A blog covering the health/care ecosystem and people.

For health care, there are many uncertainties as we reflect, one week after the 2024 U.S. elections, on probably policy and market impacts that we can expect in 2025 and beyond. In today’s Health Populi post, I’ll reflect on the first of several certainties we-know-we-know about U.S. health citizens and key factors shaping the American health ecosystem. In this first of several posts on “What Stays True for U.S. Health Care Post #Election2024,” I’ll focus on U.S. consumer dissatisfaction with drug prices — across political party identification.          Let’s set the context with data from a recently-published

In the past week, a few major events bring the nature of pharmacies and the market for retail pharmacy into sharp view: First, news that CVS is undergoing self- and market-scrutiny about its business — specifically, the company’s vertical integration and financial punishment wrought by the organization’s insurance group, Aetna, leading to considering the break-up of the company into certain parts (whether the insurance business, the retail pharmacy, the specialty pharmacy unit, etc.). Second, the PBM (pharmacy benefit management) business has come under harsh light from the FTC and Congress, most recently resulting in a lawsuit filed by the FTC

“If the U.S. were sensible, weight management would be treated as a public health issue,” David Cutler writes in the JAMA Health Forum dated August 15, 2024. Dr. Cutler, distinguished economics professor at Harvard, talks about “the pathology of U.S. health care” citing the example of weight loss medications — in short, the uptake of GLP-1 drugs to address Type 2 diabetes first, and subsequently obesity.          Dr. Cutler notes that the price of these drugs in the U.S. “far exceeds” that of other countries: specifically, 9 times that of the prices in Germany and the Netherlands

Most Americans follow some kind of eating regime, seeking energy, more protein, and healthy aging, according to the annual 2024 Food & Health Survey published this week by the International Food Information Council (IFIC). But a person’s household finances play a direct role in their ability to balance healthful food purchases and healthy eating, IFIC learned.              In this 19th annual fielding of this research, IFIC explored 3,000 U.S. consumers’ perspectives on diet and nutrition, trusted sources for food information, and new insights into peoples’ views on the GLP-1 weight-loss drugs and the growing sense

Health insurance plans make mainstream media news every week, whether coverage deals with the cost of a plan, the cost of out-of-network care, prior authorizations, or cybersecurity and ransomware attacks, among other front-page issues. This week, AHIP (the acronym for the industry association of America’s Health Insurance Plans) is convening in Las Vegas for its largest annual 2024 meeting. We expect at least 2,400 attendees registered for the meeting, and they’ll not just be representing the health insurance industry itself; folks will attend #AHIP2024 from other industry segments including pharmaceuticals, technology, hospitals and health systems, and the investment and financial services

This post follows up Part 1 of a two-part series I’ve prepared in advance of the AHIP 2024 conference where I’ll be brainstorming these scenarios with a panel of folks who know their stuff in technology, health care and hospital systems, retail health, and pharmacy, among other key issues. Now, let’s dive into the four alternative futures built off of our two driving forces we discussed in Part 1.             The stories: 4 future health care worlds for 2030 My goal for this post and for the AHIP panel is to brainstorm what the person’s

At the end of each year since I launched the Health Populi blog, I have put my best forecasting hat on to focus on the next year in health and health care. For this round, I’m firmly focused on the key noun in health care, which is the patient – as consumer, as Chief Health Officer of the family, as caregiver, as health citizen. As my brain does when mashing up dozens of data points for a “trendcast” such as this, I’ll start with big picture/macro on the economy to the microeconomics of health care in the family and household,

“We definitely do see a slight change compared to the total population, we do see a slight pullback in overall basket,” the CEO of Walmart US is quoted in Bloomberg. “Just less units, slightly less calories.”                   With patients’ use  GLP-1 drugs such as Ozempic, Wegovy, and Mounjaro fast-rising in the pharmacy market, so are the concerns of companies that stock the-middle-of-the-grocery-store aisles for processed foods like sweet and salty snacks. As the prospects for the drug companies who manufacture prescription drugs made for patients managing diabetes and obesity are on the

It’s time for the annual ASCO conference, currently convening the American Society for Clinical Oncology in Chicago. Starting 2nd June, there have been dozens of positive announcements updating research and therapies bringing hope to the 2 million new patients who will be diagnosed with cancer in the U.S. in 2023, and millions of more people worldwide. Just in time for #ASCO2023, the IQVIA Institute published their annual report on Global Oncology Trends 2023 – Outlook to 2027, an update featuring pipelines, therapy approvals, research updates, costs of oncology products, and patients.                  

Reviewing the annual 2023 report from the IQVIA Institute for Human Data Science discussing The Use of Medicines in the U.S. is always a detailed, deep, and insightful dive into the state of prescription drugs. It’s a volume speaking volumes on the current picture of prescribed meds, spending and revenues, health care utilization trends, and a forecast looking out to 2027. In my read of this year’s review, I see a flashing light for U.S. health care: “Wake up, public health!” I’ve pulled out a few of the data points that speak to me about population health, prevention and early

Patients have more financial skin-in-their-healthcare-games facing high-deductibles and direct out-of-pocket costs for medical bills…including prescription drugs. I collaborated with GoodRx on a “yellow paper” discussing The Health Consumers as Payer, with implications and calls-to-action for pharma and life science companies. You can download the paper at this link.               The report is intended to be a playbook for understanding patients’ growing role as consumers and health care payers, providing insights into peoples’ home economic mindsets and how these impact a patient’s adherence to medication based on cost and perceived value. With inflation facing household

Most U.S. adults across political parties favor allowing the Federal government authority to negotiate for drug prices — even after hearing the arguments against the health policy. Drug price negotiation, say by the Medicare program, is a unifying public policy in the current era of political schisms in America, based on the findings in a special Kaiser Family Foundation (KFF) Health Tracking Poll conducted in late September-early October 2021. Overall, 4 in 5 Americans favor allowing the Federal government negotiating power for prescription drug prices, shown in the first chart from the KFF report. By party, nearly all Democrats agree

In April 2020, telemedicine morphed into mainstream medical care as hospitals and physicians risk-managed exposure to infection by meeting with patients, virtually, when possible. By March 2020, telehealth channels were replacing visits to doctors and emergency departments as shown in the first chart from the CDC’s report on the early pandemic period. By the spring of 2021, telehealth use stabilized, but health systems had built the processes and policies to deliver on the promise of omni-channel health care — from the patient’s home and hands (via smartphones) into community sites closer-to-home, and returning to brick-and-mortar medical buildings. Welcome to Telehealth

People living in the U.S. have weathered over fifteen months of life-shifts for work, school, prayer, fitness, and social lives. So you might think that the most important public priority for Congress might have something to do with COVID-19, vaccines, or health insurance coverage. But across all priorities, it turns out that prescription drug costs rank higher in Americans’ minds than any other issue in the Kaiser Family Foundation Health Tracking Poll for May 2021. Two-thirds of U.S. adults said that allowing the federal government and private insurance plans to negotiate for lower prices on Rx drugs was their top

2021 is the 20th anniversary of the University of Michigan Center for Value-Based Insurance Design (V-BID). On March 10th, V-BID held its annual Summit, celebrating the Center’s 20 years of innovation and scholarship. The Center is led by Dr. Mark Fendrick, and has an active and innovative advisory board. [Note: I may be biased as a University of Michigan graduate of both the School of Public Health and Rackham School of Graduate Studies in Economics].   Some of the most important areas of the Center’s impact include initiatives addressing low-value care, waste in U.S. health care, patient assistance programs, Medicare

The reputation of the pharmaceutical industry gained a “whopping” 30 points between January 2020 and February 2021, based on the latest Harris Poll in their research into industries’ reputations. The study was written up by Beth Snyder Bulik in FiercePharma. Beth writes that, “a whopping two-thirds of Americans now offer a thumbs-up on pharma” as the title of her article, calling out the 30-point gain from 32% in January 2020 to 62% in February 2021. Thanks to Rob Jekielek, Managing Director of the Harris Poll, for sharing this graph with me for us to understand the details comparing pharma’s to

The coronavirus pandemic has exposed major weaknesses in the U.S. health care system, especially laying bare inequities and inertia in American health care, explained in The Progress We Need: Ten Health Care Imperatives for the Decade Ahead from Manatt Health. The report details the ten objectives that are central to Manatt’s health care practice, a sort of team manifesto call-to-action and North Star for the next decade. Their ten must-do’s for bending the cost curve while driving constructive change for a better health care system are to: Ensure access Achieve health equity Stability the safety net and rebuild public health

COVID-19 is re-shaping all industries, especially health care. And the pharma industry is challenged along with other health care sectors. In fact, the coronavirus crisis impacts on pharma are especially accelerated based on how the pandemic has affected health care providers, as seen through research from Accenture published in Reinventing Relevance: New Models for Pharma Engagement with Healthcare Providers in a COVID-19 World. For the study, Accenture surveyed 720 health care providers in general practice, oncology, immunology, and cardiology working in China, France, Japan, the United Kingdom, and the U.S., in May and June 2020. Top-line, Accenture points to four

People in the U.S. rank prescription drugs, lab tests, emergency room visits, dental and vision care, preventive services, chronic disease management and mental health care as the “most essential” health care services, according to the 2019 Survey of America’s Patients conducted by The Physicians Foundation. When asked what factors contribute to rising health care costs in America, most consumers cite the cost of prescription drugs. Taken together, these two data points demonstrate the potent political import of prescription drug prices as the U.S. approaches the 2020 Presidential election. The Physicians Foundation surveyed 2,001 U.S. adults between 27 and 75 years

“Drugmakers Push Their Prices Higher” is the top story under the Business & Finance banner in today’s Wall Street Journal. That’s in terms of drugs’ list prices, which most patients don’t pay. But drug costs to patients are in the eye of the beholder, who in a high-deductible plan or Medicare Part D donut hole becomes the first-dollar payer. Patients continue to face rising drug costs, pushing them into what I’ve been thinking about as luxury-goods territory. The economic definition of a luxury good is a product for which demand increases more than proportionally as income rises, so that spending

Consider the voice of a patient before the advent of the Internet in the digital 1.0 world, and then the proliferation of social networks in v 2.0. One patient could talk with another over their proverbial neighborhood fence, a concerned parent at the PTA meeting with others dealing with a children’s health issue, or a recovering alcoholic testifying in person at an AA session. Today, the voice of the patient is magnified one-to-many, omnichannel and multi-platform — via video, blogs, podcasts, social networks, listservs….and, yes, still in live forums like AA meetings, church basements, Y-spaces, and the Frazzled Cafe meet-ups

All health/care is retail now in America. I say this as most people in the U.S. who have health insurance must take on a deductible of some amount, which compels that insured individual to spend the first dollar on medical services up until they meet their financial commitment. At that point, health insurance kicks in, and then the insured may have to spend additional funds on co-payments for general medicines and services, and coinsurance for specialty drugs like injectables and high-cost new therapies. The patient is a consumer is a payor, I asserted today during my talk on the expanding

Most Americans have been surprised by a medical bill, a NORC AmeriSpeak survey found. Who’s responsible? Nearly all Americans (86% net responsible) first blame health insurance companies, followed by hospitals (82%). Fewer U.S. patients blamed doctors and pharmacies, although a majority of consumers still put responsibility for surprise healthcare bills on them (71% and 64% net). Most of the surprise bills were for charges associated with a physician’s service or lab test. Most surprise charges were not due to the service being excluded from a health plans provider network. The poll was conducted among 1,002 U.S. adults 18 and over

  There’s growing evidence that a majority of U.S. voters, across the three-party landscape, agree on two healthcare issues this year: coverage of pre-existing conditions, and lowering the consumer-facing costs of prescription drugs. A new poll jointly conducted by Politico and the Harvard Chan School of Public Health bolsters my read on the latter issue – prescription drug pricing, which has become a mass popular culture union. There may be no other issue on voters’ collective minds for the 2018 mid-term election that so unites American voters than the demand for lower-cost medicines. This is directly relates to consumers’ tri-party

When it comes to healthcare costs, lines that decline over time are generally seen as good news. That’s how media outlets will cover the top-line of PwC’s report Medical cost trend: Behind the numbers 2019. However, there are other forces underneath the stable-looking 6.0% medical trend growth projected for 2019 that will impact healthcare providers, insurers, and suppliers to the industry. There’s this macro-health economic story, and then there’s the micro-economics of healthcare for the household. Simply put: the impact of growing financial risk for healthcare costs will be felt by patients/consumers themselves. I’ve curated the four charts from the

Less can lead to more for so many things: eating smaller portions, lowering sugar consumption, and driving less in favor of walking or cycling come to mind. When it comes to healthcare utilization, doing less can also result in equal or even better outcomes. Groundbreaking research presented at this week’s ASCO meeting found that some women diagnosed with certain forms of cancer do not benefit from undergoing chemotherapy. The American Society of Clinical Oncology (ASCO) is one of the largest medical meetings annually, and at this huge meeting these research results for the TAILORx trial were huge news with big

“We are at a remarkable point of cancer treatment,” noted Murray Aitken, Executive Director, IQVIA Institute for Human Data Science, in a call with media this week. 2017 was a banner year of innovative drug launches in oncology, Aitken coined, with more drugs used more extensively, driving improved patient for people dealing with cancer. This upbeat market description comes out of a report on Global Oncology Trends 2018 from the IQVIA Institute for Human Data Science. The subtitle of the report, “Innovation, Expansion and Disruption,” is appropriately put. The report covers these three themes across four sections: advances in therapies,

This is what happened to pharma stock prices on Friday after President Trump and Secretary of Health and Human Services Alex Azar outlined their new policies focusing on prescription drug prices. The graph is the Nasdaq U.S. Smart Pharmaceuticals Index (NQSSPH) from May 11, 2018, the date when POTUS and Secretary Azar made their announcement. What this upward driving curve indicates, from the start of stock trading in the morning until the ring of the closing bell, is that the pharma industry players, both manufacturers and PBMs, were quite delighted with what they heard. The blueprint for restructuring the prescription drug industry,

While the use of medicines continues to rise in the U.S., spending grew by only 0.6% in 2017 after accounting for discounts and rebates. In retail and mail-order channels, net spending fell by 2.1%. Prescription drug spending on branded products grew nearly $5 billion less than in 2016; generic drug spending fell by $5.5 billion, according to Medicine Use and Spending in the U.S., a report from the IQVIA Institute for Health Data Science. The report reviews medicines spending in 2017 looking forward to 2022. There were over 5.8 billion prescriptions dispensed in 2017, and generic drugs accounted 90% of

Picture this scenario: you, the consumer, take a dollar and spend it, and you get 90 cents back. In what industry is that happening? Here’s the financial state of healthcare in America, explained in the 2016 Health Care Cost and Utilization Report from the Health Care Cost Institute (HCCI). We live in an era of Amazon-Primed consumers, digital couponing, and expectations of free news in front of paywalls. We are all in search of value, even as the U.S. economy continues to recover on a macroeconomic basis. But that hasn’t yet translated to many peoples’ home economics. In this personal

The biggest healthcare spenders in the United States are households and the Federal government, each responsible for paying 28% of the $3.3 trillion spent in 2016. Private business — that is, employers covering healthcare insurance — paid for 20% of healthcare costs in 2016, based on calculations from the CMS Office of the Actuary’s report on 2016 National Health Expenditures. The positive spin on this report is that overall national health spending grew at a slower rate in 2016, at 4.3% after 5.8% growth in 2015. This was due to a decline in the growth rates for the use of

  A response to Amazon’s potential moves in healthcare and pharmacy…strategic positioning for the post-Trump healthcare landscape…vertical integration to better manage healthcare utilization and costs…these, and other rationale have been offered by industry analysts and observers of the discussions between CVS and Aetna, for the former to acquire the latter. “A pharmacy chain buying a health insurance company?” many have asked me over the past few days. These inquiring minds include people who work both inside and outside of health/care. I ask back: in 2017 and in the future, “What is a pharmacy? What is a health plan?” See the