Time to Get Together: Delivering Improved Health Outcomes through Pharmaceutical and Payer Collaboration

These healthcare stakeholders will need to partner in the near and long terms to reduce cost while increasing or maintaining quality—as demanded by patients and providers—across the entire care continuum.

In particular, three major trends will be integral to the future environment:

• Increased integration across the care continuum, as evidenced by the growth of integrated delivery networks (IDNs) and future accountable care organizations (ACOs).

• Persistence of health information technology reforms.

• Influence of real-world evidence and the data required to support it.

Pharmaceutical organizations that do not capitalize on the healthcare industry dynamics risk being left behind. Accenture’s perspective is that organizations that will succeed need the following:

1. Willingness to change: It may sound simple, but the culture of an organization can negate any chance of significant change by holding on to outdated beliefs, such as the existence of a competitive battle between payers and pharmaceutical companies, or between payers and providers.

2. Broader strategic vision: Significant change to the strategic direction of an organization is only going to come from incorporating new perspectives and approaches to creating value with key decision makers.

3. Expertise in areas of collaboration: A prerequisite to broadening the organization’s strategic vision is knowledge and experience in developing and executing these collaborations and in new ways of creating value.

4. Capability to execute and implement: Setting the strategic direction is a necessary, but not sufficient, condition for change. Once the strategy is defined, organizations must be able to execute in ways that are uncomfortable due to the degree of change they entail, and have the discipline to avoid reverting back to old ways.

As the healthcare industry undergoes continuous change, pharmaceutical companies will encounter new imperatives—and opportunities—to collaborate with payers. Indeed, the industry is moving steadily toward a focus on outcome-based payment models, reduced costs and higher quality across the full continuum of care—all of which will require more partnerships and greater coordination across company and segment boundaries.

For those life sciences organizations that can embrace the changes underway and collaborate to create value while supporting better outcomes, opportunities abound to achieve high performance.