The Impact of “Social Resistance”
By Norm Smith
A major question being asked around pharma these days is the impact ACOs (accountable care organizations) will have on the sales of branded drugs. Will ACOs hire PBMs to manage their use of drugs, and will this lead to a decrease in prescribing of patented products? Will PBMs place “onerous” prior authorizations on all new products, just to limit their launches? How will higher price products, even when used for unmet medical needs, fare in this new climate?
One aspect that could impact brand utilization is the “social resistance” that will be felt within some physician’s group. This will not come because of an ACO’s prior auth, or a step edit by a payer, but by peer-to-peer pressure exerted on those doctors who are high users of expensive technologies. Who wants to be the guy responsible for limiting the amount of bonus payments a group deserves because you used the more costly alternative. Pathways and guidelines have been around a long time, but the advent of ACOs, and their cousins the “medical home” may have the greatest impact on higher cost products.
Norm Smith is president of Viewpoint Consulting, Inc, a consulting company driven by market research among decision makers at large buyers of pharmaceuticals, including health plans, PBMs, Long Term Care, Hospitals, and in Medicare and Medicaid. Norm can be reached at ViewpointConsulting.net.
