Corporate Magazine 2012 - Boehringer Ingelheim

1 View of San Francisco, the leading financial and culturalcentre of Northern California.2 The increasing diversity in the US population (age,ethnicity, technology access/adoption, socioeconomicstrata) requires targeted solutions and approachesto meet specific patient and physician groups’ needs.1 2USA – FUNDAMENTAL REFORMSThe USA spends more on healthcare per capita than any otherdeveloped country, however increasing costs are no longersustainable in the context of the economic challenges and theneed to significantly reduce the federal deficit. The magnitudeof the funds to be identified is such that healthcare programmes(Medicare, Medicaid) are being targeted for spending cuts inaddition to other areas, such as defence.collaboration between payers, plansand providers. With mounting pressurefrom employers and government and agrowing lower margin in Medicare andMedicaid business, the insurance sectorand healthcare providers are continuallyconsolidating to achieve efficiencies,and making strategic decisions.Definitions are blurring between payersand providers as new entities mergeand emerge.PATIENT PROTECTION ANDAFFORDABLE CARE ACT (ACA)The ACA will make significantreforms to the healthcare system.ACA puts in place comprehensivehealth insurance reforms that willroll out over many years. One ofthe primary elements is providingcoverage to the uninsured due tostart in 2014. In addition, theMedicaid health programme forlow-income Americans will beexpanded. The ACA also imposesnew fees and rebates on the healthcaresector (pharmaceutical, healthplans, hospitals) to fund the expansionin coverage.Besides insurance coverage, the newAffordable Care Act (see left) encouragesvalue-based health system deliveryby providing incentives for healthcareproviders to form AccountableCare Organisations (ACOs), which willbe incentivised to coordinate careacross settings, improve quality, preventdisease and reduce hospital admissions.Unlike the current ‘fee forservice’ system, organisations with thebest outcomes will be paid more thanthose that perform poorly on qualitymeasures. One of the most fundamentalchanges the law may incent is thesubstantial increase in the levels ofEnduring implicationsThe combination of factors driving significantchange in the US healthcareenvironment has critical implicationsfor the pharmaceutical industry. Recognitionof the necessity of change, andthe planning and execution of effectivestrategies to meet the needs of the marketwill define success. Some examplesof areas of focus are:• Increased burden of proof will be requiredfor market access. With blockbustermedicines losing patent exclusivity,there are many generics withstrong profiles. Payers are seeking124 Boehringer Ingelheim annual report 2012