Issue link: https://beckershealthcare.uberflip.com/i/1047089
70 THOUGHT LEADERSHIP The evolving relationship between hospitals and Big Pharma By Michael J. Dowling, President and CEO of Northwell Health T he pharmaceutical industry has been the target of wide- spread public criticism in recent years, with most of the nar- rative centered on seemingly unjust pricing. But if providers and pharma- ceutical companies make an effort to cultivate stronger partnerships, consumers can reap the benefits. Hospitals and pharmaceutical man- ufacturers have traditionally looked at themselves as transactional partners, but that relationship is changing dramatically. As independent hospitals become part of larger health systems, they have improved their leverage as partners and transcended the role of simple purchaser. The traditional purchasing relationship between big pharma and physicians — the pharmaceutical sales rep model — has become outdated since upwards of 40 percent of U.S. physicians are employed by hospitals or large inte- grated health systems, which now have policies prohibiting such sales practices. From an ethics and a compliance standpoint, we all rec- ognize the reasons why we needed to better manage the way pharma representatives market to providers, but for the benefit of our patients, we still need to collaborate with Big Pharma. At Northwell, we've created an entity called Phar- ma Ventures that focuses attention and resources on enter- prise partnerships with pharmaceutical companies. It's led by Elaine Brennan, one of our healthcare executives with a background in the pharmaceutical industry, who has helped formalize our agenda around clinical trials, research and val- ue-based agreements. Recognizing that pharmaceutical companies are key stake- holders in the healthcare ecosystem, I meet regularly with pharmaceutical company executives to discuss mutually beneficial strategies. After all, prescribing drugs as part of treatment modalities is an integral part of physicians' re- sponsibilities, and the companies that create these drugs should be given a seat at the table to forge partnerships that can lower costs and increase efficiency. Pharma Ventures has been exploring risk-based contracts with pharmaceutical partners, which are designed to link drug prices to drug performance with actual patients. Large health systems like Northwell can also serve as a su- per-site for clinical trials, where clinical researchers can re- cruit from multiple locations in fully integrated systems and reduce patient enrollment and site set-up costs, thanks to our systemwide EHR. Northwell and pharmaceutical companies have also collab- orated on numerous digital and consumer-driven initiatives we believe can leverage the combined strengths of our or- ganizations to improve the customer experience and lower costs. These initiatives include a physician education pilot program to better inform physicians about clinical trials and new treatment options. I commend the efforts of some providers to enter the phar- maceutical manufacturing arena themselves, though these goals require capabilities that hospitals and health systems don't have on hand. Though I wish only the best for health systems that look to begin manufacturing generic drugs, the investment required to scale up these capabilities has led Northwell to decide its resources are better spent on part- nerships with established organizations such as Boehringer Ingelheim, AstraZeneca, Johnson & Johnson and Merck. Many people have called for increased regulation of the pharmaceutical industry. One instance where regulation may be beneficial is broadening the reach of clinical trials so they include a more diverse patient population. Northwell has one of the most diverse patient populations in the U.S., making it a highly attractive destination for clinical research trials. Highly publicized instances of bad actors within the phar- maceutical industry, such as Martin Shkreli and his unfath- omable greed, have soured public opinion on the sector, but it would be a misstep to paint the industry in broad strokes based on the actions of a few. Almost every mem- ber of the public takes some kind of prescription medica- tion, and if providers approach the manufacturers of those drugs with a collaborative mindset, innovative solutions can create significant benefits for both parties and, most importantly, the consumer. n "The companies that create these drugs should be given a seat at the table to forge partnerships that can lower costs and increase efficiency." — Michael J. Dowling, President and CEO, Northwell Health