A blog covering the health/care ecosystem and people.

There’s good news on the macro-health economics front: the growth rate in national health spending in the U.S. fell in 2011, according to an analysis published in Health Affairs January 2013 issue. Furthermore, this study found that consumers’ spending on health has fallen to 27.7% of health spending, down from 32% in 2000, based on three spending categories: 1. Insurance premiums through the workplace or self-paid 2. Out-of-pocket deductibles and co-pays 3. Medicare payroll taxes. A key factor driving down health spending is the growth of generic drug substitution for more expensive Rx brands. Generics now comprise 80% of prescribed

Estimates on health spending in the U.S. are under-valued, according to The hidden costs of U.S. health care: Consumer discretionary health care spending, an analysis by Deloitte’s Center for Health Solutions. Health spending in the U.S. is aggregated in the National Health Expenditure Accounts (NHEA), assembled by the Department of Health and Human Services (DHHS) Centers for Medicare and Medicaid Services (CMS). In 2010, the NHEA calculated that $2.6 trillion were spent on health care based on the categories they “count” for health spending. These line items include: Hospital care Professional services (doctors, ambulatory care, lab services) Dental services Residential

Reducing health care costs far outranks improving quality and safety, improving the public’s health, and upping the customer experience as Americans’ top priority for President Obama’s health care agenda, according to a post-election poll conducted by PwC’s Health Research Institute. In Warning signs for health industry, PwC’s analysis of the survey results, found that 7 in 10 Americans point to the high costs of health care as their top concern in President Obama’s second term for addressing health care issues. Where would cost savings come from if U.S. voters wielded the accountant’s scalpel? The voters have spoken, saying, Reduce payments

Wired magazine, longtime evangelist for all-things-tech, has played a growing role in serving up health-tech content over the past several years, especially through the work of Thomas Goetz. This month, Wired featured an informative section on living by numbers — the theme of a new Wired conference held 15-16 October 2012 in New York City. This feels like the week of digital health on the east coast of the U.S.: several major meetings have convened that highlight the role of technology — especially, the Internet, mobile platforms, and Big Data — on health. Among the meetings were the NYeC Digital Health conference, Digital

The average annual premiums for employer-sponsored health insurance in 2012 are double what they were a decade ago in terms of both total premium and worker contribution increases. The picture shows the story, according to the 2012 Employer Health Benefits Survey from the Kaiser Family Foundation (KFF). This annual survey polls small, mid-size and large employers to assess their updates for providing health insurance and prescription drug coverage to active and retired employees. The percentage growth of health costs in the past year were a “modest” 4%, according to KFF. Modest is a relative term: this single digit increase is indeed much

It’s become evident that more health care does not often lead to better health: Shannon Brownlee’s seminal book, Overtreated, uncovered the negative relationship between more health care and worse outcomes. However, when it comes to accessing primary care, more may be a good thing. In Extended Office Hours and Health Care Expenditures: A National Study, published this week in the Annals of Family Medicine, researchers found that offering longer office hours, into evenings and weekends, leads to lower total health care expenditures for patients than practices without extended hours. Extended hours are also associated with lower prescription drug and office visit

Amidst uncertainties and wild cards about health care’s future in the U.S., there’s one certainty forecasters and marketers should incorporate into their scenarios: consumers will bear more costs and more responsibility for decision making. The 2012 Deloitte Survey of U.S. Employers finds them, mostly, planning to subsidize health benefits for workers over the next few years, while placing greater financial and clinical burdens on the insured and moving more quickly toward high-deductible health plans and consumer-directed plans. In addition, wellness, prevention and targeted population health programs will be adopted by most employers staying in the health care game, shown in

50% more women than men are worried about health care affordability and access in the U.S., revealed in a new Kaiser Opinion Poll, the Health Security Watch, based on interviews from May 2012. Overall, about the same proportion of men and women had problems paying medical bills in the past year — 26% vs. 27%, respectively. However, when it comes to self-rationing health care — delaying or skipping treatment due to cost — gender gap shows, with 52% of men and 64% of women delaying or skipping health care. Underneath these numbers are even greater gaps between men and women.

While 2 in 3 U.S. adults are active on social media, we are skeptical about trustworthiness of the content we find there. Welcome to the 13th quarterly Heartland Monitor Poll from Allstate and National Journal, surveying how U.S. adults look at social media, trust, and the political future of the nation. The Poll surveyed, by landline and cell phone, 1,000 U.S. adults over 18 in May 2012. The most common social network used is Facebook, among 51% of U.S. adults, followed by Google+ (28%), Twitter (13%), LinkedIn (12%), Pinterest (6%), and MySpace (5%). While Americans are drawn to using social

On May 23, 2012, Pfizer announced its teaming with EatingWell magazine to launch a mobile app for patients on Lipitor. Eight days later, on May 31, 2012, generic versions of Lipitor will hit the market. Lipitor is the best-selling drug in pharmaceutical history, to-date. Sales of the product top $125 billion. While generic atorvastatin has been available in the U.S. since November 2011 from two manufacturers, low prices for the generic will drop to $10 or less for a month’s supply at the end of May. This is Pfizer’s first foray into a prescription drug-affiliated app. The free mHealth app,

Transparency, data-based pharmacy decisions, incentivizing patient behavior, and outcomes-based payments will reshape the environment for marketing pharmaceutical drugs in and beyond 2012. Two reports published this week, from Express Scripts–Medco and PwC, explain these forces, which will severely challenge Pharma’s mood of market ennui. Express-Scripts Medco’s report on 9 Leading Trends in Rx Plan Management presents findings from a survey of 318 pharmacy benefit decision makers in public and private sector organizations. About one-half of the respondents represented smaller organizations with fewer than 5,000 employees; about 20% represented jumbo companies with over 25,000 workers. The survey was conducted in the

In PwC‘s landmark report, Social Media “Likes” Healthcare, there’s a data point obscured by lots of great information generated by the firm’s survey of 1,060 U.S. adults: that over one-half of people value patient support groups and social networks with other patients that are offered by drug companies. Not surprisingly, U.S. consumers. who are taking on increasing financial responsibility to pay for health care products and services, also highly value discounts and coupons, and access to information that helps them find the “cheapest” medications — both favored by two-thirds of people. The report found, overall, that over one-third of U.S. adults

U.S. health consumers’ purchase and use of over-the-counter medicines (OTCs) generate $102 billion worth of value to the health system every year. Half of this value accrues to employers who sponsor health insurance for their workforce; 25% goes to government payers (e.g., Medicare, Medicaid); and, 25% returns to self-insured and uninsured people. For every $1 spent on OTCs, $6.50 is saved by the U.S. health system, shown by the chart. For millions of health consumers, OTCs substitute for a visit to a doctor’s office: most cost-savings generated by OTC use are in saved costs of not visiting a clinician, as discussed

Technology, autos, food and consumer products — two-thirds of people around the globe trust these four industries the most. The least trusted sectors are media, banks and financial services. Welcome to the twelfth annual poll of the 2012 Edelman Trust Barometer, gauging global citizens’ perspectives on institutions and their trustworthiness. This survey marks the largest decline in trust in government in the 12 years the Barometer has polled peoples’ views. Interestingly, trust in government among US citizens stayed stable. The top-line finds a huge drop in global citizens’ trust in government, with a smaller decline for business. There’s an interplay

The growth in prescription drug costs covered by employers and Rx plan sponsors are driving them to adopt a long list of utilization management and price-tiering strategies looking to 2012, according to the 2011-2012 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda Pharmaceuticals. The average drug trend for 2011 — that is, the average annual percentage increase in drug cost spending — was 5.5%, 1.5 percentage points greater than general price inflation of about 4%. The generic fill rate was 73% of prescription drugs purchased at retail. While drug price inflation is expected to increase in 2012, plan

“Value” in prescription drugs is first and foremost about outcomes, in the eyes of physicians and biopharma. For managed care, “value” is first about safety, then patient outcomes. However, although one-third of patients managing a chronic condition cannot define “value” in health care, 9 in 10 say that prescription drugs are “valuable” to their health and wellbeing. In fact, 80% say that the money they spend on prescription medications is “worth it.” Yet patients feel largely out of the prescription drug development process. These findings come from Quintiles research report, The 2011 New Health Report, subtitled: exploring perceptions of value and collaborative relationships among

Americans are opting for Botox and cosmetic procedures more than colonoscopies and cancer tests, according to a story in Reuters. This trend makes companies like Allergan, makers of Botox and the Lap-Band for gastric surgery, very happy indeed. Plastics and gastric bypass surgeries are back up to pre-recession levels as of 2Q11. However, for companies and providers in other segments of the health care and surgery value-chain, prospects for bounceback in 2011 aren’t as promising. Various indices on consumers’ health care sentiment — such as the Thomson-Reuters Consumer Healthcare Sentiment Index and the EBRI Health Confidence Survey, show U.S. consumers’ perceptions of their ability to

The environmental landscape for pharmaceutical manufacturers and retail pharmacies is marked with landmines, yield signs, and cautionary wild cards: health reform, supply chain dynamics, specialty drug pricing, pharmacogenomics, and the high burden of chronic disease among them. But the crux of the challenge for achieving optimal outcomes has less to do with these factors than it does with consumer behavior: specifically, the chasm between what people/health consumers say they want versus what people actually do. Express Scripts calls this “The Intent-Behavior Gap,” and it’s the theme of the company’s 2010 Drug Trend Report, Complex Challenges, New Solutions. The cost of sub-optimal pharmacy behaviors are huge: in 2010, pharmacy-related waste

In the pharmacy market battle between Davids and the Goliath, David wins in the latest Consumer Reports survey on best drugstores according to consumers: independent pharmacies come out on top, and Walmart ranks last on the roster. The most highly-rated chains, highly indexed at 90 or more points, Health-Mart, The Medicine Shoppe, Bi-Mart, Publix, Hy-Vee, and Wegmans. Target, which was just ranked the #1 retailer in brand equity by the Harris Poll (where Target also beats Walmart in general retailing brand equity), ranked lower with an 88: much higher than Walmart with a 78 index, but below Walmart’s Sam’s Club and several grocery

If you are a person with heart disease and you have received treatment at the Mayo Clinic, you’re certainly a fortunate health citizen. The hospital was just ranked #2 best hospital in the U.S. by US News & World Report. However, if that’s you and the costs of post-op treatment — namely prescription drugs — are out of your financial reach, then you might skip them; thus, undoing your top-notch acute care. This scenario is discussed in the April 2011 issue of Mayo Clinic Proceedings, which describes a study by Mayo researchers among 209 patients with heart failure who were prescribed

The Federal government covers about $1 in every $3 of spending on prescription drugs in the U.S. That equates to $78 bn of the total $250 bn spent on Rx in 2009. Between 2006 and 2010, the indexed cost of the usual and customary price for commonly used branded prescription drugs grew by 8.3%; in that period the price of commonly used generic drugs fell by 2.6%. The General Accounting Office (GAO), those nonpartisan bean-counters in Washington DC, analyzed pricing trends of prescription drugs over the most recent five years, based on changes from first quarter to first quarter in each subsequent year. The GAO also

For every $1 spent on health care in the U.S., 10 cents goes to prescription drugs, 31 cents goes to hospital care, and 27 cents goes to professionals (doctors, dentists, and other services), based on 2009 health spending reported to the Centers for Medicare and Medicaid Services (CMS). There’s evidence that by spending a bit more on medication and bolstering prescription drug adherence among patients, total health spending can be lowered for vascular medical conditions. The study and data which leads to this conclusion is published in Medication Adherence Leads to Lower Health Care Use And Costs Despite Increased Drug Spending appears in

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