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A report by Decision Resources projects that for moterol/mometasone, an asthma therapy codevel oped by ScheringPlough and Novartis, will be approved in 2009 and become the clinical gold standard for treating asthma by 2011 because of its competitive advantages in delivery over AstraZeneca’s Symbicort. Because of the saturated and competitive nature of the asthma market, the development of fixeddose combination inhalers that can treat patients with per sistent disease ranging frommild to severe is the most commercially compelling sector of the pipeline. As such, the latestage asthma pipeline is dominated by new fixeddose, longacting beta2 agonist/inhaled corticosteroid (LABA/ICS) combinations. According to the DecisionBase 2008 report,Asth ma: Novel Product Differentiation Remains a Key Challenge, formoterol/mometasone may have a greater number of inhaler device options if Scher ingPlough and Novartis decide to pursue both metered dose inhaler (MDI) and dry powder inhaler (DPI) formulations of the drug, which are the same delivery mechanisms offered by market leader GlaxoSmithKline’s Advair. The 60 primary care physi cians surveyed for the report indicate they would prescribe formoterol/mometasone to 34% of their patients with persistent asthma. “Pulmonologists emphasize that delivery device “More than anything, the findings convince us that Americans no longer see themselves only as patients but as consumers who want to take greater control of their healthcare,” Mr. Keckley says. “Con sumers will redefine our healthcare market,but how they do it is the most important strategic question the healthcare industry must answer.” The way Americans think and behave in buying, managing, and using their healthcare varies widely by gender, age group, and cultural background, according to the survey. Women and men, for instance, have very different approaches to how they select and pay for their healthcare. The sur vey found that women have a higher tendency to make their own decisions about treatment, rather than deferring to their doctors, and they are more likely to explore alternatives to tradi tional healthcare services and to engage in more comparison shopping for reduced healthcare costs and better hospital services.Women are also more Websavvy consumers; they consult health related Websites for medical information in greater numbers than men, and they insist in higher per centages upon online access to test results and appointments. By contrast, men are more likely than women to pay more for sameday appointments and to make changes to health coverage, and more men than women want higher deductible and lower copay premiums. Men also have a higher tendency to choose prescription drugs over alternative therapies. Despite some demographic differences, the study found that consumers overall have the same needs — better service, personalization, and value — and that they want specific tools to customize the health services and insurance programs they use. Respondents are also embracing innovation; they want health plans to provide help with clinical decisions, not simply administrative services, and many want to customize their insurance with unique coverage and pricing features. Other key findings of the survey include: . 93% of respondents say they are not wellpre pared for future healthcare costs. . 34% say they would use a retail clinic, and 16% already have done so. Those who have visited a retail clinic indicate 92% satisfaction with conve nience and 89% satisfaction with quality of care. . 60% want physicians to provide online access to medical records and test results and online appointment scheduling; one in four say they would pay more for the service. . Three out of four consumers want expanded use of inhome monitoring devices and online tools that would reduce the need for visits and allow individuals to be more active in their care. . One in three consumers wants more holistic/alternative therapies in their treatment program. . Two in five consumers want a wellness program to improve health and/or save money;one in four say they would pay more for it. . 29% support a tax increase to help cover the uninsured; another 34% say they would consider a tax hike. U.S. HEALTHCARE CONSUMERSWant Changes in Healthcare Design Americans see themselves less as patients and more as consumers who want more from their healthcare system than they’re currently getting, according to a recent survey conducted by the Deloitte Center for Health Solutions.They want greater online connection to healthcare providers and medical records, customized insurance coverage, and wider access to emerging innova tions such as retail clinics. They express anxiety about future healthcare costs,but many also say they are willing to pay extra for wellness programs and to sup port tax increases to cover the uninsured. The 2008 survey,a Webbased poll of 3,031 Americans between the ages of 18 and 75, assesses adult consumers’ behavior, attitudes, and unmet needs for four sectors: providers, health plans, lifesciences organizations, and the public sector. It was directed by Paul Keckley, exec utive director of the Deloitte Center for Health Solutions, and William Copeland, Jr., national managing director of the Life Sciences and Health Care practice of Deloitte Consulting. PHARMA TRAX SALES, MARKETING, AND R&D TRENDS AFFECTING THE HEALTHCARE INDUSTRY Consumers will redefine our healthcare market, but how they do it is the most important strategic question the healthcare industry must answer, says Paul Keckley, Executive Director, the Deloitte Center for Health Solutions. Paul Keckley PATIENTCENTRIC MODEL # Physicians as decisionmakers # Patients consider only the diagnostic and therapeutic options that are recommended to them # Patients bear little responsibility for adherence and outcomes # Patients have limited financial accountability CONSUMERCENTRIC MODEL # Physicians as coaches # Consumers consider all available options # Consumers bear greater responsibility for adherence and outcomes # Consumers have full accountability for costs Source:2008 Survey of Health Care Consumers by the Deloitte Center for Health Solutions,Washington,D.C. For more information,visit centerforhealthsolutions. PATIENT ORIENTATIONVS. CONSUMERORIENTATION Men have a higher tendency than women to choose prescription drugs over alternative therapies. 0408 Layout FINAL MW 3/21/08 11:45 AM Page 86 PHARMA trax and formulation can influence patient compliance and, in turn, outcomes; as a result, they value a variety of options for their patients,” says Cindy Mundy, Ph.D., director at Decision Resources. Decision Resources’ Deci sionBase 2008 reports combine market forecasts with clinical and commercial endpoints to assess marketshare projections in 35 indications, driven by quantitative and qualitative primary research. Globalization Challenges Clinical SUPPLYCHAIN MANAGEMENT As organizations increasingly conduct clinical tri als worldwide, the accompanying legal and regula tory requirements are giving rise to new challenges in managing the clinical supply chain and efficiently completing trials. According to a benchmarking study conducted by BearingPoint and AMR Research, companies that delay implementing best practices to address the regulatory complexities of conducting clinical trials across geographic bound aries are at risk of falling behind in the increasingly competitive global lifesciences market. The study, Managing the Clinical Trials Supply Chain, surveyed more than 100 pharmaceutical and biotech executives and found that about onequar ter expect to conduct 21 or more Phase I studies annually by 2010,an 18% increase from 2007.The sur vey also showed significant growth in global trials, with Africa, the Middle East, Eastern Europe, and South America topping the list of regional expansion. “Globalization is having a significant impact on every industry, and the pharmaceutical and biotech space is no exception; this study validates that,” says Ellen Reilly, managing director, life sciences, at Bear ingPoint.“As a result, these organizations need to be implementing best practices now to efficiently manage their clinical sup ply chains to bring new drugs to market faster and in an effective manner, while also remaining com pliant with global regulations. Other wise, they will be left in the dust try ing to navigate this very dynamic and competitive market.” Key findings of the study

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