Physicians said the No. 1 improvement needed from pharmaceutical companies this year is to improve affordability. A new InCrowd survey of 200 physicians found that 71% of physicians said healthcare affordability was their top concern.
Improving access to therapies ranked second. Affordability and improved access have ranked first and second for the past four years in InCrowd surveys.
Despite the need for improvements in those areas, 82% of doctors said it's unlikely that healthcare costs will improve this year. Only one-third predicted healthcare access would get better.
There is plenty of discussion about healthcare's problems and how to fix them. Payers, health systems and state and federal leaders all have their thoughts about the issue. The new survey moved away from those stakeholders and went directly to doctors, who are on the healthcare front line.
Doctors surveys see "smart prescribing" as a growing trend that can improve affordability. Informing patient drug prices and limiting the use of non-generic drugs are two reasons physicians are optimistic about the practice.
Slightly more than half of the doctors surveyed wanted pharma to spend less money on direct-to-consumer marketing and advertising. For the second consecutive year, physicians said reducing money spending on marketing is one way to reduce drug costs.
Doctors surveyed have ranked the same five issues for the past four years with affordability always the top concern. A whopping 95% of respondents said they would like to see efforts to reduce costs this year. That easily eclipsed other issues, such as improving insurance coverage and price transparency.
InCrowd said even respondents who didn't rank affordability or access as the top issues chose other factors they believed would also reduce costs to patients.
"In a changing healthcare landscape, our 2019 predictions survey shows that unfortunately physicians perceive little change in the two most important parameters impacting US healthcare — and that they are overwhelmingly eager to address them in a lasting way," Diane Hayes, president and co-founder of InCrowd, said.
The Trump administration has promoted the need to cut prescription prices as a way to reduce costs. Last week, HHS announced ending safe harbor protections for drug rebates through pharmacy benefit managers in Medicare Part D and Medicaid managed care plans. The administration wants those discounts to go directly to consumers.
In recent months, payers have been expanding their PBM influence, including Cigna buying Express Scripts, Anthem creating its own PBM and CVS Health purchasing Aetna. Payers see pharmaceutical costs as a key driver of healthcare spending. By bringing PBMs in-house, payers are betting they can bend the cost curve more effectively than contracting with a third-party PBM.
Despite these efforts, InCrowd's survey found doctors don't expect those efforts and other pharmaceutical cost-containment programs will make much of a difference this year.