![]() Accountability, at-risk contracting, performance, and skin in the game are here to stay.Įxamples of innovation or alternative value-based arrangements might include the following: Cures greater than $1 million per person will come to the marketplace, in droves, at the same time that our national debt is likely to start choking our ability to insure ourselves as a country against storms, economic events, and other catastrophic events, let alone the costs associated with fantastical advances in medicine.įee for service is dying. Innovative medications must continue to be developed, not stifled. ![]() The prevalence of chronic diseases is growing, not shrinking. We can avoid cliff conversions and radical change if we are planning for the future and being clear-eyed about the reality of what is ahead. With continued, increasing rates of generic drug use and higher and higher concentrations of specialty products consuming the whole of the pharmacy dollar, the existing model will become outdated. Our policymakers need to get out of the conventional financing mindset. Meanwhile, the future of pharmacy is left in the lurch, because everyone lumps pharmacists into the cost of everything, from getting raw materials to patient administration, without any regard for the need for services that ensure that curative agents actually produce the intended result and not conflicting therapies, partially completed courses of therapy, or wasted physician visits. That results in legislators leaning toward blunt legislative instruments, such as reimportation or prices based on committee proceedings in big concrete buildings, which leads to increases in development and regulatory costs. That leads to pharmacy benefit managers pointing at manufacturers for their huge market influence. The manufacturers pointed to rebates that come through the spreadsheet analysts who create (ironically) drug pricing spreads. On February 26, the House called in executives of biopharmaceutical companies and lambasted them for rising drug prices. There is a lot of finger pointing, and every time somebody is invited to Capitol Hill, that is on display. It is coming soon, but with a really big price tag.ĭEATH THROUGH INABILITY TO PAY IS JUST AS POWERFUL Imagine no Alzheimer disease or autism, less pain and suffering, and hundreds of billions of dollars of increased productivity. We are now directing our own cells to attack cancer. There are more than 3000 gene therapies in the development pipeline. ![]() Imagine a world without blindness, diabetes, paraplegia, or psychotic episodes. But as Freddie’s father said in the movie, “Good thoughts, good words, and good deeds,” a reference to one of the core Zoroaster religious maxims, which reinforces the idea of doing the right thing, and worldly rewards will follow. Would anthem rock still be alive had Freddie been cured? What sort of pain and suffering among millions would have been avoided? Those who are infected are no longer ostracized and outcast, but in the 1980s and 1990s, some people neglected and even spurned the afflicted. It is hard to avoid thinking about what might have been with Farrokh Bulsara, Freddie Mercury’s real name, had a cure been available in the early 1980s, which is when most of us first learned of the horrors of AIDS and HIV, both medical and through derived social stigma. It appears that we are nearing the final breakthroughs in a more than 3-decades-long progression of biopharmaceutical and medical advancements in treating HIV. As the movie ended, it occurred to me that I had read an article fewer than 8 hours earlier declaring the second person in human history had achieved sustained HIV remission after being infected.įreddie Mercury died in 1991 of the type of pneumonia that is a common complication from HIV infection and progression. It is a pretty good movie that ends in a reenactment of what is widely considered the best live musical performance in modern history: 1985’s Live Aid at London’s Wembley Stadium. I decided on Bohemian Rhapsody, a biopic about the band Queen and the life of its lead singer Freddy Mercury. After contemplating whether to ask Delta for a refund, I browsed through the in-flight movies, which, given the recency of those awards, featured several Oscar nominees. I am not sure how those of us who travel for work got along before in-flight Wi-Fi, but I survived nonetheless. I recently traveled to Las Vegas to speak at the annual MHA business summit, which required a 5-hour flight-with no internet access.
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