The new pharmaceutical consumer: in search of value and information
While two-thirds of American adults use the internet (including social media) to seek health information, only 11% use a pharmaceutical company website most often. It is intriguing that 2 in 3 adults who seek information about health care online are looking for information on illnesses and conditions from a pharmaceutical company. But the pharma company website isn’t the top-of-mind, go-to place. In fact, 2/3 of health citizens whose households use prescription drugs say their trust in medications is not heavily influenced by advertising by pharmaceutical companies. These insights into the new pharmaceutical consumer come out of The Evolving Consumer and The
Walgreens’ Wellness Wisdom – what it means for pharmacy’s role in health
Two weeks ago at the company’s AnalystDay conference, Greg Wasson, the CEO of Walgreens, told the audience that the pharmacy chain was on a mission to “own well.” In the New York Times magazine dated November 12, 2010, an article titled Fresh Approach talks about Walgreens work in low-income Chicago neighborhoods coupling with greengrocers to bring “food oases” to inner cities. Two weeks ago, I learned that Walgreens is teaming with Orbitz to provide travelers’ health services. Married to an international banker who travels globally, I am pleased to know he can get his esoteric inoculations in local, convenient retail mode. Walgreens’ data found that 25% of
The biggest consumers of prescription drugs, seniors, need patient-centered medical homes, too
“The use of medications in older patients is arguably the single most important health care intervention in the industrialized world,” Dr. Jerry Avorn asserts in a concise analysis called Medication Use in Older Patients in the October 13, 2010, issue of the Journal of the American Medical Association (JAMA). Since the population over 65 is the biggest consumer of health care services (and thus, driver of costs), and continues to grow, the segment commands the attention of health system stakeholders: policymakers, payers, medical schools, and pharmaceutical drug researchers. Medicare Part D, which covers payment for seniors’ drug costs, put the Federal government in the
The hot trigger of Rx price at the point-of-prescribing
Medical drug benefits meet doctors and their patients via mobile platforms: that’s the prescription for a retail health care experience with the consumer’s checkbook in mind, brought to you by Walgreens pharmacy and Epocrates, the #1 most widely-used mobile drug information source among U.S. physicians. In this offering, Walgreens will channel its discount formulary information through Epocrates’s mobile application. About 300,000 U.S. physicians use the Epocrates drug database for prescription information. These users will be able to use Epocrates to check a Walgreen PSC member’s formulary profile against the prescription drugs the doctor is considering. At that point-of-prescription, the doctor can have a conversation with
What prescription drug plans and health reform mean for personalized medicine
Prescription drug formularies are getting more complex to drive cost-savings as well as promote adherence to drug regimens, as told by the data in the 2010-2011 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda Pharmaceuticals NA. The average rate of drug cost increases is 6.3%, compared to 4.4% in the 2009-2010 survey — the lowest rate of increase since this survey was launched. A key part of the story of the new value-based benefit design is told by the co-payment differentials for Rx drugs, shown in the chart. Health consumers who have three-tiered prescription drug insurance face an
Seniors Are Happy With Rx Plans, Five Years After Part D Begins
Contrary to stereotypes, older people can adapt, learn, and use new products and services. The introduction of Medicare Part D five years ago was an experiment in public policy, with some policymakers fretting about seniors’ ability to navigate a new system. It appears Medicare Part D is a hit, and people are working well with it across gender, age cohorts, incomes (from very low to upper-income strata), educational levels, and especially very sick and disabled people. Among all seniors, 90% have prescription drug coverage. 61% of U.S. adults 65 and over have a Medicare prescription drug plan, 16% are covered by an employer-sponsored
Patients’ use of online health tools will grow–especially for self-diagnosis, prevention, and treatment options
Most patients and doctors alike are currently using some type of online tool in the “understanding, management, and guidance” of health care, according to a survey from IMI Healthcare – Voice of the Market. Virtually all physicians, and 73% of patients, are using some kind of online health tool. Based on the IMI Healthcare survey methodology, these tools include health content sites, used by 57% of patients and 77% of doctors (e.g., WebMD, mayoclinic.com); general search sites (e.g., Wikipedia), used by 48% of patients and 68% of doctors; health association sites (e.g., American Heart Association), used by 19% of patients and
Service First, But Cost Increasingly Drives Consumers’ Pharmacy Satisfaction
Cost-competitiveness is driving overall consumer satisfaction with pharmacies in 2010, 2.5 times the importance that cost had in 2009. But even so, customer service and convenience still trump price in the pharmacy. For brick-and-mortar pharmacies, the key factors driving consumer satisfaction are: Prescription order and pick-up process (convenience) The condition of the store Cost competitiveness Non-pharmacist staff The pharmacist. In 2010, cost competitiveness accounts for 24% of overall satisfaction among brick-and-mortar Rx shoppers; that number was 9% in 2009. The retail pharmacy chains garnering highest satisfaction nationally are the Good Neighbor Pharmacy, Health Mart, and The Medicine Shoppe Pharmacy, all awarded
Giving consumers an “active voice” in pharmacy nudges healthy decisions
The U.S. health system could conserve $170 billion in avoidable medical costs related to patients not taking prescription drugs as-prescribed. That’s known as “sub-optimal pharmacy care,” and it’s estimated that 3 in 4 prescription drug users fall into this category. In other words, only 1 in 4 patients on Rx drugs take their prescriptions as directed by their physicians (known as compliance) or weren’t prescribed the optima drug therapy in the first place. At least 1 in 4 patients never even fill their first prescription for a drug their physician has prescribed. CVS Caremark has found that health citizens can become more
Prescription Drug Nation
In 2008, 2 in 3 people in the U.S. over 60 took 3 or more prescription drug medications in the past month, and 14% of kids 11 and under regularly took an Rx. The CDC’s National Center for Health Statistics latest issue brief on prescription drug use illustrates that prescription drugs are as much of American popular culture and life as fast-moving consumer goods. It’s the more intense use of Rx drugs, 5 or more, where the most significant growth has been since 1999-2000, when 6.3% of Americans took 5 or more prescription drugs in the past month. In 2007-8, the proportion
Pharma-economics: retail drug prices rice, and consumers react
Two reports, from Consumers Union and the AARP, put the pharmaceutical industry in the spotlight again this week, and not in a good way. First, Consumer Reports polled U.S. adults who take prescription drugs and found that 39% took some action to reduce costs. 27% didn’t take the Rx as prescribed: 16% didn’t fill the prescription, 12% took a drug past its expiration date, and 4% shared a prescription with someone else. These and other survey findings are discussed in Consumers say big pharma influence on docs is concerning, published in the Consumer Reports Health Blog on August 24, 2010. Second, the AARP calculated
As employers’ health costs increase 8.9% in 2011, employees will have more skin in the game
Large employers expect health care costs to increase by 8.9% in 2011, up from 7.0% in 2011. To stem cost increases, employers will adopt an array of tactics, most prominently offering consumer-directed health plans (CDHPs) and expanding wellness programs that encourage incentives to healthy lifestyles. These expectations come from Large Employers’ 2011 Health Plan Design Changes, a survey report from the National Business Group on Health poll of large employers. 1 in 5 employers say CDHPs are the most effective approach for managing health care cost growth, as shown in the chart. 61% of employers will off CDHPs in 2011, 20% of whom will
Caveat emptor for consumers buying medicine
Two weeks ago, I bought a package containing 100 caplets of Tylenol PM caplets from my grocery store’s pharmacy aisle. I checked the lot number marked on the box against the list on the McNeil consumer healthcare website, and my lot appears to be fine. Today, Avandia, the prescription drug that treats diabetes, hit the headlines of the world’s major newspapers: Avandia Panel Hints At Doubts of Credibility, says the New York Times Avandia Hearings To Reveal True Dangers of Popular Drug, according to FOXNews GlaxoSmithKline Hid Negative Avandia Data: Lawmakers, reads ABC News Glaxo to Pay $460 million in Avandia Settlement, notes Reuters. And there’s also
Employee Health Benefits: Wellness Up, Rx Down
As the recession continues to negatively impact U.S. business, employers are tightly managing benefits across-the-line, from health to housing and travel categories. Benefits overall are experiencing a downward trend versus 5 years ago. In the health arena, benefits that show staying power include wellness resources (covered by 75% of employers), on-site flu vaccinations (68%), wellness programs (59%), and 24-hour nurse lines (59%). On the downside, benefit programs that are expected to erode in the next 12 months are prescription drug coverage, dental insurance mail-order drug programs, and chiropractic coverage, among others shown in the chart. The Society for Human Resource
The new consumer health advocate: the Pharmacist
90% of people seek help identifying over-the-counter medications (OTCs) that suit their conditions. 80% of people ask pharmacists for counsel regarding which OTCs would best fit with their prescription medications. The pharmacist plays a central, pivotal role in the American health ecosystem, based on these data points from the American Pharmacist Association’s (APhA) Pharmacy Today Over-the-Counter Product survey. In the Today’s perspective introducing the survey details, Dr. Stefanie Ferrari of the UNC Eshelman School of Pharmacy writes, “As more prescription products become available OTC, we need to think about the special populations we see every day and determine if the new
The pharmacy as health hub – what the Rite Aid/American Well alliance means
As Rite Aid partners up with American Well, here’s another example of the further retail-ization of health in the U.S. The subtext of this arrangement is the fact that the pharmacy is a touch-point for health consumers who seek trust, convenience, access, and an understandable market channel for health. Rite Aid will be the first pharmacy to test the American Well service that enables patients to interact online with providers. In this program, consumers will interact live online via Internet or phone with Rite Aid pharmacies from both their homes and private consultation rooms at select Rite Aid pharmacies. The consults will
How to save $290 billion in health care in America? Improve medication adherence
13% of the $2.4 trillion U.S. health economy could be saved by improving adherence to medication, according to an analysis from the New England Healthcare Institute (NEHI). Poor medical adherence leads to poor outcomes and increased medical costs, as described in NEHI’s report, Thinking Outside the Pillbox: a System-wide approach to improving patient medication adherence for chronic disease.. NEHI identified poor medication adherence as a key component in the overall waste and inefficiency in American health care, where poor adherence leads to preventable worsening of disease and increasing health risks — especially among people with chronic disease(s). Since
Americans’ spending on complementary and alternative medicine is up, but most of the increase is "do-it-yourself" care
U.S. adults spent $33.9 billion on complementary and alternative medicine (CAM) in 2007. The largest expenditure on CAM was on self-care costs of $22.0 billion, the largest component of which was $14.8 billion spent on non-vitamin, non-mineral natural products. In addition, Americans spent $11.9 out-of-pocket (OOP) on practitioners such as chiropractic, osteopathic manipulation, naturopathy and chelation therapy; $4.1 billion on yoga (equal to 12% of the total), $2.9 billion on homeopathy, and $0.2 billion on relaxation techniques. The National Health Statistics Reports series published Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United
What Michael Jackson can teach us about health
Having grown up outside of Detroit, Berry Gordy and Hitsville, U.S.A., aka Motown Records, plays the core beat in the soundtrack of my younger life, and still to this day. The Jackson 5’s hits are woven into that musical quilt, and Michael Jackson’s work with Quincy Jones even more: in particular, Off the Wall and Thriller. This brilliant force in our lives had much to teach us in life: Be a lifelong learner, and grow every day in your craft – whatever that might be. Reach beyond your grasp. Delight in what you do for a living. Give to
$16,771 is the cost of health care for a family of four in 2009
$16,771 is roughly the cost of health care for an American family of four in 2009, according to the Milliman Medical Index. If the median family income in 2008 was about $67,000, then health care costs represent about 25% of the annual household paycheck (remember, that’s gross, not net, income). As the chart illustrates, 1 in 3 health care dollars goes to physicians, with another third paid to inpatient services. Outpatient services and prescription drugs consume 15-17 cents on the health dollar in 2009. The greatest increase in cost trends in 2008-9 is with hospital outpatient services, which grew more
Generic drugs have saved $734 billion to US health system over 10 years
The Hatch-Waxman Act passed in 1984 to hasten the introduction of generic competition into the pharmaceutical market. According to an analysis from IMS Health, $734 billion have been saved in the past 10 years through the use of generic pharmaceuticals. $121 billion was saved in 2008 alone, based on the IMS data, published in the report, Economic Analysis of Generic Pharmaceuticals 1999-2008. The long name of the Hatch-Waxman Act is the “Drug Price Competition and Patent Term Restoration Act of 1984.” The law has indeed brought drug price competition into the prescription drug market — which was anticipated
Can Wal-Mart Mass Merchandise Electronic Health Records?
“We believe America can have high quality, affordable and accessible health care by 2012.” Who said that? If you guessed President Obama, Senator Edward Kennedy, or Hillary Clinton, you’re wrong. It’s Wal-Mart, on its Health and Wellness webpage. Wal-Mart’s got a new direct-to-physician strategy: selling electronic health records (EHRs). The world’s largest retailer, #1 on the Fortune 100, expands on the company’s experience with retail health clinics. The chain now has 30 clinics sprinkled throughout the south, and in each clinic, there’s an EHR system. The EHRs will be offered through Wal-Mart’s subsidiary, Sam’s Club, jointly with Dell and eClinicalWorks,
Health care in every pot – what we can learn from Costco
And the pot will be from Costco, not Williams-Sonoma. The most telling point about health reform in President Obama’s budget is that, “Some researchers believe that healthcare costs could be reduced by a stunning 30 percent — or about $700 billion a year — without harming quality if we moved as a nation toward the proven and successful practices adopted by the lower-cost areas and hospitals.” That sentence gives us some grist for forecasting some of the elements of health reform — in particular, the last phrase which talks about moving from higher-cost, unproven health practices to lower-cost proven approaches.
From the fiscal to the physical: insured workers try to lower their medical costs
This is open enrollment season for those workers fortunate enough to (1) still be employed and (2) still be offered a health benefit. It’s also the season of economic decline. According to Watson Wyatt, these workers are making different health and benefit decisions in this fiscally-constrained era. Watson Wyatt has released its 2008 version of the report, Employee Perspective on Health Care. Some of the most dramatic health behavior changes this year include: Only 19% of employees are willing to pay higher premiums to keep deductibles and copayments lower. In 2007, 38% were willing to do so. 66% of
Don’t cross Baby Mama — McNeil Will Need More Than Motrin For This New Headache
It all started with a baby, a baby carrier, and Motrin. Oh, and an advertising agency who probably got their Mommy-messaging more than a little bit wrong. Twitter, the social networking software, helped fuel this uproar in a matter of hours. In what is to-date among the fastest viral campaigns in consumer health — that backfired –well over a hundred of mommy blogs and countless Twitter messages expressed emotions on a continuum from outrage to insult about a new campaign targeted to Moms who carry their babies in on-the-body carriers. The ad begins, “Wearing your baby seems to be
Very slow growth forcast for pharma in U.S. in 2009
The U.S. pharmaceutical market is slow-growth for 2009, according to IMS Health. The company forecasts a tiny 1-2% growth rate for the next year. The data point comes from IMS’s annual Global Pharmaceutical and Therapy Forecast. The U.S. market for pharmaceuticals will be worth about $300 bn in 2009. What’s slowing growth prospects for the U.S. are the overall declining macroeconomy, and its impact on visits to physicians and, ultimately, drug sales. Other factors slowing down drug sales in the U.S. are loss of patent protection on former big-name drugs and the influence of payers in drug coverage
Walmart, Caterpillar, and growing brand equity in health
George Washington ate and drank here. Now, there’s a Walmart Supercenter in that spot. There’s an important crossroads in my vicinity where four major highways meet; it’s called King of Prussia, which is the intersection of the Schuylkill Expressway (I-76), the Pennsylvania Turnpike, US 422, and US 202. A new Walmart Supercenter opens at this intersection today. Across-the-street from the new Supercenter are Neiman-Marcus, Bloomingdales, and Nordstrom, along with hundreds of other retail chains in the shopping mecca known as the King of Prussia Mall. So Walmart’s on my mind. Walmart has become a sort of touchstone for me
Seniors grab brands for Part D, and generics for self-pay
Seniors are acting like true, Adam Smith-style Rational Economic Man and Woman when it comes to their behavior as Medicare Part D enrollees. They go for the more expensive prescription drug brands when covered by the government; once getting to the ‘donut hole,’ though, seniors opt for lower-cost generics. Medco Health discovered this in their latest study into Medicare drug trends. Their conclusion is that Medicare could save more money if seniors went for generics 100% of the time. Rational selection, indeed. In a study from the Kaiser Family Foundation (KFF), Medicare Prescription Drug Plans in 2008 and
Drugstore Dominance, and the Walmart Wild Card
While reading the August 16/17 2008 issue of the Financial Times to keep up with the global political news in Russia and Georgia, and Olympic medal drama in Beijing, I ran across a story that hit much closer-to-home: “Bitter pills in fight for drugstore dominance.” The announcement by CVS Caremark that it would acquire the Longs Drugs store chain for over $2.5 billion is the latest salvo in the battle for the neighborhood pharmacy. This is CVS’s major incursion into California and other western states, where Walgreens enjoys a dominant market share. The most important point in the FT article
As prescription drug sales decline, mail order grows
Globally, prescription drug sales grew 6.1% between 2006 and 2007. In the U.S., Rx sales grew 3.8% in the same period. This is the weakest U.S. sales rate for prescription drugs since 1996. These stats come to you from IMSHealth, whose annual U.S. Pharmaceutical Market Performance Review found over a 50% drop in Rx sales growth from the 8% rate reached in 2006. The backstory to what’s slowing drug sales is a good-news/bad-news mix. The flood of many popular blockbuster drugs going off-patent means that generics spending is up. Now, 2 in every 3 prescribed drugs is a
Happy Birthday, Viagra
It’s the drug that raised the profile of medicine in popular culture. It’s been hawked by a prominent politician and has been the butt of jokes on late-night TV. It’s Viagra, and it’s turning 10 today. The FDA approved the drug on March 27, 1998. Here is the FDA’s approval page for it. Pfizer‘s Viagra reshaped pharmaceutical marketing in several ways. The company used direct-to-consumer advertising to great effect, and changed the game of DTC by advertising the drug not only in late at night broadcast outlets. More broadly, the marketing of Viagra bolstered the trend of medicalization of
The golden era of generic drugs
This is how IMS recently referred to 2008 and the next phase of the pharmaceutical drug market. I recently posted here a pharma market update on drug prices (up), DTC (working), and generics (“the un-detail”). Here’s the PS for that post, brought to you from IMS, the prominent market research firm focused on pharma. In their latest report on the industry released on March 12, IMS has found that last year’s 3.8% growth rate was the slowest since 1961. Generics are now more prominent in the U.S. health scene than branded pharmaceutical drugs. The total U.S. market for
Wal-Mart’s leading role in health care — now, as PBM
When the health care Oscars are announced in 2010 for top roles, the health care academy won’t know whether to cast Wal-Mart as the lead, supporting, director, or producer in health care. Wal-Mart is the third largest pharmacy chain in the U.S. As #1 on the Fortune 500 list, the retailer’s role as a jumbo employer means it has clout in health care negotiations and in the entire American health system. According to the company’s CEO, the company may enter the pharmacy benefits management business. During the company’s annual “Year Beginning Meeting” last week, Wal-Mart CEO Lee Scott talked about
Health Populi’s Tea Leaves for 2008
I “leave” you for the year with some great, good, and less-than-sanguine expectations for health care in 2008. These are views filtered through my lens on the health care world: the new consumer, health information technology, globalization, politics, and health economics. Health politics shares the stage with Iraq. Health care is second only to Iraq as the issue that Americans most want the 2008 presidential candidates to talk about, according to the latest Kaiser Health Tracking Poll. Several candidates have responded to the public’s interest with significant health care reform proposals. But major health reform – such as universal access
Happy birthday, Prozac!
The Financial Times celebrates the 20th birthday of Prozac in the newspaper’s Nov 17/18th issue. It’s valuable to look at the rise and fall of Prozac, the brand; the rise of its generic equivalent; and how the drug has profoundly impacted one consumer’s life. Prozac Market. Before it treated depression, Prozac was thought to be an anti-hypertensive. When that didn’t seem to work, Eli Lilly considered it for an anti-obesity treatment. Strike two, clinical-wise. Finally, Lilly took the drug to market to fight depression after it was approved by the FDA on December 29, 1987. In two years, Prozac became
Colds, kids and labels
Over-the-counter medicines (OTC meds) don’t cure colds in kids. The FDA has spoken, and said that the kinds of kid-targeted medicines photographed on the right aren’t only useless — they can be dangerous. The offending incredients are dextromethorphan, used in cough suppressants; pseudoephedrine and phenylephrine, used in decongestants; guaifenesin, an expectorant; and, brompheniramine, chlorpheniramine maleate, or diphenhydramine, used in OTC meds labelled as antihistamines. If ever there was a time for a parent to get into label-reading, it’s now. The good news is that more of us are reading labels, according to the Hartman Group, the food and wellness research
The Future of Retail – Implications for Health
I’ve been looking at health care through a retail lens for some time. Perhaps it’s that I’m a rag trader’s daughter, or that I’ve been known to like shopping, that I have clients in consumer goods, or that I understand how tiered drug pricing impacts the consumption of medicines (answer: it’s all of the above). I’ve just reviewed the latest trend report from PricewaterhouseCoopers and TNS Retail Forward on the future of retailing. My mind is connecting the dots between the future of retail and the American health care consumer. Four future retail trends are already embedding in health care
The grocery store as health destination
We love new food products, as evidenced by the ever-growing array and permutation of new goodies at our grocery stores. Among those who say new food products are important to them, the top reason why they buy new food products is health. Open your eyes when you’re next grocery shopping and look around you — your favorite grocer is morhping into a health destination. Whole Foods has launched its Whole Body store-within-a-store concept. Wegmans offers their Eat Well Live Well program. Even Wal-Mart, home of the $4 generic drug price-point, has begun to offer organic food based on demand according
I was invited to be a Judge for the upcoming CES 2025 Innovation Awards in the category of digital health and connected fitness. So grateful to be part of this annual effort to identify the best in consumer-facing health solutions for self-care, condition management, and family well-being. Thank you, CTA!
Thank you Team Roche for inviting me to brainstorm patients as health citizens, consumers, payers, and voters in the Healthcare Transformers series.
For the past 15 years, the annual CES conference in Las Vegas has been my go-to meeting for updating my research and network in digital health and consumer-facing electronics that people find meaningful for their well-being, families, and home lives. I'll be back in Vegas in January for a full week of Media Days, one-on-one meetings, and speaking about my perspectives on health consumers.