ACHP Live InterviewHigh-Cost Drugs: Challenges

and Opportunities

June 15, 2015

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Kavita Patel, M.D., M.S.Fellow and Managing Director,Brookings Institution Center for Health Policy

Dr. Patel is a Fellow and Managing Director at the Center for Health Policy at the Brookings Institution where she leads research on delivery system reforms, healthcare cost, physician payment and healthcare workforce productivity. Additionally, Dr. Patel is a practicing primary care physician at Johns Hopkins Medicine and a clinical instructor at UCLA's Geffen School of Medicine. Dr. Patel was previously a Director of Policy for The White House under President Obama and a senior advisor to the late Senator Edward Kennedy. Her prior research in healthcare quality and community approaches to mental illness have earned national recognition and she has published numerous papers and book chapters on healthcare reform and health policy.  She has testified before Congress several times and she is a frequent guest expert on CBS, NBC and MSNBC as well as serving on the editorial board of the journal Health Affairs.

Dr. Patel can be reached at KPatel@brookings.edu.

Ceci ConnollyManaging Director, PwC’s Health Research Institute

Ceci Connolly is the Managing Director of the Health Research Institute at PricewaterhouseCoopers, a research organization dedicated to objective analysis on the issues, policies and trends important to health organizations and policymakers. She is a veteran journalist, and as the national health correspondent for the Washington Post, chronicled enactment of the Affordable Care Act and was co-author of Landmark: The Inside Story of America’s New Health Care Law and What It Means for Us All. In her role at the Health Research Institute, Connolly oversees a team of analysts and writers who track major developments and emerging issues across the healthcare spectrum.

Ceci can be reached at ceci.connolly@us.pwc.com.

Leslie Fish, Pharm.D.Vice President of Clinical Programs, Fallon Health

Dr. Fish is the Vice President of Clinical Programs at Fallon Health and has more than 25 years of experience in the health care field as a practicing pharmacist with particular expertise in oncology and cardiology, a consultant, educator, researcher and writer. She is on the faculty of the John Meyers Primary Care Institute Managed Care Residency Program and has taught at the University of Massachusetts Medical School, Massachusetts College of Pharmacy and Allied Health Sciences and Northeastern University School of Pharmacy, Boston. She has served on the editorial board of several journals and is an active member of the Academy of Managed Care Pharmacy where she serves on the Professional Practice Committee. Dr. Fish is on the state’s Drug Utilization Review board in Massachusetts and has been recognized for her work as the winner of the National Osteoporosis Award (1997), Innovations in Pharmacy Award (1999) and the American Medical Group Association’s Acclaim Award (2001).

Dr. Fish can be reached at leslie.fish@fchp.org.

Eileen Wood, R.Ph., M.B.A.Vice President of Clinical Integration and Chief Pharmacy Officer, Capital District Physicians’ Health Plan

Eileen Wood has more than 30 years of experience as a pharmacist and health care industry leader. Eileen joined CDPHP in 2005 and is responsible for the pharmacy benefit, clinical pharmacy programs, health care performance management, and quality management teams. Prior to joining CDPHP, Eileen served as vice president of clinical services and director of pharmacy services for Seton Health System in Troy, NY, part of the Ascension Health System. Eileen began her career in an independent community pharmacy practice, and her experience includes progressive hospital pharmacy and management experience in oncology, surgery, laboratory, cardio-pulmonary, medical imaging, and other clinical services management.

Eileen can be reached at Eileen.Wood@cdphp.com.

ACHP Live InterviewHigh-Cost Drugs: Challenges

and Opportunities

June 15, 2015

ACHPHigh-Cost Drugs: Challenges and Opportunities

Ceci ConnollyManaging Director, PwC’s HRI

June 15th, 2015

PwC Health Research Institute

Why are specialty drugs costs becoming a big issue?

361% growth

Source: PwC’s Health Research Institute: Behind the Numbers 2015 and analysis of CVS Caremark data.

Only 4% of patients use specialty drugs, but those drugs account for 25% of total US drug spending.

One specialty drug costs more than a

company's annual drug spending budget.

The difference in price between two therapies was approximately 4000 times

the cost of gold! – Dr. L. Saltz, colorectal oncology, Memorial Sloan Kettering Cancer

Center

PwC Health Research Institute

Specialty drug approvals continue to race ahead

 

Source: PwC Health Research Institute research based on data from the FDA, Express Scripts, Catamaran, and Thomson Reuters

PwC Health Research Institute

Physician reimbursement

Mortgaging drug costs

Improving transparency

Paying for drugs requires new finance models

Exclusivity on ROS

Outcomes based

contracts

Reforming Medicaid’

s Best Price

Reference pricing

Ceiling price

Alternative models

Panelists

12

Kavita Patel, M.D.

(Moderator)

Ceci Connolly Leslie Fish, Pharm.D.

Eileen Wood, R.Ph., M.B.A.

QUESTIONS?

REMINDER: When submitting questions we ask that you use the CHAT function and direct your

questions to the HOST.

Phone: 202-785-2247

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