In an increasingly competitive and challenging business environment, we at AstraZeneca put patient access to medicine at the center of our decision making from the earliest days of discovery to even after the medicine goes off patent, AstraZeneca US Chief Operating Officer Marion McCourt said Tuesday.

Speaking at the Bloomberg Healthcare Innovations Conference in New York, McCourt said this approach demonstrates our commitment to healthcare that works – not just for individual patients but for the system as a whole. (You can watch a video of the full panel discussion here.)

And a key way to make sure healthcare works for patients is to ensure that payers will pay for our medicines once we deliver them to market.

“When it comes to responding to the challenges in today’s marketplace, it comes down to clinical trial design, collaborations, partnerships with other companies – large and small – and bringing appropriate products into the marketplace with a clear value proposition,” McCourt told the conference, which included payers, providers, pharmaceutical companies, investors and more.

That commitment to access extends from discovery to the use of real-world evidence to collaboration to new ways of delivering our medicines. Here’s a look at those four areas:

Discovery

McCourt said AstraZeneca has transformed our research and discovery to ensure our medicines and the evidence supporting them can answer payers’ questions about value so patients who need them are able to benefit from them.

“We use rigor to make sure we are comparing our medicines to what’s available in the market, to stand against the therapies of choice,” McCourt told the audience at the Bloomberg conference.

That process starts early. We begin talking to payers and health technology appraisers throughout the development of medicines to discuss where the greatest clinical needs are and what type of data will be required to provide the evidence to support access and reimbursement in specific healthcare settings.

We incorporate structured input regarding payer needs and value into our portfolio governance, forecasting and decision-making processes. If we don’t believe we will be able to demonstrate the value of an investigational medicine to those who will pay for it, we won’t invest in it.

Additionally, we are designing our clinical trials with an understanding of payer needs to minimize the uncertainty associated with predicting the use and associated outcomes of our new medicines in the real world.

Real-World Evidence

McCourt also said AstraZeneca uses real-world evidence as part of the body of evidence to demonstrate the value of our medicines and our commitment to healthcare that works.

“We are more frequently looking at market experiences to show the value proposition for patients, providers and payers,” McCourt said.

We are significantly expanding the types of evidence individual payers want to demonstrate the value of our medicines. We recognize the differences in payers’ needs and use real-world evidence to answers the questions:

• “Why do patients need this medicine?”
• “Which patients should get it?”
• “Why is your drug better than the alternatives?”
• “Why is it worth the cost?”

Our investments include building a skills center of health economists, epidemiologists, programmers, statisticians and informaticians and forging partnerships with healthcare data companies – HealthCore in the US and IMS Health in the EU — insurance groups, governments and healthcare authorities.

This approach is important because it can play a key role in painting a clearer picture of how a medicine will impact patients, healthcare systems and costs in real world settings.

We will be taking a closer look at real-world evidence here on the blog later in the week.

Collaboration

Providers, payers and pharmaceutical companies have an unprecedented opportunity to work more collaboratively together to understand and recognize value that innovative medicines play in improving patient health and managing the total cost of care.

Substantial gains in health have been achieved over the last 50 years through the introduction of new medicines. People today live longer, better lives through the application of science and technology in medicine. However, significant unmet need remains in many diseases and in many parts of the world.

Over the years, spending on prescription medicines has been 10 percent of the total healthcare cost equation. Now we need a greater lens on what makes up the remaining 90 percent.

How can we build a purchasing system that values innovation appropriately because of the vital role it plays in managing costs and delivering better outcomes for patients?

The health system needs to remove the silos to healthcare budgets and avoid short-term budget-cutting exercises that ignore the value question. We need to be able to recognize that an innovative medicine may increase the medicines bill for a therapeutic area but improve outcomes and save costs in other areas, such as hospitalizations and need for surgeries.

At AstraZeneca, we believe the solutions to the rising costs of healthcare will be found because the pharmaceutical industry, payers, providers and policy makers all share the goal of improving health outcomes for patients in cost effective ways.

Filling The Gaps

Gaps remain despite the health system’s best efforts around patient access. For those who don’t have coverage or who need medicines not included on formularies, we are finding new ways to help physicians and patients access our medicines directly.

For example, we recently introduced our first direct-to-patient program allowing patients with prescriptions for this medicine to purchase it directly from AstraZeneca.

This program was built in response to calls from patients in plans with policies that made the medicines unaffordable to them. Programs like this are one way we can help meet needs of patients who want to receive and pay for their medicine on their own.

For those low income patients in Medicare or without any coverage, we offer our AZ&Me Prescription Savings Programs through which qualifying patients receive our medicines for free. We have one of the industry’s longest running programs and are committed to making sure this program remains available as a last resort for those who would have no other means of being able to access their AstraZeneca medicines.

Taken together, these areas reflect how we have adapted the way we discover, develop and deliver our medicines to patients. We understand that if payers refuse to reimburse for our medicines and patients cannot afford them, they will be of little benefit to patients.

That is why we are building and expanding our relationships and partnerships with payers, providers and other stakeholders to ensure we are able to truly help address patient and healthcare system needs.