Three Basic Truths About the US Healthcare System

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AstraZeneca’s Rick R. Suarez looks at workable solutions to the challenges facing healthcare in the US and why inter-stakeholder collaboration, rather than finger-pointing, is the only way forward.

 

Discussion and debate related to cost and quality in healthcare has never been more pronounced or more contentious, whether focusing on medicines, healthcare services, providers or elsewhere. As all stakeholders in healthcare struggle to rise above the political rhetoric to find real and workable solutions to the challenges we collectively face, three basic truths about the current state of the US system become apparent:

 

1. The current system isn’t working

Patients are facing higher out-of-pocket costs, including rising deductibles and higher coinsurances. And with so many people feeling the strain at the pharmacy counter, no one would argue the system is working in patients’ best interest.

Yet, all too often the breath of argument is being reserved for political solutions more focused on creating a popular villain than achieving better health for patients and a more sustainable healthcare ecosystem. Price controls, importation, direct government negotiations for medicines, so many of these so-called solutions heralded as a simple solve would ultimately harm patients and the research-based pharmaceutical industry as it continues to search for tomorrow’s treatments and cures.

The current system unquestionably needs to evolve to address patient access and affordability, and we need to achieve this by striking the right balance that won’t impede continued scientific innovation on behalf of patients.

 

2. Blaming each other isn’t fixing it

While it is apparent there is no one simple solution to our collective challenges, if as much time were spent by the stakeholders in US healthcare working together to solve some of the fundamental issues as is spent trying to pinpoint the sole responsible party for the current state of healthcare, perhaps we would be further towards a path of more sustainable solutions.

One such example of a collaborative solution is the concept of value-based agreements (VBAs). VBAs are agreements where pharmaceutical manufacturers and payers/health systems are working together to move from reimbursement based on volume to reimbursement based on the value of medicines to improve patient outcomes and benefit the healthcare system.

 

3. Workable solutions require innovation

Innovation shouldn’t be restricted to the scientific arena. If we continue to view the landscape as “business as usual” we are missing the point. We must be driven to think differently about payment and reimbursement in the US, just as we are driven by the evolving science in research.

AstraZeneca is thinking differently about innovative solutions to improve patient access and affordability; focusing on the value our medicines bring to patients and the healthcare system. We’re doing this by working together with other stakeholders.

We are leading in this space, having entered into over 50 agreements across our therapeutic areas with health plans and pharmaceutical benefit managers (PBMs) to stand behind the value of our medicines. And just like our approach to scientific discovery, we continue to learn together as we go. While progress will naturally be incremental rather than an immediate breakthrough, incremental progress can be quite meaningful. We are already seeing VBAs result in improved patient outcomes and savings to patients. We believe VBAs ultimately result in value to the healthcare system overall.

 

Any difficult challenge will require many solutions

To be clear, while VBAs are an innovative solution to some of the challenges we face in healthcare, they are far from the only solution. Singular solutions have no place in our existing and dynamic healthcare system. Seeking an independent solve as many are proposing makes for popular politics but so many of these “silver bullets” would surely unbalance the delicate scale that exists to both foster innovation and addresses access and affordability for patients.

AstraZeneca supports several solutions to improve our current healthcare system beyond facilitating greater adoption of value-based agreements. We support simplifying the system so patients have a better understanding of what they’re paying and making medicines more affordable by ensuring patients are benefiting from rebates and discounts we provide. We advocate for capping out-of-pocket costs for Medicare patients. We believe generic versions of biologics called biosimilars should be encouraged.

We know this is just a start, but all stakeholders in healthcare, including AstraZeneca and our industry, have a responsibility to patients to make progress. It’s time to turn the fingers pointed towards each other to point collectively in the direction of a better system for the US and most importantly for patients.

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