Asthma and COPD (Accountable Care Organizations) | Physician & Payer Forum | US| 2015

What Does This Emerging Trend Hold for Branded Agents?

Asthma and chronic obstructive pulmonary disease (COPD) are chronic diseases of the airways affecting millions of Americans and representing a costly health expense for the nation’s healthcare payers. The chronic symptoms of COPD and asthma can be controlled through the use of several long-acting inhalers such as GlaxoSmithKline’s Advair (salmeterol/fluticasone propionate) and Boehringer Ingelheim’s Spiriva (tiotropium). For these two chronic conditions, the lack of generic alternatives due to patented delivery systems has kept drug prices high. The rising costs of pharmaceuticals and medical services in general have prompted health insurers to turn to accountable care organizations (ACOs) to manage the health risk of their membership. Surveyed MCO pharmacy and medical directors and physicians predict that ACOs can generate, on average, double-digit savings on medical and drug costs for both asthma and COPD. ACOs are making pulmonologists and allergists more conscious of the long-term consequences of each prescribing decision by linking their reimbursement to the achievement of goals such as reducing hospital readmissions and total medical costs as well as saving on prescription drug costs. The ACO focus on cost-cutting drives prescribers to generic competitors of brand-name drugs, a trend that will accelerate starting in 2016 when several market-leading branded drugs lose patent protection, including Advair, GlaxoSmithKline’s Flovent (fluticasone propionate), and AstraZeneca’s Symbicort (formoterol/budesonide).