My colleagues John Hennessy from Valuate Health Consultancy and Douglas Bock from Archbow Consulting and I had the opportunity to collaborate with national cancer leaders at the Association of Value-Based Cancer Care 2023 Educational Summit in New York City last week. The diversity of attendees – payers, pharma, HCPs, pharmacies, distributors, regulators, and employers – always raises the bar on the conversation around the future of oncology and cancer care and what it means for all of us across the pharmaceutical industry.

1. The Inflation Reduction Act (IRA) is keeping everyone up at night.

Experts agree that navigating the IRA is not a sprint; it’s a marathon, that will take many years to unfold. While there are more unknowns with the IRA than knowns, it’s expected to have an outsized impact on oncology. Conversations on stage and with other attendees often pointed to the “unintended consequences” of the IRA, such as:

• The fastest path to market for new products may no longer be the best path. Manufacturers may inadvertently weaken their long-term economic value story by taking advantage of expedited regulatory review when addressing unmet needs.
• Financial toxicity is unlikely to go away downstream from the IRA; instead, it’s expected to shift, causing the market to pivot to address it.
• Innovation in pharma and biotech will likely be suppressed.
• Provider economics are likely to be negatively impacted.
• The cost of clinical trials must be compressed to sustain the economic viability of drug development.

You can learn more about the IRA from our colleagues at Valuate Health Consultancy in this POV.

2. The perfect storm is brewing for value-based agreements (VBAs), and those who aren’t prepared will likely suffer the consequences.

The typically high costs of oncology therapies drive payers to prioritize VBAs. Because stakeholders define “value” differently, it’s essential to understand how your customer defines value so you are speaking the same language. When targeting payers, it’s necessary to understand and address their most pressing questions:

• If the product is expensive, does it add significant value compared to the standard of care?
• Is there significant market competition among innovative therapies?
• What is the total cost of care?
• Where does the uncertainty lie around the value of the product?

All stakeholders at AVBCC are asking pharma to come to the table with value solutions but noted that these solutions don’t always have to center around refunds. Other solutions may include funding alternative therapies or providing patient and provider support solutions. It was even suggested that a well-crafted VBA could evolve into an IRA negotiation tool in the future.

3. Health inequities may be most pronounced in oncology.

If healthcare is messy, oncology is messier. Health inequities in oncology treatment are significant, but economic and geographic barriers can be prioritized to have the most significant impact on the most patients. Additionally, manufacturers must know and solve the fact that financial, logistical, and time toxicity can equal clinical toxicity. Manufacturers must address these concerns effectively to focus on holistic patient care and the best possible outcomes while driving access.

While AVBCC speaker Doug Long from IQVIA reported that access to oncology medications has increased 5 percent year-over-year for the last five years, in that same period, 79 percent of oncology launches had annual costs above $100,000. To make matters worse, diagnostic testing for cancer has not fully rebounded from the pandemic, disproportionally affecting underserved populations.

Manufacturers can only meet the needs and desires of diverse oncology patient populations if they ask them directly what they need and want, making patient engagement and market research more important than ever.

On a high note, a panel on health equity noted that addressing social determinants of health (SDoH) is finally receiving recognition for being essential to improving outcomes. With pending regulatory changes, much-needed incentives to integrate SDoH into the standard of care should see greater adoption.

4. It’s time to keep your “frenemies” closer.

Adam Fein from the Drug Channels Institute spoke in detail at the Summit about the opacity created by the ongoing vertical consolidation of the supply chain in the battle for better margins. He said the 340B program has made “frenemies” of hospitals and PBMs, and we would add that the conference was full of potential frenemies. Bringing all stakeholders to the table to work together on behalf of patients is challenging but worth the extra effort. Siloed decision-making simply isn’t viable in today’s reality.

Small networks and limited distribution are evolving to meet the market needs. With product indications becoming narrower, ensuring low-volume oncology products efficiently get to patients means the participants are adapting. Traditional specialty pharmacies will continue to play a role, but in-office dispensing and integrated delivery network (IDN) pharmacies will likely become a significant component of many limited delivery networks.

Because the world of oncology is seemingly only growing more complex, finding experts you can trust is more important than ever. Archbow, Valuate, and Entrée Health formed a network that leverages real-world experience to provide strategic guidance to manufacturers launching new products or optimizing existing product lifecycles. Our teams work seamlessly to align even the most complicated patient, product, and reimbursement journeys. Contact us today to put our team to work for you.

Archbow Consulting and Valuate Health Consultancy are sister companies under the Value and Access division of Omnicom Health Group. Learn more about our united organizations here.

For additional insights on this topic, you may also enjoy the following related blog posts:

Archbow Consulting helps pharmaceutical and biotech companies in the USA and Europe design, build, and optimize product distribution and patient access strategies. Archbow was founded by industry veterans to meet a need in the marketplace for consulting options that offer diverse real-world experience, are able to leverage deep connections across the industry, and can also provide actionable strategic guidance. We invite you to learn more about our team, services, and clients’ success, and connect with us via email, LinkedIn or subscribing to this blog which you can do below.

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