What is the Future of the Specialty Market Model?

By Robin Robinson

There are so many redefining forces affecting the specialty commercial model today that it will be evolving for several years. The industry will be coping for the next four or five years will continual changes in its environment. While reimbursement issues are a prominent challenge, there are many other factors that play in to this ever-developing landscape, including the complexity in selecting a personalized health and treatment strategy, unexpected complications, unnecessary care, and a total cost that is not properly assessed or shared by the beneficiaries.

“The transformative forces that are moving healthcare from a cottage industry in recent decades to a mass produced, but still personalized system with interchangeable parts is going to be disruptive for years until we settle into a new electronics-based equilibrium,” says Doug Moeller, M.D., medical director at McKesson Health Solutions. “Where will we be in five years? What a great question.”

In order to emerge successfully through the increasing complexities, better feedback from all stakeholders will be necessary. Dr. Moeller says thoughtful discussion in various media channels, websites, and related sources of information must facilitate much more transparency about benefit–to-cost evaluations. Patient compliance is ultimately about convincingly demonstrating benefit with a data and educational process at its heart.

The pressure for performance is not unique to healthcare; banking, manufacturing (especially automobiles), retail, and information management industries are all addressing major upheavals in business models and competitive threats.

“Substantive ‘emerging technology’ is nearly always ‘disruptive’ to the status quo,” Dr. Moeller says.  “In general, the disruption of the status quo is a good thing when it creates a perpetual impetus to reassess quality and cost. Any industry that is not perpetually reassessing cost and benefit is probably in some stage of ‘dying.’”

For more information on the evolving commercial model for specialty drugs,  read the complete forum in the PharmaVOICE Digital Edition.