GlaxoSmithKline's Jack Bailey on value-based care experiments

{1} 美国制药公司总裁杰克贝利说，制药公司需要采取新的方式来获得产品报酬。 1000亿美元的英国制药商葛兰素史克（GlaxoSmithKline）。葛兰素史克（GlaxoSmithKline）已经尝试了三到四年的新方法。称为基于价值的护理，这意味着GSK不是按每丸获得报酬，而是根据这些药丸的运作情况获得报酬。 贝利让我们深入了解了这些项目以及他从这次经历中学到了什么。继续阅读更多信息。访问Business Insider的主页了解更多故事。美国医疗保健系统正在发生变化。长期以来，人们一直在谈论将美国医疗保健转变为“以价值为基础”的模式药品公司根据他们的药物是否适用于患者，而不是他们销售的每种药物来获得报酬。然而，将其付诸实践是很复杂的。例如，您如何跟踪药物是否有效？这可能意味着不同的事情取决于疾病和药物。如果像葛兰素史克（GlaxoSmithKline）这样一家总部位于伦敦的2000亿美元制药商这样的公司，药品如何获得报酬尤其重要。该公司在过去的三到四年里一直在美国进行试验，以找出更好的方法来获得治疗费用。“非常清楚我们需要去哪里，”美国药品总裁Jack Bailey说。在葛兰素史克。 “一般来说，我认为大多数制药公司已经意识到我们不能凭借静止而获胜。”在上周与曼哈顿市中心的商业内幕人士谈咖啡时，Bailey - 一位在2015年担任葛兰素史克公司美国药品负责人的制药行业资深人士 - 描绘了一个行业在每个层面都处于不稳定状态的画像，从它的资金来源到如何组织以及如何提供护理。阅读更多：一种可以治疗罕见和破坏性疾病的革命性药物是非常昂贵的。但是一个州有计划支付其潜在的500万美元的价格标签。葛兰素史克从其七个实验中学到了什么基于价值的计划葛兰素史克开始寻找一些关于基于价值的医疗在制药行业如何运作的答案。该制药商目前在美国有七个针对肺病药物的价值计划，它有与健康保险公司等各种支付方建立了合作关系。基于价值的护理模式对于价格最高的药物尤其具有吸引力，健康保险公司除非真正帮助患者，否则他们不愿意为此付出代价。 肺病是葛兰素史克公司的一个主要领域，治疗它的产品价格昂贵。在最近一份攻击该药物巨头的报告中，倡导组织“负担得起的药物患者”批评了该公司在美国对一些产品的定价，包括最畅销的哮喘药物Advair。 葛兰素史克公司基于价值的计划涵盖的药物包括用于慢性阻塞性肺病（COPD）的Breo Ellipta和Anoro Ellipta吸入器。据Bailey指出，患者服用药物对COPD等疾病尤其重要，因为它们可能会失去肺组织。总体而言，七个以价值为基础的计划占Glaxo业务的一小部分。 。 Bailey说，最大的教训就是“确实需要进行一些实验。”另一个关键的教训是关于与付款人达成协议的性质。那些必须小心平衡，或者贝利说，“足够复杂，每个人都可以同意，但不是那么复杂”，以至于无法复制。 这些协议采用了不同的方法来衡量药物的运作情况。例如，Glaxo计划中的一个涵盖了各种GlaxoSmithKline呼吸药物，并按照每季度测量的年度合同运行。该计划追踪患者是否使用救援吸入器作为药物使用情况的替代品。工作，因为救援药物是哮喘或COPD等疾病无法控制的重要标志。该公司表示，发现最终需要救援药物的患者比例是非常小。“另一种追踪它的方法是观察患者从一种治疗方案进展到另一种治疗方案。这一努力得益于葛兰素史克公司在这一领域拥有广泛的药物组合， Bailey说，使用相同设备并每天服用一次的患者。所有基于价值的协议”已经存在了几年，所以我认为这是一个好兆头，“Bailey说。”没有一个一个人现在已经取消了，因为他们说它不起作用。“阅读更多：'很可能是未来'：公司已投入85亿美元用于创建新版本一个前沿的，高度个性化的癌症治疗方案医疗保健行业的首席执行官每年赚取2600万美元。这是该行业的高管在2018年获得的收益。科学家们正致力于治疗这种疾病的癌症治疗方法圣杯”。大型制药公司和生物技术公司已投入超过10亿美元。我们看看硅谷健康科技创业公司Semper Health的宣传平台。它揭示了一个40亿美元的产业如何成熟中断。 {1}{0}{1}

Pharma companies need to move to new ways of getting paid for their products, said Jack Bailey, president of US pharmaceuticals for the $100 billion British drugmaker GlaxoSmithKline.

GlaxoSmithKline has been experimenting with a new approach for three to four years. Called value-based care, it means that instead of getting paid per pill, GSK gets paid based on how well those pills work.

Bailey gave us an inside look at the programs and what he's learned from the experience. Read on for more.

Visit Business Insider's homepage for more stories.

Change is afoot in the US healthcare system.

There's long been talk of shifting US healthcare to a “value-based” model, where drug companies get paid based on whether their medications work for patient, rather than for each pill they sell.

Putting that into practice, though, is complex. For instance, how do you track whether a drug is working？ That can mean different things depending on the disease and medication in question.

How drugs get paid for is especially important for a company like GlaxoSmithKline, the $200 billion drugmaker based in London. The company has been experimenting for the past three to four years in the US to figure out better ways of getting paid for its treatments.

It's “pretty clear where we need to go,” said Jack Bailey, president of US pharmaceuticals at Glaxo. “Generally I think most pharma companies have realized we can't win by standing still.”

Speaking with Business Insider over coffee in midtown Manhattan last week, Bailey — a pharma industry veteran who started as Glaxo's head of US pharmaceuticals in 2015 — painted a portrait of an industry in flux at every level, from how it's financed to how it's organized and how care is delivered.

Read more: A revolutionary drug that could treat a rare and devastating disease is prohibitively expensive. But one state has a plan to pay for its potential $5 million price tag.

What Glaxo has learned from its about seven experiments with value-based programs

GlaxoSmithKline is starting to find some answers about how value-based care works in pharma.

The drugmaker currently has seven value-based programs for lung disease drugs in the US, which it has established with various payers like health insurers.

Value-based care models are particularly attractive for the highest-priced drugs, which health insurers are reluctant to pay for unless they actually help patients.

Lung disease is a major area for GlaxoSmithKline, and the products that treat it can be expensive. In a recent report attacking the drug giant, advocacy group Patients for Affordable Drugs criticized the company's US pricing for a number of products, including the bestselling asthma medication Advair.

The drugs covered by GlaxoSmithKline's value-based programs include the Breo Ellipta and Anoro Ellipta inhalers for chronic obstructive pulmonary disease (COPD).

That patients take their medications is especially important in a disease like COPD, because they can otherwise lose lung tissue, Bailey noted.

In total, the seven value-based programs make up a small slice of Glaxo's business. And the biggest lesson, Bailey said, has been that “it does take some experimentation.”

Another key lesson has been about the nature of the agreements with payers.

Those have to strike a careful balance, or be “sophisticated enough that everyone can agree, but not so complex” that they can't be reproduced, Bailey said.

The agreements have employed different ways to gauge how well the drugs work. One of the Glaxo programs, for instance, covers various GlaxoSmithKline respiratory medications and runs on an annual contract that is measured each quarter.

The program tracks whether patients have used a rescue inhaler as a stand-in for how well medication is working, since rescue medications are an important sign that a disease like asthma or COPD isn't under control. The company says it's found that the share of patients that end up needing rescue medication is “very small.”

Another way to track it is looking at patients as they progress from one treatment option to another. That effort is helped along by the fact that GlaxoSmithKline has a broad portfolio of medications in this area, all administered to patients using the same device and taken once a day, Bailey said.

All of the value-based agreements “have been in place several years, so I think that is a good sign,” Bailey said. “Not a single one right now have we cancelled because they've said it just doesn't work.”

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