new healthreport 2012
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Rethinking the Risk Equation in Biopharmaceutical Medicine
Rethinking the Risk Equation in Biopharmaceutical Medicine
Overvie w
e xpec tatiOns and Obs tacles in He altHc are
patients a s a part Of tHe s ys tem
b iOpHarma’s e vOlving business mOdel
payers seek mOre participatiOn
inves tOr ambivalence, Op timism
mitigating risk : tHe need fOr ne w me tric s
cOnclusiOn
about The New Health Report
about Quintiles
contact information
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t a b l e O f c O n t e n t s
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for a patient, risk largely entails drug safety, such
as concerns over side effects, but patients must
also evaluate the risk of taking one medication
over another, or perhaps none at all. Healthcare
professionals must weigh the risk in using new
drugs versus existing ones. biopharmaceutical
companies, on the other hand, must assess the
risk of moving forward with one investigational
compound or another, proceeding or pausing in
the chain of clinical trials, collaborating with other
stakeholders or going it alone—all of this plus
a host of other concerns. for payers, the risks
involve when and why to reimburse for particular
treatments, while investors seek methods of
analysis to reduce their risks as they decide where
to infuse capital.
The New Health Report 2012 shows, however, that
today’s stakeholders often disagree—between
and within groups—on what risks matter
the most. this study arises from a survey of
biopharmaceutical executives; patients living with
a chronic disease in the united kingdom or the
united states; national Health service (nHs)
executives in the united kingdom; managed care
executives in the united states; and investors
with a focus on the life sciences sector. payer and
patient respondents were deliberately culled from
both the united kingdom and the united states
under the premise that attitudinal differences and
perceptions of healthcare might reveal that an
understanding of risk and benefit is not universal.
further, as the global economic crisis has
produced austerity budgets throughout europe,
cost-conscious payers in these countries need to
make increasingly difficult coverage decisions
that accurately weigh the value and risks of
new treatments.
for stakeholders to make better collective
decisions based on value and risk, they first
need to assimilate the varying perceptions of the
concept, and then take a systematic approach
in order to better manage it. currently, the tools
used to balance healthcare risk versus reward
remain rather rudimentary, and lessons from
other industries could accelerate improvements
in patient outcomes. for example, making the
most of the available data—from preclinical
information to patient outcomes—requires new
tools and sophisticated methods to interrogate
the data. with more robust sources of data,
healthcare players can plan the pathways to the
next generation of lower-risk, higher-benefit
medications that balance the needs of all
stakeholders. as the results of this survey reveal,
considerable evidence already suggests a new
pathway. the stakeholders must function like
teammates, instead of opponents, to make the
most of existing opportunities. the resulting
collaboration could spawn a range of improved
methods for reducing and communicating the
risks and benefits of biopharmaceutical medicine.
overview
The essence of healthcare arises from the tradeoffs between risk and value. Last
year’s New Health Report focused on value, and patients, physicians, payers and
biopharmaceutical executives defined this concept in many ways. For example, only
two percent of patients polled mentioned cost and outcomes when defining value as
opposed to 38 percent of biopharmaceutical executives. As with value in healthcare, risk
extends across the constellation of stakeholders, and each group sees risk from a unique
perspective.
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On a fundamental level, risk is always attached to expectations. This idea lies behind the
business concept of the risk-return tradeoff, which states that increasing the potential of
the return raises the risk. To understand the risk-return tradeoffs in healthcare, The New
Health Report 2012 asked biopharmaceutical executives, managed care executives in the
United States, National Health Service executives in the U.K. and healthcare-focused
investors a series of questions designed to uncover different perceptions as to what the
future of healthcare might look like.
In terms of the general health of people born today, most of the respondents see longer
lives ahead. For instance, the majority of biopharma executives and U.K. payers expect
lifespan to reach an average of 90 years, and nearly half of U.S. payers and half of investors
agree. Regarding the health of people in general, just under half of the respondents from
most groups predict improvements, and a slightly higher percentage of U.K. payers agree.
Expectations and Obstacles in Healthcare
Expectations and Obstacles in Healthcare 5
Investors Sums may not add to 100% or be equal to components due to rounding
in terms of the capabilities of medicines in the
future, the responses are less certain. fewer than
half of the experts from biopharma and u.s.
payers and even fewer of the investors expect
to see cancer becoming a manageable disease
in the near future, but u.k. payers are more
optimistic. when asked about the likelihood of a
cure for alzheimer’s over the next generation, the
stakeholders answer similarly to their responses
on managing cancer, although the investors rank
alzheimer’s disease as more likely to be cured.
those medical milestones, however, will come at
a cost. for example, less than one-fifth of u.s.
payers and one-quarter of biopharma experts
expect cost-effective healthcare in the united
states over the next generation in comparison
to other countries. in contrast, about half of
u.k. payers expect cost-effective healthcare—
more than twice the amount of their american
counterparts.
r e s t r a i n e d O p t i m i s m f O r a n u n c e r t a i n f u t u r e
l e s s t H a n O n e - f i f t H O f u . s .
p ay e r s a n d O n e - Q u a r t e r
O f t H e b i O p H a r m a e x e c s
e x p e c t c O s t- e f f e c t i v e
H e a lt H c a r e i n t H e u n i t e d
s tat e s O v e r t H e n e x t
g e n e r at i O n i n c O m p a r i s O n
t O O t H e r c O u n t r i e s .
Life expectancy for the average person will be 90 years
Most cancers will become a manageable disease
A cure for Alzheimer’s will be found
The nation will become healthier overall
US / UK healthcare will be considered cost-effective
compared to other developed countries
64% 45%
45% 45%
45% 40%
68% 50%
55% 37%
59% 51%
43% 41%
24% 19%
59% 47%
45% NA
Biopharma, Payers, Investors | Percent who consider it very or somewhat likely that in the lifetime of people born today...
I N V E S T O R SB I O P H A R M A P A Y E R S
6 2012 | The New Health Report
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looking more closely at the elements of
tomorrow’s healthcare, stakeholders were asked
about their optimism or pessimism related to
future healthcare quality and pharmaceuticals. in
terms of the quality of healthcare a decade from
now, two-thirds or more of biopharma executives,
u.s. payers and u.k. payers, plus nearly three-
quarters of investors express optimism, but less
than half of u.k. and u.s. patients agree. in fact,
fewer than 40 percent of u.k. patients claim to be
optimistic about tomorrow’s quality of healthcare.
the disconnect between u.k. payers (66 percent)
and u.k. patients (38 percent) is striking and may
indicate an underlying lack of confidence in the
future direction of the nHs.
despite eight out of 10 biopharma executives
being optimistic about the quality of prescription
medications in 10 years, they do anticipate
challenges. foremost, these experts expect to
travel a rough road with regulators from the u.s.
food and drug administration (fda). a lack of
capital and the increased reluctance of payers to
reimburse for new medication are also serious
concerns. in general, investors agree with the
concerns over a changing regulatory landscape,
but show less concern over financing, perhaps
because investors live every day in a world of
financial risk.
Biopharma, Payers, Investors, Patients | 2012 ; Biopharma, US Payers, Physicians, US Patients | 2011Percent who are somewhat or very optimistic about the future of healthcare
QUALITY OF HEALTHCARE
IMPROVED 10 YEARS FROM NOW
QUALITY OF PRESCRIPTION
MEDICINES IMPROVED
10 YEARS FROM NOW
0 % 2 0 % 4 0 % 6 0 % 8 0 % 1 0 0 %0 %2 0 %4 0 %6 0 %8 0 %1 0 0 %
2 0 1 1 2 0 1 2
U S P H Y S I C I A N SU K P A Y E R S I N V E S T O R SB I O P H A R M A U S P A Y E R S U S P A T I E N T S U K P A T I E N T S
64%
63%
44%
54%
72%
76%
59%
72%
69%
68%
66%
74%
49%
38%
80%
81%
93%
68%
N/A
N/A
N/A
N/A
N/A
N/AN/A
N/A
N/A
N/A
Expectations and Obstacles in Healthcare 7
Investors Sums may not add to 100% or be equal to components due to rounding
29% More difficult FDA approval process
12% Increased requests for more data
19% Increased payer reluctance to cover new medications
10% Global economic downturn
20% Lack of funding / capital
9% Other
Biopharma | Which is the biggest challenge facing your company? a l a c k O f c a p i ta l a n d t H e
i n c r e a s e d r e l u c ta n c e
O f p ay e r s t O r e i m b u r s e
f O r n e w m e d i c at i O n s a r e
s e r i O u s c O n c e r n s .
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One could argue that patients take on the most risk in healthcare because their quality of
life hangs in the balance. Consequently, they stand to gain the most from understanding
their own health. Yet when asked to rate their overall health, three-quarters of U.S. patients
consider their health good to excellent which seems unlikely in a country where more
than two-thirds of the population is overweight or obese. By comparison, only about 50
percent of U.K. patients give themselves similar assessments. In short, U.S. patients see
themselves as healthy—probably healthier than they are—and U.K. patients are likely
providing somewhat more accurate self-evaluations.
Patients as a Part of the System
Patients as a Part of the System 9
Investors Sums may not add to 100% or be equal to components due to rounding
given that the population of patients in this
survey all suffer from a chronic disease, no
surprise comes from their overwhelming response
to being adequately informed about the benefits
of taking their medicines. more than 90 percent
of both u.k. and u.s. patients feel they know the
benefits of taking their medication—an expected
result from respondents in which two-thirds take
at least three prescription medications, and more
than a quarter of them take more than five (data
not shown).
some variations among the patients start to
appear when examining their beliefs about the
risks behind those prescriptions. although both
patient groups show this drop in confidence when
moving from understanding the benefits of a
medication to assessing its side effects, the data
do reveal differences between the two cohorts.
for instance, u.s. patients appear far more
confident than u.k. patients when it comes to
information about side effects, 86 to 69 percent,
respectively. likewise, u.s. patients exhibit a
similar offset when it comes to knowing about a
drug’s potential risk (84 percent), when compared
with the u.k. patients (64 percent).
direct-to-consumer advertising in the united
states may partly explain these differences, as
patients are bombarded with lengthy disclaimers
about potential side effects and safety concerns.
another explanation may be the litigious nature
of the united states, where physicians are more
apt to discuss the side effects and not just the
benefits of medications. in any case, these data
reveal an opportunity for biopharmaceutical
companies to better communicate the risk-benefit
tradeoffs of medicines in terms meaningful
to patients.
in the u.s and the u.k., patients give the
biopharmaceutical industry little credit for making
medications safe and effective. both patient
populations believe that physicians do the best
job of that, followed by patient-advocacy groups.
in addition, fewer than half of the patients feel
like the biopharmaceutical industry does a good
job of making new medications available as
Patients | Percent who feel adequately informed about...
U S P A T I E N T S U K P A T I E N T S
The benefits of taking your medication
94%
92%
Side effects
86%
69%
64%
Potential risks of taking it
84%
How the drug works in your body
71%55%
How it compares to existing medication
66%
51%
u . s . p at i e n t s a p p e a r fa r
m O r e c O n f i d e n t t H a n u . k .
p at i e n t s w H e n i t c O m e s
t O i n f O r m at i O n a b O u t
s i d e e f f e c t s .
1 0 2012 | The New Health Report
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quickly as possible. given that getting new drugs
on the market provides the income that feeds
biopharma, the industry seems unlikely to halt
or slow down drug development for anything
other than risk or benefit concerns. notably, both
groups of patients realize the role of regulators
in the timing of medicines reaching the market.
a misunderstanding of the process is clearly
evident, however, as more than 60 percent of
u.s. patients credit physicians with making drugs
available as soon as possible, and more than
a third of patients in the u.s. and the u.k. feel
patient advocacy groups have significant bearing
on drug development.
despite both patient populations showing a
lack of faith in the biopharmaceutical industry’s
ability to ensure safe and effective drugs, patients
want the industry to work even faster. nearly 90
percent of u.k. patients think that it takes too
long to get new drugs to patients. some of the
negative responses from u.k. patients, however,
might have been heightened by media coverage
which regularly highlights instances in which the
nHs has declined to fund a new medication.
although the majority of u.s. patients seems to
think that no one—except physicians—does a
very good job of getting drugs on the market as
fast as possible, only 69 percent of those patients
say that the process takes too long, which is
nearly 20 percent fewer than u.k. patients.
perhaps most interesting of all, a high percentage
of both patient populations express an interest
in taking more risk with medications. more than
70 percent of u.s. patients and four out of five
u.k. patients believe it should be their right to
take a high-risk medication if they hope for some
improvement in their health. in other words,
these responses indicate that many patients want
Patients | Group does an excellent/ good job of…
DOCTORS
PATIENT ADVOCACY GROUPS
PHARMACEUTICAL COMPANIES
REGULATORY AUTHORITIES
HEALTH INSURANCE PROVIDERS
0 % 2 0 % 4 0 % 6 0 % 8 0 %0 %2 0 %4 0 %6 0 %8 0 %
MAKING SURE MEDICATIONS ARE SAFE AND EFFECTIVE
MAKING SURE NEW DRUGS ARE AVAILABLE TO PUBLIC AS QUICKLY AS POSSIBLE
U S P A T I E N T S U K P A T I E N T S
Patients as a Part of the System 1 1
Investors Sums may not add to 100% or be equal to components due to rounding
medicines faster rather than safer, if they must
choose. nonetheless, half of u.s. patients also
feel that medications get approved too quickly
without balancing safety. taken together, the
responses from u.s. patients highlight some
disconnected thinking regarding risk: they want
and expect medications quickly, but aren’t fully
aware of the trade-offs involved.
simply thinking about risk often differs from
acting on it. instead of wondering how patients
respond when faced with the risks related to
prescription pharmaceuticals, their behaviors
provide a much clearer picture. to get at those
behaviors, patients were asked if they ever turned
down or stopped taking a medication because of
safety or side-effect concerns. roughly speaking,
only about one-third of u.k. patients said that
they had, compared to half of u.s. patients. so
even if most u.s. patients want the right to take
a risky medicine if they choose to, at least half
of them might forego the drug for fears related
to safety or side effects. again, the safety- and
side effect–laden advertising in the united states
—and the related litigious environment—might
cause some of this difference between the patient
populations.
to explore how patients approach assessing
risk and value, they were presented with several
Patients | Do you agree or disagree that...
The process of getting new drugs to patients takes too long.
69%
88%
We take too long to make drugs available, which costs lives by forcing people to go without potentially beneficial therapies.
71%
87%
81%
Patients should be able to choose to take potentially risky medication even if it is not approved for use if they feel it is their only chance to improve their health.
72%
In this country, we are too quick to approve new prescription medications without understanding all of the possible safety issues.
% who agree
50%
31%
U S P A T I E N T S U K P A T I E N T S
Patients | Have you ever….
Turned down a medication that your doctor has prescribed because of concerns about safety or side effects.
% answering yes
51%
27%
Stopped taking a medication before checking with your doctor because of side effect or safety concerns.
46%
35%
U S P A T I E N T S U K P A T I E N T S
m O r e t H a n 7 0 p e r c e n t O f
u . s . p at i e n t s a n d n e a r ly
9 0 p e r c e n t O f u . k . p at i e n t s
b e l i e v e i t s H O u l d b e t H e i r
r i g H t t O ta k e a H i g H - r i s k
m e d i c at i O n i f t H e y H O p e
f O r s O m e i m p r O v e m e n t i n
t H e i r H e a lt H .
1 2 2012 | The New Health Report
www.quintiles.com/newhealthreport
hypothetical scenarios with varying degrees of
both benefit and risk. in circumstances in which
a cancer drug could extend a person’s life by a
decade, the patients considered two side-effect
risks, one related to nausea (a 15 or 75 percent
risk) and another related to heart attack (a 5 or
50 percent risk). across all of these scenarios,
u.k. patients express far more willingness to
accept the risks for the potential 10-year return.
even when facing a 50 percent risk of a heart
attack, nearly 80 percent of u.k. patients still
want the treatment, but less than half of u.s.
patients do.
u.k. patients continue to show less aversion
to risk than u.s. patients when presented with
chronic pain–based scenarios, but in almost all
cases patients in both countries were less willing
to accept an increased risk for a lesser benefit.
while nearly six out of 10 u.s. patients and nine
out of 10 u.k. patients would be interested in a
drug that reduced chronic pain to a manageable
level with a 15 percent risk of nausea, the number
of patients interested in the same drug with a 50
percent risk of heart attack drops precipitously
among both groups (26 percent for u.s. patients,
40 percent for u.k. patients).
these findings have several implications for
the biopharmaceutical industry. as with other
stakeholders, patients go through a process of
assessing risk versus benefit by weighing factors
of varying importance to them. as shown above,
patient tolerance for risk is dependent upon
the perceived value of a medication relative to
its safety profile, although it appears that many
patients struggle with assessing risk based on the
probability of an adverse event. this underscores
the industry’s imperative to better communicate
U S P A T I E N T S
20%
20%
60%
U K P A T I E N T S
21%
29%
50%
Very/Somewhat Interested
Not sure
Not very/Not at all interested
Patients | If there were a new medication that was available that could reduce the symptoms you currently have and improve your day-to-day life, but had an increased risk of a serious event like a heart attack, how interested would you be in it?
U S P A T I E N T S
26%
20%
54%
U K P A T I E N T S
20%
33%
47%
Patients | If there were a new medication that was available that could improve your condition so much that you would live longer, but had an increased risk of a serious event like a heart attack for some, how interested would you be in it?
Very/Somewhat Interested
Not sure
Not very/Not at all interested
Patients as a Part of the System 1 3
Investors Sums may not add to 100% or be equal to components due to rounding
the value and risks of new medications in terms
that are meaningful to patients. further, coupled
with increasing payer scrutiny for demonstrable
proof of a new product’s superiority versus
existing therapies, the biopharmaceutical industry
must strive to develop more sensitive measures
that incorporate patient-important outcomes into
clinical development.
15% RISK OF NAUSEA
75%
RIS
K O
F N
AU
SE
A
5%
RI S
K O
F H
EA
RT
AT
TA
CK
5 0 % R
I S K O F H E A R T A T T A C K
46%
77%
84%
48%
88%
49%
92%
55%
1 5 % R I S K O F
7 5 % R I S K OF
5% R
I SK
OF
50
% R
I SK
OF
15
% R
ISK
OF
75%
RIS
K O
F
5% RISK OF
50% RISK OF
N A U S E A
N A U S E A
HE
AR
T A
TT
AC
K
HE
AR
T A
TT
AC
K
NA
US
EA
NA
US
EA
HEART ATTACK
HEART ATTACK
E L I MI N
AT E S P AI N
MA
NA
GE
AB
LE PAIN LEVEL
75%54%
60%
83%
59%
63%58%
84%
89%
42%47%
40%
26%
31%
86%
48%
We tested a series of 12 scenarios around a hypothetical new medication, which included a condition (cancer or chronic pain), a benefit (extended life or better QOL) and a risk (safety or side effect). Each patient indicated how interested he/she would be in the new medication.
U S P A T I E N T S U K P A T I E N T S
C A N C E R / E X T E N D L I F E 1 0 Y E A R S C H R O N I C P A I N
% who are interested
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While patients provide clear but disparate answers about accepting risk, biopharmaceutical
executives paint a much more clouded picture. Asked to assess the level of risk their
company must take when exploring new opportunities, the group as a whole could not
agree. Roughly equal amounts of them respond that they should reduce their risk, keep the
same risk or take on more risk. Although these data seem to suggest confusion, the lack
of a homogenous perception of risk may be partly explained by various companies’ current
location on the risk tolerance spectrum. Those with stronger pipelines and less patent
exposure may have less of an appetite for risk than those who are facing such challenges.
Biopharma’s Evolving Business Model
Biopharma’s Evolving Business Model 1 5
Investors Sums may not add to 100% or be equal to components due to rounding
biopharmaceutical executives agree, however,
that regulators should accept more risk. when
asked to indicate which stakeholders should take
on more risk in the healthcare industry, 65 percent
of biopharma execs say government regulators
in the u.s. or the u.k. nearly 60 percent of the
executives also believe that payers should accept
more risk.
perhaps surprisingly, half of the biopharmaceutical
executives point the risk finger at their own
industry. taken collectively with the previous
indication that only 36 percent of the executives
B I O P H A R M AE X E C U T I V E S
38% Reduce risk profile
36% Take on more risk
27% Maintain existing risk profile
Biopharma | For your company to be successful in the future, will it need to...
0 %
2 0 %
4 0 %
6 0 %
8 0 %
1 0 0 %
Biopharma | Which group(s) need to take or accept more risk to improve pharmaceutical agents and public health?
B I O P H A R M A
The FDA Health insurance companies
Pharmaceutical companies
Investors Physicians
t H i r t y- s i x p e r c e n t O f
b i O p H a r m a e x e c u t i v e s f e e l
t H e i r c O m p a n y s H O u l d
ta k e O n m O r e r i s k . t H i s
f i n d i n g u n d e r s c O r e s t H e
l a c k O f a g r e e m e n t w i t H i n
t H e b i O p H a r m a c e u t i c a l
i n d u s t r y O n i t s r O l e
i n r i s k a n d w H e r e t O
t r a n s f e r i t.
1 6 2012 | The New Health Report
www.quintiles.com/newhealthreport
feel their company should take on more risk, this
finding underscores the lack of agreement within
the biopharmaceutical industry on its role in risk
and where to transfer it.
for the industry to be successful in transferring
or mitigating risk, it is helpful to determine where
in the development process biopharma execs
perceive the most risk.
asked to estimate the risk across the drug
development and clinical testing cycle, 55 percent
of biopharma respondents understandably say
that phase iii testing poses the largest risk. at
both the early and post-marketing stages, the
executives see relatively small risks. the focus on
phase iii as the highest risk makes perfect sense,
given the high cost of this stage of testing, as well
as the overall investment of resources and time
that are on the line at this point.
confidence among biopharma execs to accurately
assess the risk/opportunity ratio at the various
development phases raises some questions,
however. Overall, the executives show high
confidence in their ability to assess risk across the
drug creation cycle. the surprise comes in the
trend—indicating higher confidence in their ability
to assess risk versus opportunity at earlier stages
and progressively less as the process moves
forward. it would seem intuitive that biopharma
companies would have more data to assess risk
over time as they gather more evidence and a
better understanding of the drug. but a lack of
confidence in the underlying data used for phase
iii risk assessment is an acknowledgement that
the level of risk is higher. that only 62 percent
of biopharma execs feel they have adequate
information to assess risk at phase iii is likely a
reflection of the increasing stakes at this stage
from a financial and reputational perspective.
nonetheless, with nearly four out of 10 execs
saying they don’t have enough information, the
need for more robust sources of data becomes
very clear.
if the biopharmaceutical industry applied a wider,
more encompassing lens to gathering data and
then relied on more sophisticated tools and
techniques to unearth the true insights embedded
in the data, it could start along a path toward
better decisions about risk-value tradeoffs. for
example, better endpoints at early development
stages could make phase iii results more
confirmatory, and thereby less prone to risk.
P H A S E I T E S T I N G
P H A S E I I T E S T I N G
P H A S E I I I P O S TA P P R O VA L
Biopharma | At what stage(s) of the drug development process do you see the greatest risks?
Biopharma | Percent who feel they have necessary data to accurately assess risk vs. opportunity for new products
B I O P H A R M A
P R E C L I N I C A L T E S T I N G
B I O P H A R M A
B I O P H A R M A
77%
11%
77%
15%
69%
31%
62%
55%
61%
16%
Biopharma’s Evolving Business Model 1 7
Investors Sums may not add to 100% or be equal to components due to rounding
in addition to incorporating better sources of
data into clinical development to alleviate some
of the risk along the development lifecycle, risk-
sharing agreements between biopharmaceutical
companies and payer organizations hold potential
as well. in fact, 60 percent of biopharma execs
expect to see more risk- and cost-sharing
agreements with payers in the next five years.
further benefits—beyond the obvious reduction
of risk for the biopharmaceutical industry—
should come from such sharing. respondents
see enhanced patient population targeting as the
top potential benefit of such agreements, as data
collected by payers could help biopharmaceutical
companies improve their ability to personalize
prescriptions to a population that would benefit
more than others. likewise, the executives believe
that such agreements would improve access to
drugs and accelerate time to market. such risk-
sharing agreements between drug companies
and payers might also drive earlier interactions
between the two stakeholders, which could
fuel faster, broader access to new drugs. the
collaborations could also enhance outcomes data,
according to 60 percent of the executives.
getting these stakeholders to interact throughout
the process could lead to other benefits. for
example, more than half of them believe that
such risk-sharing would increase sales and nearly
half expect such risk-sharing to improve patient
adherence.Biopharma | Do you think risk- and/or cost-sharing agreements with payers will become more common in the next five years?
60% YES
r i s k - s H a r i n g a g r e e m e n t s b e t w e e n d r u g c O m p a n i e s
a n d p a y e r s m i g H t a l s O d r i v e e a r l i e r i n t e r a c t i O n s
b e t w e e n t H e t w O s t a k e H O l d e r s .
i f t H e b i O p H a r m a c e u t i c a l
i n d u s t r y a p p l i e d a w i d e r ,
m O r e e n c O m p a s s i n g l e n s
t O g at H e r i n g d ata a n d
t H e n r e l i e d O n m O r e
s O p H i s t i c at e d t O O l s a n d
t e c H n i Q u e s t O u n e a r t H
t H e t r u e i n s i g H t s e m b e d -
d e d i n t H e d ata , i t c O u l d
s ta r t a l O n g a p at H t O wa r d
b e t t e r d e c i s i O n s a b O u t
r i s k- va l u e t r a d e O f f s .
1 8 2012 | The New Health Report
www.quintiles.com/newhealthreport
despite the numerous perceived benefits of
risk-sharing agreements with payers, biophar-
maceutical executives appear hesitant to actually
put them into practice. when asked about
potential issues that could cause problems, most
of the executives indicate trouble from all of them.
at the top, 71 percent of the biopharmaceutical
executives say that the agreements will eat up too
much in administrative costs. the executives do
indeed expect improved outcomes data from such
agreements, yet claim that understanding clinical
versus real-world outcomes could be another
obstacle exacerbated by risk-sharing agreements
with payers. the list goes on, and the executives
paint a picture in which such agreements look
far off at best and maybe unlikely at all.
as an overview of the opinions that the
biopharmaceutical executives express, they
appear to see the need for changes in how they
handle risk, but they see no way forward. in fact,
they still perceive regulators as the bottleneck,
while appearing unable to agree on whether the
pharmaceutical industry itself should accept more
or less risk. in addition, the executives indicate—
across a variety of metrics—the potential value of
developing risk-sharing agreements with payers,
but then check off virtually every reason that
precludes such forward motion.
Biopharma | Percent saying risk-sharingagreements would mean significant/slight improvements in...
B I O P H A R M A
Enhanced patient population targeting
70%
Increased patient access to drugs that otherwise would not make it to market
65%
Drugs available to patients more quickly
63%
Improved outcomes data
60%
Increased sales for manufacturers
53%
Shorter timeline to market formanufacturer
52%
Improved adherence
47%
b i O p H a r m a e x e c u t i v e s
a c k n O w l e d g e t H e
p O t e n t i a l va l u e O f
d e v e l O p i n g r i s k- s H a r i n g
a g r e e m e n t s w i t H p ay e r s ,
b u t t H e n c H e c k O f f
v i r t u a l ly e v e r y r e a s O n
t H at p r e c l u d e s s u c H
f O r wa r d m O t i O n .
Biopharma’s Evolving Business Model 1 9
Investors Sums may not add to 100% or be equal to components due to rounding
Biopharma | Percent saying these are somewhat/significant problems with risk-sharing agreements
B I O P H A R M A
Administration costs too high
71%
Difficult to pre-assess what outcomes will result in real-world use of agent, rather than clinical trials
69%
Difficult to agree on definition of success with payers / manufacturers
68%
Regulatory risk
63%
Information produced might be useful to competitors
63%
Difficult to accurately measure success in a performance-based risk-sharing agreement
60%
Have to shift post-marketing resources from enhancing the product to proving the product
54%
www.quintiles.com/newhealthreport
In healthcare, organizations providing coverage most likely perform some of the most
focused analysis of risk. For this study, the payers consist of managed care executives
in the United States (U.S. payers) and National Health Service executives in the U.K.
(U.K. payers). In assessing their own allocation of risk versus opportunity, the majority
of payers—nearly two-thirds—express confidence that they get the balance about right.
Despite the vast differences that distinguish the single-payer system in the United
Kingdom and the multi-payer system in the United States, the two payer groups take very
similar views on their organizations’ current handling of risk.
When it comes to other stakeholders, however, payers want them taking on more risk to
improve pharmaceutical agents and public health. Both U.K. and U.S. payers—68 and
77 percent, respectively—want the biopharmaceutical industry to accept more risk, and
more than half of both groups also feel that regulators should shoulder more risk. Perhaps
surprisingly, particularly given the payers’ claims of effective risk balancing, nearly half of
U.S. payers and 39 percent of U.K. payers reply that their own groups also need to accept a
higher level of risk to benefit public health. Unlike U.S. payers, half of U.K. payers feel that
investors must risk more, as well. Overall, the payers favor spreading risk across a wide
section of healthcare stakeholders.
Payers Seek More Participation
Payers Seek More Participation 2 1
Investors Sums may not add to 100% or be equal to components due to rounding
in addition to a strong preference for spreading
risk among multiple stakeholders, payers also
seek increasing involvement in the entire lifecycle
of a medicine. as a step toward this, the payers
in this survey—70 percent of the u.k. payers and
79 percent of u.s. payers—expect more risk- and
cost-sharing agreements between themselves
and the biopharmaceutical industry over the
next five years. in parallel with that evolution, the
payers want more interaction across the drug-
development cycle.
portions of the payers already indicate some
participation in drug development. among u.k.
payers, for example, one-quarter or less of them
indicate taking part in preclinical and phase i
testing. for phases ii and iii, the percentages
increase, rising to 52 percent for the latter. for
post-marketing surveillance, 59 percent of u.k.
payers claim some level of involvement. so out
of those five stages of drug development, the
majority of u.k. payers only participate toward
the end. a similar trend appears in the responses
from u.s. payers, although with slightly higher
involvement at the preclinical stage, and then less
involvement at the other stages in comparison
with u.k. payers. for instance, only 31 percent of
u.s. payers—21 percentage points fewer than
U S P A Y E R S
11%
27%
63%
U K P A Y E R S
23%
18%
59%
Payers | Which comes closest to your feeling about how your organization balances risks and opportunities?
We need to reduce risk by taking a more conservative approach
We need to take more risks to capture more opportunities
We do a good job balancing risks and opportunities
0 %
2 0 %
4 0 %
6 0 %
8 0 %
1 0 0 %
Payers | Which group(s) need to take or accept more risk to improve pharmaceutical agents and public health?
U K P A Y E R SU S P A Y E R S
The FDA; UK: Government
regulators
Health insurance companies;
UK: Primary Care Trusts and other
providers
Pharmaceutical companies
Investors Physicians Patients
2 2 2012 | The New Health Report
www.quintiles.com/newhealthreport
the u.k. ones—claim to participate in phase iii
testing. given the general consensus that phase
iii carries the highest risk of all, payers clearly
desire more involvement at that stage of drug
development.
in fact, this survey finds that payers want
more involvement at every stage. in a general
comparison of the responses for current versus
desired involvement, the numbers nearly double
in many instances. for preclinical testing, for
instance, only 18 percent of u.k. payers claim
current involvement, but 43 percent—nearly two
and a half times as many—say that they should be
involved. as expected, both groups of payers also
show strong interest in gaining more involvement
in phase iii testing.
the lack of involvement by payers in drug
development indicates that the biopharmaceutical
industry does not interact effectively with its
customers—who are increasingly the payers,
more so than physicians and patients—about the
products that it should be making.
if the payers’ predicted increase in risk-sharing
agreements does arise in the next five years, these
stakeholders also expect significant returns—
particularly for patients. as a group, the payers
believe that risk-sharing between themselves and
the biopharmaceutical industry will give patients
quicker access to drugs. interestingly, u.k payers
respond more strongly on these points than u.s.
payers. indeed, such risk-sharing should return
higher benefits in a single-payer system, where a
Payers | How involved is your organization / how involved should it be at the following stages of drug development?
I S I N V O L V E D
S H O U L D B E I N V O L V E D
I S I N V O L V E D
S H O U L D B E I N V O L V E D
PRECLINICAL
PHASE I
TES
TIN
G
PH
AS
E I
I T
ES
TIN
G
PH
ASE
III
TESTIN
G
POST APPROVAL
23%
45%
24%44%
27%
48%
31%
61%
42%
76%
PRECLINIC AL
PHASE I TESTIN
G
PH
AS
E II T
ES
TIN
G
PH
ASE III TESTIN
G
POST APPROVAL
18%
43%
25%
48%
36%
64%
52%70%59%
84%
U S P A Y E R S U K P A Y E R S
Payers Seek More Participation 2 3
Investors Sums may not add to 100% or be equal to components due to rounding
coordinated attack on disease might be easier to
orchestrate than in the u.s. multi-payer system.
somewhat oddly, and like the biopharmaceutical
executives surveyed, about half of payers expect
such risk-sharing agreements to improve patient
adherence, although such a connection does
not seem immediately obvious. moreover,
few strategies can boast making significant
improvements in adherence, which is notoriously low.
similar to the biopharmaceutical executives,
the payers convey many concerns that must
be addressed to implement such risk-sharing
agreements. Of significant interest, these
responses indicate the different level of control
that might be possible in a single- versus a multi-
payer system. for example, u.k. payers express
less concern over related administration costs and
the related parties’ ability to agree on successful
outcomes. so although both groups of payers
seek more involvement in the drug development
process, neither shows high confidence that
risk-sharing agreements can be developed in the
current climate.
Payers | Percent saying risk-sharingagreements would mean significant/slight improvements in...
Increased patient access to drugs that otherwise would not make it to market
68%
89%Drugs available to patients more quickly
59%93%
75%
Improved outcomes data
61%Increased sales for manufacturers
Shorter timeline to market for manufacturer
Real-world validation of pharmaceutical risk/benefit
Improved adherence
61%77%
69%70%
U S P A Y E R S U K P A Y E R S
61%69%
44%59%
Payers | Percent saying these are somewhat/significant problems with risk-sharing agreements
Administration costs too high
72%
59%
Difficult to pre-assess what outcomes will result in real- world use of agent, rather than clinical trials
64%
59%
64%
Difficult to agree on definition of success with payers / manufacturers
61%
Difficult to accurately measure success in a performance-based, risk-sharing agreement
Have to shift post-marketing resources from enhancing the product to proving the product
56%50%
U S P A Y E R S U K P A Y E R S
59%
75%
www.quintiles.com/newhealthreport
The healthcare-focused investors surveyed for this report rate the biopharmaceutical
industry as high-risk. In fact, 94 percent of the investors see more risk in placing capital
in the biopharmaceutical industry than in other sectors. Moreover, almost none of the
investors—only 6 percent—rate the biopharmaceutical industry as less risky for investing
than other areas. Consequently, this high-risk expectation forms one of the strongest
examples of consensus in the results of this year’s survey.
Investor Ambivalence, Optimism
Investor Ambivalence, Optimism 2 5
Investors Sums may not add to 100% or be equal to components due to rounding
despite the high risk of investing in the
biopharmaceutical industry, 73 percent of
investors feel optimistic about the prospects for
investments in this area. One-third of investors
even expect to invest more in this industry over
the next three to five years, and only 17 percent
intend to invest less. still, even more of the
investors—65 percent—expect to increase their
investments in biotechnology specifically, and
only 13 percent expect to invest less in that field.
given that investors see high risk in investing in
the biopharmaceutical market as it is, one would
imagine that could keep them from suggesting
that the drug industry should take on any more
risk. in fact, 47 percent of the investors feel that
the biopharmaceutical industry does a good job
of balancing risk with rewards. among those who
disagree, however, most of them—37 percent—
believe that the drug industry should take on
additional risk. with investors always interested
in spreading the risk and feeling that they already
take big risks to invest in this industry, some
of them naturally want to see the drug industry
raising its risk bar, too.
I N V E S T O R S
44% Significantly greater risk
50% Slightly greater risk
6% Less risk
Investors | Does investment in the biopharmaceutical sector represent greater or less risk than other sectors?
Investors | Are you pessimistic or optimistic about the investment prospects in the biopharmaceutical industry in the next 5 years?
I N V E S T O R S
73% Optimistic
27% Pessimistic
s e v e n t y t H r e e p e r c e n t O f i n v e s t O r s f e e l O p t i m i s -
t i c a b O u t t H e p r O s p e c t s f O r i n v e s t m e n t s i n t H e
b i O p H a r m a c e u t i c a l i n d u s t r y .
O n ly s i x p e r c e n t O f i n v e s -
t O r s r at e t H e b i O p H a r m a -
c e u t i c a l i n d u s t r y a s l e s s
r i s k y f O r i n v e s t i n g t H a n
O t H e r s e c t O r s .
2 6 2012 | The New Health Report
www.quintiles.com/newhealthreport
when it comes to risk- and cost-sharing between
biopharma and payers, investors display
ambivalence. Only 42 percent of them expect
such agreements to be common in five years.
likewise, investors stand largely divided on
the potential benefits of such agreements for
themselves and for patients.
Investors | Increasing / decreasing investment in specific sectors in the next three to five years
D E C R E A S EI N C R E A S E S T A Y T H E S A M E
P H A R M A C E U T I C A L C O M P A N I E S
B I O T E C H N O L O G Y C O M P A N I E S
17%
50%
33%
65%
22%
13%
Investors | Do you think risk/cost-sharing agreements between biopharmaceutical companies and payers will become more common in the next five years?
I N V E S T O R S
42% Yes
58% No
I N V E S T O R S ’ V I E W O FB I O P H A R M A I N D U S T R Y
They need to reduce risk by taking a more conservative approach
They need to take more risks to capture more opportunities
They do a good job balancing risks and opportunities
Investors | Which statement comes closest to your feeling about how the biopharmaceutical industry balances risks and opportunities?
16%
37%
47%
Investor Ambivalence, Optimism 2 7
Investors Sums may not add to 100% or be equal to components due to rounding
Investors | What are the implications of risk-sharing agreements between biopharma and managed care for firms like yours?
D I S A G R E EA G R E E N E I T H E R
These agreementswill generally mean less return on our
investment.
We will invest less in this sector if these
agreements become more common.
These agreementswill mean more access
to the market fornew drugs.
49%
14%
37%22%
53%
46%
45%
9%
25%
i n v e s t O r s a r e r a t H e r i n d i f f e r e n t w i t H r e g a r d s t O
r i s k - a n d c O s t - s H a r i n g a g r e e m e n t s b e t w e e n b i O p H a r -
m a c e u t i c a l c O m p a n i e s a n d p a y i n g O r g a n i z a t i O n s .
www.quintiles.com/newhealthreport
Although biopharmaceutical executives and payers from the U.S. and the U.K. expect
more risk-sharing ahead, such agreements could come in many forms. The form itself,
however, will determine the likelihood of success from such arrangements. Despite that
fact, biopharmaceutical executives and payers express different views on the most likely
risk-sharing plans.
Among the biopharmaceutical executives, nearly three-quarters of them support
agreements in which patient adherence determines future discounts to the manufacturer.
They also show similar support of agreements in which some aspect of patient outcome
serves as the goal. The biopharma execs show less enthusiasm for some other possible
forms of risk-sharing, including population-based performance guarantees. As the
numbers show, however, this group spreads its interests across a collection of approaches
to risk-sharing.
Mitigating Risk: The Need for New Metrics
A Need for New Metrics 2 9
Investors Sums may not add to 100% or be equal to components due to rounding
in comparison, the payers display equally
widespread opinions. both groups of payers prefer
agreements based on coverage with evidence
development (ced), which depends on how well
a drug performs against a specific outcome, and
the population-based performance approach, in
which in drug must meet some long-term benefit
to merit coverage. more than biopharmaceutical
executives or u.s. payers, u.k. payers provide the
most aligned opinion, with 95 percent of them
supporting the ced-based option. notably, this
option ties for first among u.s. payers and ranks
second with the biopharmaceutical executives.
so despite the support of a variety of options in
risk-sharing agreements, these data indicate that
these three groups of stakeholders could possibly
agree on how to get started with this transition.
if the biopharmaceutical industry and payer
organizations could agree on a way forward,
that might generate a variety of risk-sharing
agreements. two key interests, especially from the
patient perspective, involve getting new therapies
to the market faster and making those therapies
more effective. with regard to speed-to-market,
half of biopharmaceutical executives feel that risk-
sharing agreements will decrease that time, but
that expectation drops to 43 and 32 percent for
u.s. and u.k. payers, respectively. in terms of risk-
sharing agreements increasing the innovative and
effective aspects of new therapies, nearly three-
quarters of u.k. payers show optimism there, and
a majority of the respondents from u.s. payers
and biopharma agree.
when considering a range of other ways to
decrease the time-to-market for new therapies,
none generates a strong consensus among the
stakeholders. even with the most agreed-upon
concept—pre-competitive collaborations among
biopharma companies—it only gains favor from
about half of most of the groups, and even less
from u.k. payers. Overall, the options generate
widely disparate responses and the lack of
majority support.
to enhance the innovation of new drugs, however,
the stakeholders display some level of agreement.
Biopharma, Payers | Percent who support specific types of risk-sharing plans
U S P A Y E R S U K P A Y E R SB I O P H A R M A
Adherence-based deals
Coverage with Evidence
Development (CED)
Individual performace guarantees
Discounts to managed care plans for better formulary placement
Contracting to provide copay offsets
Population-based performance
guarantee
0 %
2 0 %
4 0 %
6 0 %
8 0 %
1 0 0 %
73%77%
66% 69%
84%
95%
67%59%
69%
60%68%
61% 59%64%
30%
56%
84%89%
3 0 2012 | The New Health Report
www.quintiles.com/newhealthreport
upwards of three-quarters of biopharmaceutical
executives and payers, plus 61 percent of
investors, hold hope for pre-competitive
collaborations among biopharmaceutical
companies. nonetheless, other responses (data
not shown) in this survey indicate that 69 percent
of biopharmaceutical executives support pre-
competitive alliances, but only 37 percent of them
claim that their company currently participates
in them. Overall, the responses suggest that
some biopharma executives believe that pre-
competitive alliances might extend—or at least
not shorten—the time that it takes to bring a new
drug to market, but the alliances could increase
the innovative aspects of new drugs. although
that could create a more precise approach than
today’s often scattershot strategy, a majority of
these executives also indicate that creating such
alliances must overcome a series of problems,
including defining the boundary between
pre-competitive and proprietary data and
protecting intellectual property. so these alliances
might appeal to the executives more in theory
than in practice.
to manage risk effectively, stakeholders need
reliable ways to measure it. that is, the healthcare
industry needs powerful tools to estimate
the risk/benefit tradeoffs generated by a new
drug. the results from this survey show that
the biopharmaceutical industry and payers in
the u.k. and the u.s. apply a variety of tools
to address this problem. for example, most of
them look at patient-reported outcome measures
and minimum clinical efficacy, and about half
use quality-adjusted life years. for each of these
metrics, though, the stakeholders only rate these
tools as more or less mediocre in assessing the
risk-benefit profile of a new drug. for example,
nearly three-quarters of u.k. payers rely on
52%43%
32%
50%57%
41%
31%
28%32%
72%
25%41%
43%
41%41%
Biopharma, Payers | Percent who feel the following will decrease time-to-market for new therapies
U S P A Y E R S U K P A Y E R SB I O P H A R M A
Risk-sharing agreements between biopharma and payers/managed care
Pre-competitive collaborations among biopharma companies
Direct government participation in drug development
Outcomes research from quasi-governmental bodies governing real-world research practices such as PCORI/NICE
Managed care / payer input in drug development
55%63%
73%
75%72%73%
27%44%
55%
31%60%
57%
32%29%
36%
Biopharma, Payers | Percent who feel the following will mean getting more innovative and effective therapies to market
U S P A Y E R S U K P A Y E R SB I O P H A R M A
Risk-sharing agreements between biopharma and payers/managed care
Pre-competitive collaborations among biopharma companies
Direct government participation in drug development
Outcomes research from quasi-governmental bodies governing real-world research practices such as PCORI/NICE
Managed care / payer input in drug development
A Need for New Metrics 3 1
Investors Sums may not add to 100% or be equal to components due to rounding
patient-reported outcome measures, but only
a bit more than half of them judge this as an
excellent or good tool for measuring risk. in other
cases, the stakeholders give high marks to some
tools that they use infrequently. for instance,
nearly three-quarters of u.s. payers believe
that minimum clinical efficacy measures risk
effectively, but only 44 percent of them use this
tool. to some extent, these responses indicate
that stakeholders use some of their least
favorite methods and forego some of the more
effective ones.
these data illustrate one of the problems with
most risk-based tools: that they fail to recognize
the underlying predispositions toward value and
therefore make it extremely difficult to understand
the tradeoffs involved in such equations.
without considering the values attached to the
risk—which can sway the perception of the risk/
benefit proposition—stakeholders are unable to
assign the proper weight to different values that
influence perception of risk.
Patient Reported Outcome (PROs)
Minimum Clinical Efficacy (MCE)
Quality Adjusted Life Years (QALYs)
Number Needed to Treat (NNT)
Clinical Utility Index (CUI)
Number Needed to Harm (NNH)
Disability Adjusted Life Years (DALYs)
Proprietary instruments
Biopharma, Payers | How well do the following types of data do in accurately assessing a biopharmaceutical product’s risk/benefit profile?
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ExcellentGood
B I O P H A R M A
ExcellentGood
U S P A Y E R S
ExcellentGood
U K P A Y E R S
N/A
Patient Reported Outcome (PROs)
Minimum Clinical Efficacy (MCE)
Quality Adjusted Life Years (QALYs)
Number Needed to Treat (NNT)
Clinical Utility Index (CUI)
Number Needed to Harm (NNH)
Disability Adjusted Life Years (DALYs)
Proprietary instruments
56% 60% 71%
53% 44% NA
47% 44% 66%
41% 31% 46%
29% 24% 21%
17% 20% 21%
12% 19% 16%
22% 31% 11%
Biopharma, Payers | Do you currently use the following types of data?
B I O P H A R M A
P A Y E R S
% answering yes
3 2 2012 | The New Health Report
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in the context of assessing risk and benefit,
one area that warrants further examination is
comparative effectiveness research (cer). as
payers and quasi-governmental agencies in the
u.s. rush to embrace cer, some clarity as to the
utility and construct of cer can be gleaned by
looking at the perception among u.k payers as
to the benefits produced by health technology
assessments (Hta)—a different yet related form
of product appraisal.
u.k. payers seem unimpressed by the overall
performance of Hta on a number of different
measures. less than a third of them feel that
Hta initiatives perform very or extremely well
on improving patient outcomes, and less than a
quarter feel that Hta does a good job of ensuring
that the right patient population receives the right
medication. these findings contrast sharply with
the perception of cer among u.s. payers, the
majority of whom say that cer performs well on
both measures.
given that the u.k. has more than 10 years
experience in putting Hta into practice, u.k.
payer skepticism as to their utility should be
seen as a learning opportunity for u.s.-based
organizations looking to conduct cer initiatives.
critical to the future application of cer is the
data and methodology employed in the research.
cer methods should not only address technical
aspects of study design, subject selection,
analytic techniques, and process and outcome
measurement, but also address such weighty
issues as ethical, humanistic and feasibility
considerations related to real-world research.
Payers | Percent who believe current CER / HTA initiatives are doing extremely / very well on...
U S P A Y E R S U K P A Y E R S
Improving patient outcomes / improving effectiveness
56%
32%
Ensuring the right patient population receives the right medication
51%
23%
43%
Improving patient safety
44%
Controlling cost for members in your plan
40%
5%
3 3
Given risk’s fundamental place in healthcare—from patients’ well-being to
biopharmaceutical companies’ financial security—the interconnected stakeholders
know surprisingly little about how to measure and manage it. Overall, each group of
stakeholders desires more control over the risks that they face and prefers to reduce their
own risk by transferring it to others whenever possible. These perceptions may arise from
a law of nature of sorts—protect yourself. But risk in healthcare involves us all. As such,
the risks must be balanced so that each stakeholder accepts a fair share, and the members
of the healthcare system must find ways to accurately measure and communicate risk and
benefit to each other.
Conclusion
3 4 2012 | The New Health Report
www.quintiles.com/newhealthreport
much of the data analyzed in this report reveals
the need for deeper knowledge of the inherent
risks in healthcare and medicine. for example,
some of the patient responses indicate a lack
of understanding of how the drug development
process actually works. likewise, the comparison
of patients from the u.k. and the u.s. shows a
need for better education about balancing risk
and benefit. at the same time, biopharmaceutical
executives report little confidence in many of the
tools that they use to evaluate the risk/benefit
balance of a drug in development.
in today’s world of data and informatics,
computation should improve risk assessment
and management, but access to robust sources
of data to feed the model is severely lacking.
instead, no one stands behind a confident
consensus regarding how to measure risk, how
to reduce it, how to manage it or how to weigh
the tradeoffs. without that confidence in the data
which underpins assessments, a more effective
system to enhance health around the world cannot
be built.
to address this challenge, the biopharmaceutical
industry must develop new approaches—and do
that as soon as possible. the results of this survey
indicate that the biopharmaceutical industry
can act now in several ways: collaborating
early with payers on new compounds under
development; striking pre-competitive alliances
among industry competitors to enhance the
innovative characteristics of new compounds; and
developing risk-sharing agreements to enhance
patient-population targeting.
if the biopharmaceutical industry fails to adapt to
the changing landscape of risk in healthcare, other
stakeholders—perhaps the paying organizations,
well-versed as they are in measuring and working
with risk—will move ahead on their own, and
the responses from both u.k. and u.s. payers
about their interests in earlier involvement in drug
development presages that possibility.
the ultimate goal revolves around reducing risk
for everyone. to enhance the health of patients—
while keeping the biopharmaceutical industry and
investors financially healthy and payers balancing
their inputs and outlays—healthcare must
accurately assess the value of and risks behind
a promising compound as soon as possible and
then track that balance across the entire drug
development cycle. Only then can the world make
the most of modern medical capabilities.
3 5
about the new health report
The New Health Report is based on surveys of biopharmaceutical executives, managed care executives
in the u.s., national Health service executives in the u.k., patients living with chronic disease in both
the u.s. and the u.k., and investors who focus on the healthcare sectors. each survey was conducted
by richard day research of evanston, illinois, u.s.a., a market probe company, on behalf of Quintiles.
richard day research was responsible for all survey design, data analysis and data reporting.
data for this survey were collected between January 8 and march 14, 2012. screened and included in
the sample were 102 biopharmaceutical executives at the director level or above, 75 managed care
executives in the united states at the director level or above, 72 national Health service executives
(director or above) in the u.k., 509 u.s. and 500 u.k. adults ages 18+ diagnosed with a chronic
health condition who are receiving treatment, and 100 investment professionals (vice president and
above) employed in private equity firms, investment banks, or venture capital firms that focus on the
healthcare/biopharma sector.
professionals were recruited via postal mail, telephone, fax and e-mail and completed the survey
in a self-administered online questionnaire. patient interviews were conducted via landline and
cellular telephone.
with pure probability samples of these sizes, one could say with 95 percent probability that the results
have a sampling error of +/– 10 percentage points for biopharmaceutical executives and investors, +/– 11
percentage points for managed care executives, +/– 4 percentage points for u.s. and u.k. patients.
about quintiles
Quintiles is the only fully integrated
biopharmaceutical services company offering
clinical, commercial, consulting and capital
solutions worldwide. Our network of more than
25,000 professionals in 60 countries has an eye
on the future while delivering results today with
an unwavering commitment to patients, safety
and ethics. Quintiles helps biopharmaceutical
companies develop and commercialize products
to improve and lengthen patients’ lives while
demonstrating value to stakeholders. visit
www.quintiles.com for more information and
www.quintiles.com/news for additional
company news.
contact info
for media inquiries:
mari mansfield, Media Relations, Quintiles
+1 919 998 2639
for all other inquiries:
adam istas, Corporate Communications, Quintiles
+1 708 948 7070
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