Summary and Final Thoughts on the Value-Based Marketplace

Michael Thompson: Just to kind of summarize drugs, in some ways we’re in a renaissance period of drugs. We’ve had more discovery in the past decade, and a lot of those drugs have made a huge difference in people’s lives. We should appreciate that and support that. In many instances, there’s a medical offset, and in some instances there’s not. But in any event, those are very important.

I think the issue, from a value-based marketplace, is whether we are being priced fairly, right? Are they being used appropriately, right? And are we getting the outcomes that were advertised, right? I think that’s where the value-based discussion goes from here. I think it’s still to be written. There’s some concern that our intermediaries continue to be motivated by a model that’s gotten outdated. It was a market-share model based on rebates that ultimately evolved into a rebate model, right? We need to fix that, but I don’t think that’s going to be enough. That’s part of the solution, but it’s not the only part of the solution. This is still very much an evolving area, but I think it’s an area that’s on everybody’s radar and we need to stay focused on it.

Well, thank you all for participating in this. This has been fascinating and very engaging. Before we end this discussion, I’d like to open the floor and ask each of you to provide some final thoughts. Dr. Crighton?

Andrew Crighton, MD: I think the No. 1 thing is, it’s a complicated issue that is not going to be easy to solve. But if we keep the patient in mind, and outcomes that improve their lives, we can get to where we need to be. We may have small successes as we go along, but we better celebrate those. We have to be moving in the right direction, or we’re going to be really far behind.

Michael Thompson: Great. Pat?

Patricia Haines: I agree. I think we use the term patient-centered a lot now. We didn’t earlier. So that is a step in the right direction, but there are a lot of smart people who care about this. We have an opportunity because there’s so much focus on it today. It’s different. I’ve been in this business a long time, and it’s different. I think the conversation will get raised through the next election cycle, and I’d love for it to be solved by people who are as invested in it as the 4 of us are. And so we should keep these dialogues going.

Michael Thompson: Yup. Bruce?

Bruce Sherman, MD: A couple of thoughts. I think that the current system as it stands is absolutely unsustainable from a cost standpoint—where we are with healthcare spending as a percentage of GDP [gross domestic product]. We need disruptive solutions. While I appreciate the value of incremental change, I think we have to perhaps learn from our past successes. I continue to think that primary care is an important and vital focus that we need to really increase our attention to, ensuring that it is an effective solution in the marketplace.

Michael Thompson: Yeah. So not being afraid to disrupt, focus on value, and working collectively and collaboratively to move it forward.

I want to thank you all for your contributions to this discussion. On behalf of our panel, we thank you for joining us. We hope you found this AJMC® [The American Journal of Managed Care®] discussion to be useful and informative. Thank you.