahead? That was introduced in late ’19 however closed in early ’21.
You most likely clearly have heard of 23andMe, and so they went forward and acquired Lemonaid for $400 million. They need to make customized healthcare a actuality. Clearly, it’s genetics house for 23andMe. As a substitute of constructing a digital platform, they went out and acquired one in Lemonaid. There’s a telemedicine element of that. We’re speaking about that earlier as we speak. That was October of final yr. This one probably is without doubt one of the large granddaddies of all of them, $18.5 billion {dollars}. Teladoc purchased Livongo, and Livongo is targeted in diabetes. Should you’re a pharmaceutical firm, to me, you’d need to actually be actually finding out the way you match into the diabetes equation given the place this entire effort could also be going. You might know that Glen Tullman was the CEO of Livongo. He began Transcarent the place he’s attempting to coordinate pharmacy care to have one-stop purchasing, particularly in diabetes. Individuals get their insulin from one place. They get their different drug from elsewhere. Lots of this has to do with bettering the shopper journey, and which will trump the standard of a drug. If somebody goes on-line and so they’re having fun with and are in a position to get by means of what’s perceived and the difficulties of pink tape in healthcare proper now and may get to some extent the place they’ll get care and a drug that makes a distinction, they might simply be going with the generic drug. It doesn’t matter that there’s a brand new drug within the market that’s considerably higher in a way, form, or type.
Not too long ago, USA At present did a survey; 68% of individuals need know-how to play an even bigger function in sharing real-time medical data with their doctor. Fifty-six p.c of individuals surveyed used a digital assortment instrument to watch well being. I believe numerous us most likely monitor our steps on our iPhones. Clearly, it’s going means past that transferring ahead, once more, one other indication that customers are going to manage extra of their healthcare transferring ahead. Psych Hub is only one instance of many digital well being platforms which can be on the market. They not too long ago raised a good quantity of cash. They’ve over 800 companions together with J&J. It’s an academic useful resource for psychological well being, and it connects you to a physician for a seek the advice of. To me, in the event you’re a pharmaceutical firm in psychological well being, I’d attempt to actually perceive what’s going on in Psych Hub and plenty of, many different psychological well being platforms which can be on the market.
Healthcare is altering drastically. You shouldn’t be stunned by something that you simply see up there. It’s catching as much as the remainder of the world from a digital perspective, healthcare, however clearly with the pandemic, the tempo of change has accelerated. We talked about knowledge and the way the simulation of that from an AI standpoint may actually have an effect. Clearly, the extra know-how advances are bettering issues extra rapidly however will complicate issues from a reimbursement standpoint as effectively.
Shortly, traditionally, whenever you take a look at the healthcare mannequin, it was vertical: physician, affected person, pharmacy hospital. It moved to a extra distributed healthcare throughout a lot of completely different sectors, some which can be famous right here: imaging, behavioral well being, rehab. Now, it’s actually transferring to a extra related mannequin. Integration, I discussed built-in supply networks earlier. Built-in supply networks are rising their affect within the market. In my experiences in pharmaceutical roles, they’re very troublesome to kind of penetrate and get to the appropriate decision-makers because it pertains to what their efforts are so one thing to remember.
A very vital half is extra proactive than reactive, proper? As a substitute of treating sick care, how can we get forward of the sport and deal with sufferers from a well-care perspective to extend worth. I discussed know-how earlier. We all know wearables, digital well being. All of the issues that you simply see up there, genomics, robots, 3D-printing are all proceed to advance know-how. It’s an analogous query of how do they slot in?
Much like a pharmaceutical, how do they slot in to the system, and the place are they going to have the ability to add worth and have a aggressive benefit? One factor that I suppose is vital to level out. You hear the phrase digital well being again and again and over once more. Is it actually digital well being or is it simply well being, proper? I imply, can we name it like digital looking out? Will we name it digital expense monitoring on-line? No. We simply name it what it’s. So, it’s indicative that healthcare is behind the remainder of the world because it pertains to the digital platform and ultimately, I believe it’s merely going to be known as well being.
While you take a look at prescribed drugs, whenever you look traditionally, everyone knows one in every of the primary thresholds for achievement is you need to display efficacy and security. Clearly, in newer instances, demonstrating worth from an financial standpoint or nevertheless you needed to seek out that, particularly with payers and managed care organizations, to get reimbursement is essential. I’m going so as to add now one other threshold: is how do you’re taking each of these and the place do you play in that healthcare house given all of the traits and modifications which can be taking place?
This slide is right here as a result of, in my expertise, the pharmaceutical trade tends to transfer very slowly. I believe you’ve seen that even from a digital well being standpoint, a contributing issue to why it’s nonetheless possibly known as digital well being as an alternative of well being versus different industries. It’ll be fascinating to see how issues change over time, however I actually suppose the pharma trade has to determine the place do they need to play. That is the place the hockey analogy is available in, and why I discussed that I performed hockey in faculty a very long time in the past. How will pharma slot in? One piece of recommendation from the well-known hockey participant, Wayne Gretzky, “I skate to the place the puck goes to be not the place it has been.” I believe that’s a great piece of recommendation for the pharma trade to be occupied with on this fast altering panorama of healthcare. Thanks very a lot. If in case you have any questions, pleased to take them. [Applause]
Alexine Tranquada: It’s so cool. Sure. We have now a query within the again?
Feminine 2: Might you give your ideas on how blockchain and EAOs will match into this enterprise that you’ve?
Steve: Properly, I imply, I believe it’s one other type of know-how that’s going to hurry issues up, however as issues get sped up, you bought to seek out the place that puck goes as opposed to the place it’s been. There are such a lot of issues altering so quickly. While you take a look at the pharma and biotech trade, Boston, what number of biotech corporations are there? A few of them are possibly very effectively utilizing blockchain of their efforts, however simply attending to that Part 3 trial after which approval will not be going to find out success on its personal, clearly. If there’s unmet wants, nice, but it surely’s going to go away past that. I simply see it as one other type of know-how that speeds issues up.
Feminine 2: Can I simply elaborate?
Steve: Sure. Please do.
Feminine 2: Do you suppose that pharma will find yourself adopting blockchain, or do you’re feeling prefer it’s going to be an trade that’s going to finish up being very resistant on this explicit case prefer it has with every thing else? Or do you see that there’s going to be a pattern that you simply gravitate in direction of this decentralized, democratized knowledge?
Steve: What Jonathan, I believe, stated in his presentation earlier was one thing alongside the traces of change occurs, and possibly it’s sluggish at first then swiftly it takes off. Pharma is, I believe traditionally, glacial change, and so they’re most likely in that boat because it pertains to blockchain. Possibly you’re doing extra at Novartis and possibly there’s extra exercise there. I believe all of this turns into a aggressive benefit, and I believe in some circumstances, particularly in the event you’re a smaller firm that doesn’t have the assets to determine numerous these items, they might be left behind transferring ahead. While you say blockchain, is it going to be some small to midsized pharma firm that will get concerned in blockchain to assist them? Unlikely. It’s going to be the large pharma that has the assets to attempt to determine that out and perceive the place issues are heading and the way they match into it.
Feminine 2: It’s okay.
Steve: Positive. Thanks for the query. Sure?
Male 1: You introduced up numerous the acquisitions that occurred not too long ago. Do you suppose that that’s a part of a higher pattern of issues turning into increasingly centralized within the healthcare trade, like in a couple of years it’s going to be large tech corporations which can be simply working your electronic mail account and your healthcare and that form of factor? Or do you suppose that there could be has a small [Unintelligible] entry and small [Unintelligible] would there be an inflow of extra aggressive – being that modern and coming into that [Unintelligible] alternative the place it’s going to be very centralized?
Steve: Sure. I believe it’s too advanced and there are too many alternatives within the house for it to develop into ultra-centralized. I believe there’ll at all times be a need of competitors to preserve that market forces going. So FTC seems in any respect these offers, and so they’re not solely taking a look at them. They’re trying on the one which I discussed earlier with Amazon. They’re not solely taking a look at it from a standpoint of healthcare. As a result of One Medical doesn’t signify that many sufferers within the large scheme of issues, however they’re trying from knowledge as effectively and the way a lot knowledge does anyone have entry
1. I do suppose although these individuals which can be forward of the sport in knowledge and are studying from it are going to have the ability to make selections which can be going to place them for higher development than possibly corporations have accomplished. Sure?
Feminine 3: I wish to return to the opposite query. Close to Amazon and their buy of One Medical, earlier than they did the acquisition, they’d a special measure of the place they form of utilized their Amazon-y form of strategy to every thing that they do. “We’re going to repair healthcare,” and so they frequently did numerous stuff that ended up failing as a result of they didn’t have the reference to healthcare suppliers, with sufferers. They didn’t actually perceive the complexity of the connection which led to the primary group of [Unintelligible]. Provided that and provided that Amazon has been so profitable from the areas [Unintelligible] surprising failure, if Amazon can’t do it, if they’ll’t are available and actually innovate within the house, what hope does anyone else have? In the event that they’re not doing good there, what’s one factor that anyone can do to really make enhancements, or is it actually at all times going to be inner the place the alliance now could be pharma corporations working, the hospital and payers, and it needs to be a [Unintelligible] working altogether to make the change internally. Or can anyone exterior are available and try this?
Steve: Properly, a few issues. Amazon, clearly, has some huge cash make investments and healthcare is clearly a part of their technique just by 20% of GDPs in healthcare. I suppose they’re going to maintain attempting. They’re most likely getting nearer now that they have a supplier element, however they’re not going to cease, proper? They’re going to preserve attempting to determine it out. With that stated, I don’t suppose they’re going to be like found out so effectively that they develop into healthcare, proper? I imply, it’s simply there are too many elements to it. It could be nice for among the methods. I believe IDNs are a part of that to possibly companion with a few of these organizations. I believe numerous individuals are afraid of Amazon, too, although, proper? I imply, they suppose that they’re so robust that they’re going to determine one thing that anyone else couldn’t, after which that group can be at a aggressive drawback. I inform my college students once I train this class is, “You’re getting your MBA. You need to get entangled in enterprise. What an ideal place to go in healthcare.” It’s actually sophisticated. It’s fragmented and it’s inefficient. What does that spell? Alternative, proper? Tons and plenty of alternative. Should you go backwards 10 years, we’ve realized so much, and take a look at how far we’ve come even when it comes to ordering issues on-line and them having shipped – medicine on-line after a seek the advice of with a physician have been essential and having it shipped to our home. The data that we be taught on-line, oh my gosh. “My aunt has most cancers. Okay. Let’s instantly go surfing.” You simply take into consideration how far even from 10, 15 years in the past the place we at the moment are. We’ve made numerous progress. Nonetheless numerous inefficiencies and there are numerous causes for that. Personally, I believe there’s discrimination in healthcare. I believe there are clearly at all times entry points in healthcare. We’re rather more sophisticated. Our society relies on freedom and capitalism, and others aren’t at all times in that scenario. We’re not a homogeneous inhabitants. We’re treating numerous different ailments, and we’re at all times seeking to get one of the best know-how, at the very least, a element of {the marketplace}. I believe it spells alternative even that I’m kind of in my discuss right here difficult the pharma trade, “Okay. How are you going to slot in?”
Even like one large, large pharma firm will not be going to go in and alter the world, however the place do they slot in? The place is your spot in transferring ahead foundation the place you’re going to seek out success and aggressive benefit? Thanks very a lot.
Alexine Tranquada: Thanks a lot. [Applause] Actually, I’m so grateful. That’s our program for the day. I hope you all loved it. I hope you all are taking dwelling one thing that’s actionable or inspiring or just insightful. We can be downstairs for the foreseeable future, so we’ll see you down there. Once more, thanks all. On behalf of Greenbook and everyone on IIEX occasion group thanks a lot for being right here. [Applause] Oh and thanks to Lexi for being my trusted co-chair on this monitor. It’s nice. Thanks. Good. [Applause]
