A New Lens for Pharma

Conversations about the evolution of biopharmaceutical companies in a value-based US healthcare environment tend to focus solely on value-based contracting and not much else. While value-based contracts (aka outcomes-based or risk-sharing agreements) have their place, exploring where exactly that place is is a topic for another day.

Today we’re talking about one of our pet peeves — narrow viewpoints in this area that lead to missed opportunities – opportunities that could otherwise open minds that open doors. With the shifting landscape to value-based healthcare, an evolved progressive mindset towards patient-centeredness, population health, health equity, and an overall drive to improve healthcare quality has emerged.

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When biopharmaceutical companies' engagement with external stakeholders is centered principally on value-based contracting, opportunities are often missed for customer-facing functions to stakeholders, such as providers and payers, at a new level.

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At THCQ Consulting, Inc., we believe greater opportunities start with centering conversations on what biopharmaceutical companies should do differently around healthcare’s north star of the Quintuple Aim – inclusive of health equity as the fifth leg. Flowing from the Quintuple Aim are the value-based care and payment paradigm and quality measurement –  major levers through which the US healthcare system works to realize the objectives of the Quintuple Aim.

Our goal here is to shine a light on the opportunity for a new lens for pharma. A new outlook on the level of engagement that the value-based care and payment paradigm affords biopharmaceutical companies broadly, including the customer-facing functional areas within.

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When pharma functional area senior leadership, particularly those who are outward or customer-facing, invest in deepening their teams’ knowledge of value-based care and its relevance to their provider and payer customers, it can pay tremendous dividends. Competencies need to be developed to allow for better conversations that compliantly achieve business objectives.

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For example, say you’re preparing for a strategic account engagement with a company held by a Medicaid managed care organization medical director stakeholder. Knowing the nature and level of risk and/or accountability for quality measure performance in the therapeutic area of interest will help you understand “what keeps them up at night” and is a great starting point for such an external engagement.

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This is what we mean when we say biopharmaceutical companies’ response to value-based healthcare can help key customer-facing functions “better stand in the shoes” of their provider and payer customers. From THCQ Consulting’s vantage point, improving competency in this area is key. We believe these customer-facing functions deliver higher value to customers through better aligned strategic engagement.

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The outcome is often a better positioning of these functions with key external provider and payer stakeholders that help deliver stronger results back to their businesses.

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10+ years of experience with value-based care/payment and quality strategy has led us to conclude that the functional areas listed below are where the opportunity is greatest for biopharmaceutical companies’ customer-facing functions to strategically align with external healthcare stakeholders (their customers). This has shown to result in improved job function execution and better positioning to achieve business objectives.

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These key customer-facing functions for biopharmaceutical companies include:

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• Medical affairs and external medical stakeholder engagement
• Evidence generation functions (i.e., clinical development, real-world evidence, HEOR, medical affairs)
• Market access strategy and payer account management engagement
• Policy
• Patient advocacy

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This strategic mindset for external stakeholder (i.e., provider, payer) engagement introduces a new lens for biopharmaceutical companies to be responsive to the rapidly-evolving value-based healthcare ecosystem.

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This probably won’t be the last time we complain about narrow viewpoints when contemplating much needed shifts for pharma in a value-based healthcare ecosystem. But at least we don’t complain without offering solutions! That might be a worse pet peeve, if we're being honest.

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Summary

One of our biggest pet peeves at THCQ Consulting is in the nearsighted perspective that arises in conversations about the biopharmaceutical industry and its response to the evolving value-based healthcare environment.

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There is an opportunity for a new lens for pharma to bring to external healthcare stakeholder engagement which will help to optimize execution and performance of key customer-facing functions in the industry.

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The solution lies in the Quintuple Aim, where its objectives are pursued by way of the value-based care and payment paradigm in healthcare system in the U.S. This opportunity is afforded to the biopharmaceutical industry broadly, each individual company, and customer-facing functional areas within any one company.

A Question for You

We would love to hear your thoughts.

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What other ways do you see elements of the Quintuple aim and the value-based care and payment paradigm creating opportunities for pharmaceutical companies when engaging external provider and payer stakeholders?

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