In the US, at least, there’s no doubt about the biggest healthcare issue in 2013: the implementation of the Affordable Care Act, also known as Obamacare. Indeed, if this look ahead was focused entirely on the American market, we could easily have found five separate issues related to the ACA.
But globally, the healthcare industry continues to face major challenges, from the “patent cliff,” which will continue to effect some blockbuster drugs, to digital and social media, which will continue to create opportunities for communicators and difficulties for those responsible for regulatory compliance.
1. Dealing with the fallout from Obamacare: In the US, states are moving to set up exchanges that must be ready for consumer enrollment by October and will be operational by 2014. According to Nancy Hicks, who leads the North American healthcare practice at Ketchum, “This will be a sea change in how many Americans get insurance coverage with an estimated 30 million people who may be covered by the exchanges.
“Insurance companies are working with HHS to define ‘essential benefits’ that must be covered in their plans, and they are gearing up to market their plans on the state exchanges. Hospitals and pharma companies should see more business due to the increased pool of insured people.”
At the same time, “cost concerns—particularly for individuals and small businesses—will become more pronounced as we see the effect of the ACA on premiums and the political shock waves that generates,” says Robert Schooling, head of the healthcare practice at APCO Worldwide. Much of the discussion around ACA is “hyper-partisan,” Schooling says, “and so the public is having a hard time deciphering truth from fiction and defaults to partisan biases. This makes it a very challenging environment in which to inform the public about the changes that are coming.”
There are major implications for the provider sector too, says Brandon Edwards, founder and chief executive of Revive Health, which specializes in the provider sector. “As the entire health care system is reengineered, health plans are entering the provider business, and health systems are increasingly entering the health plan business. This will have huge implications for consumers.”
Finally, a Georgetown University study predicts the number of healthcare workers will have to expand by almost 30 percent overall by 2020, which will be the most dramatic growth of any sector in the US. According to Kate Cronin, who heads the global healthcare practice at Ogilvy Public Relations, “”Due to the full implementation of ACA will be more healthcare employees to service all the individuals who will be moving into the healthcare system. In addition, the nation’s growing elderly population continues to stress the healthcare system. With the growing need for healthcare employees, so comes a potential for PR to promote these opportunities, working with nursing or nurse practitioner associations to promote these career paths.”
2. A focus on wellness and prevention: Another thing to note about the Affordable Care Act is that its impact will be felt not only by pharmaceutical companies and other health industry players, but by every major corporation in America. Those companies “will continue to focus on how the healthcare bill will impact their daily business, customers and bottom line,” say the folks at Chandler Chicco, the largest independent healthcare public relations firms in the US.
“Will we begin to see more attention on prevention activities as mechanisms for lower care costs down the line?” Allison Rosen, managing director of Chandler Chicco in Washington, DC, asks. “How will more people with insurance coverage impact the health care workforce? In terms of workplace wellness, what will large employers begin to offer their workforces under this general umbrella, or will employers do less?”
“The launch of ACA will also focus on the growth disease prevention and overall wellness,” adds Cronin. “Many large and corporations will support and develop health and wellness programs focused on better health and reducing costs. Pharmaceutical companies will focus on being more of a disease management partner to patients and healthcare practitioners.”
Cardiovascular disease, cancer, and diabetes now cause 70 percent of US deaths and account for nearly 75 percent of healthcare expenditures. And with 5 percent of the US population accounting for more than 50 percent of healthcare costs, “businesses and organizations will institute health and wellness programs to encourage better health and prevention,” says Chandler Chicco. “Awareness and prevention are considered to be the best frontline defense against poor health and cutting unnecessary costs across the board.”
Hepatitis C awareness will be a particular focus, following a recommendation that all baby-boomers should get tested. Says Hicks, “This mandate, coupled with some drug companies with HepC drugs in the pipeline, is likely to result in some public education campaigns urging awareness and testing for this virus.”
3. The “patent cliff” and the need for innovation: Major drugs like Zyprexa are due to lose their patent protection this year, just as Plavix and Lipitor did last year. It is estimated that between 2012 and 2018, $290 billion of sales are at risk due to patent expiration of major brands. One consequence will be a renewed focus on innovation.
“Selling old drugs in new markets is not the answer,” says Kym White, who leads the global healthcare practice at Edelman. “Just as many African nations skipped right over land lines and telephone poles and went straight to cellular, emerging market payers are not enthusiastic about paying top dollar for yesterday’s therapies. They, too, demand innovation and will reimburse proportionate to the value therapies bring their populations.”
Companies will also be targeting new populations.
“The pharma industry knows it needs to demonstrate the particular patient populations for which their innovative therapies work, separate and distinct from personalized medicine with its one-to-one orientation,” says White. “The health economic benefits must be shown for more specific populations to earn reimbursement and ensure therapies are used on the patients for whom there is certainty they will add value, which has clear implications for clinical trial design.”
4. New technology and digitization: “Technology will continue to pave the way for a better overall healthcare system, providing a more efficient and effective experience between consumers, healthcare providers, insurers and health wellness businesses,” says Chandler Chicco. “Of course, technology will enable our antiquated processes to be better but technology will also propel consumers to have more engaged and interactive experiences with not only their doctors and providers but healthcare brands.”
Research shows that 66 percent of doctors used tablets in 2012, up from 45 percent a year earlier, ensuring better access to electronic health records, drug information and other data information. In addition, there are thousands of healthcare apps and the number is growing.
“In 2013, there will be more apps launched for healthcare providers and for patients in the disease management space,” says Cronin. “These apps will now become more regulated by the FDA because they are affecting approaches in treatment and diagnosis. Companies will need clarity regarding the regulations around wellness apps versus true medical apps.”
5. The impact of big data: “There is a growing need for a more evidence-based approach to managing healthcare,” says Cronin. “While medical publishing continues to grow, so do additional sources of data including federally incentivized EHR programs, data from body sensors and devices, and genetic sequencing. Big data analysis will play an important role in helping clinicians make the right decisions for their patients. In addition, it will help improve overall approaches to health management, help reduce hospital readmissions, guide clinical studies and inform healthcare companies of medical approaches and practices that work.”
Adds Christie Anbar, managing director of Chandler Chicco Agency New York: “Because of the Affordable Care Act’s 30-day readmission penalty for key disease states, promoting Health Economics Clinical Outcomes Research data will be a major focus for companies.”
In-House view: "We need to more approachable..."
Ed Lang, director of public relations, Genentech
“Over the next 12 months, we should see healthcare companies showing their human side and speaking in their audience’s language. Gone are the days of one-way marketing messages that speak to the company, more than the people we serve. A solid drug, test, device or product is not an advantage alone. Being in a highly regulated industry is no longer an acceptable excuse. To pique the interest of today’s patient, doctor or scientist, an engaging personality is a must.
Healthcare companies are now in conversation with the people that matter. And let’s face it, nobody wants to be talked at. Nobody wants a dull conversation. So we need to be more approachable. Recently at JP Morgan Genentech showed its inherent funny, nerdy science side by jumping into the #jpmpickuplines contest with “Nice antibody. Wanna conjugate?” This was the most retweeted #jpmpickuplines – not a bad place to start.”