Prof. Bartels, what exactly is different today?
PROF. BARTELS Previously, as a pharmaceutical company, we only talked to health insurers or pharmacists shortly before the launch of a medicine – and then mainly about commercial issues such as pricing. Today, trustful partnerships start with disease-related discussions rather than with product-related discussions. Only in this way can we optimally pursue our common goal as partners: helping sick people with personalised medicines.
In practical terms, how do pharmaceutical companies notice this change?
PROF. BARTELS Today, health insurers no longer wish to pay per visit to the doctor or per prescription of medicines. Increasingly, their criterion is rather quality and whether a treatment was successful. For their relationship with pharmaceutical companies, this means that instead of pure volumes – that’s to say discounts – insurers are now negotiating reimbursements which depend on the effectiveness and safety of a medicine for routine clinical use. So-called “value-based contracts” are therefore gaining ground. The paradigm shift is “from volume to value”.
has been Global Head of Epidemiology at Boehringer Ingelheim since 2010. She holds a Master’s degree in epidemiology from Harvard School of Public Health, USA and a doctorate from Hanover Medical School, Germany where she is Professor of Epidemiology and Public Health. She has been Adjunct Professor at McGill University, Canada since 2013.
What role does personalised medicine play here?
PROF. BARTELS A critical one. Nowadays, the question is much more about which medicine is the best to help which individual patient. That’s also the main reason why cooperation between health insurers and pharmaceutical companies must today begin much earlier. Until now, patients had frequently already been through a long ordeal before the right medicine was found, if at all. For patients, this is both a a great strain and possibly even life-threatening, while it’s also very expensive for the health insurer. Today, we seek to jointly characterise patient groups very early on so as to be able to offer individual therapies. The analysis of data from routine clinical practice comes into play here. This is data already available prior to approval, from, for example, electronic medical records or claims data which can be used to identify and characterise patients with unmet medical need before launch.
For this purpose, for example, we’ve licensed the same analytical platform as Humana, the fifth-largest health plan in the USA. We’re now able to work jointly on Humana’s patient data as well as on databases licensed by Boehringer Ingelheim – without any breach of data protection. This increases the data pool, helps with the search for suitable patient subgroups and enables close, partnership-based cooperation within the framework of evidence-based medicine.
So the model of a pharmaceutical company going solo is on the way out?
PROF. BARTELS I prefer to put it this way: in general, going solo is no longer expedient. Neither pharmaceutical companies nor health insurers, pharmacists, IT providers or patients’ organisations are on their own able to improve human’s health and achieve progress. That is only possible with joint effort, through trustful and long-term partnership-based cooperation.