The results of a new Pharma Insights report released by Symphony Health Solutions, a provider of high-value market research, analytics and technology solutions for life science manufacturers, payers and providers, offers insight into where the estimated nine million newly insured consumers under the Affordable Care Act’s Health Exchange sought care and how prescription volumes were impacted. The company’s annual analysis of the U.S. pharmaceutical market suggests that the precarious balance point between cost and value may be shifting with the entrance of a new patient population and continued concerns over rising costs of care.
The report revealed that of the top ten physician specialties writing prescriptions for federal Health Exchange members, more endocrinologists and dermatologists wrote prescriptions than any other, including family practice and internal medicine. Nearly 66% of endocrinologists and 67% of dermatologists wrote prescriptions for federal Health Exchange members, while only 47% of family practitioners and 25% of pediatricians wrote prescriptions for this same group.
Based on this new data, the ACA may be succeeding in opening access to previously underserved populations who are either new to care or who now have better access to care. For example, dermatological care has been cited in a brief published by The Center for Studying Health System Change as one of five specialties that had been difficult to access for uninsured and Medicaid populations (the others were gastroenterology, orthopedics, cardiology, and endocrinology.) Other studies, as reported in the Annals of Surgery, have shown that uninsured patients with diabetes had statistically lower rates of the recommended physician surveillance and monitoring needed to control the disease.
Pharma Insights highlights the broader themes of cost vs. value in today’s healthcare system, exploring the value of new high cost, innovative pharmaceutical treatments that show promise in providing cures vs. the economic burden to the healthcare system. In addition, the report looks at the role of big data and analytics to enhance health system transparency and promote accountability and coordination amongst care settings as a much larger portion of the population accesses care.
Pharma Insights also provides a comprehensive overview of the biopharmaceutical marketplace leveraging Symphony’s Integrated DataverseTM(IDV). IDV brings together comprehensive prescription, medical and hospital claims to provide a complete view of the prescriber, patient, and payer dynamics that determine market activity. In 2014, U.S. biopharmaceutical prescription volume grew by 1.6 percent over 2013. Branded drug volumes continued to decline while average patient out-of-pocket cost increased more than $5 over the past four years, as high-priced specialty drugs enter the market. Generic volumes continued to grow, while patient out-of-pocket remains steady, slightly declining by 35 cents on average over the past four years.