Population Health for Pharma: Perspectives from Aetna/Healthagen

Transcription

1 Population Health for Pharma: Perspectives from Aetna/Healthagen Van Crocker, President, Healthagen Outcomes April 2015

2 The future of healthcare depends on population health management Episodic treatment of the sick Holistic care for the entire population Rising costs and transactional care Shared risk and accountability Independent and detached providers Transparent and engaged providers Outdated technology and communication New tools and services needed 2

3 Healthagen, an Aetna company, focuses on population health management as critical to Aetna s mission Clinical integration and analytics Performance management Cost and quality initiatives Data access and transparency Care coordination Provider-patient engagement High-risk and high-need patient identification, engagement, and support ACO, PCMH and CIN operations Value-based care monetization Financial incentives alignment Utilization management Family and CareTeam support Prevention and wellness 3

4 Pharma/Biotech/Device companies have their own stake in successful population health management Market size and potential Trial design, subject identification Real world evidence INFORMATION Outcomes-based studies Care management coordination INCENTIVES Valued-based payment arrangements Rx in the ACO setting Education, adherence, and clinical inertia Patient-centric approaches HUMAN CAPITAL Value beyond the pill Healthagen Outcomes exists to assist manufacturers in the healthcare space in addressing these key issues 4

5 Unlike other data, payer data is LONGITUDINAL and can be used to draw valuable conclusions about populations Longitudinal Patient Records Our assets Medical Claims stores member claims data across its 23+M population Lab Results analyzes patient data based on specific rules criteria connects and delivers clinical data across its network Rx Claims Clinical Data Our data: uniform, long-term, comprehensive, and accessible Patient Self Assessments Our reputation: a trusted source of healthcare information Geographic Data 5

6 LONGITUDINAL insights allow critical questions about populations to be asked, and extended, most effectively TODAY RETROSPECTIVE ANALYSIS Observing a population s health history Establishing comparisons among existing sub-groups POPULATION IDENTIFCATION Finding qualified participants for later analysis or trials Mapping location, type and density of healthcare activity PROSPECTIVE MONITORING Following a population forward in time as events or interventions occur Collection of real world evidence to generate and test hypotheses OUTREACH Engage and communicate with patients and their healthcare providers Enable collection of supplemental data or a clinical trial itself CONTINOUS ACCESS AND ENGAGEMENT with a population of interest is the key value of longitudinal answers 6

7 Scenario 1: Drug adherence, chronic condition, pharmaceutical client RETROSPECTIVE ANALYSIS PROSPECTIVE MONITORING FIRST PROJECT: OBJECTIVE Determine whether drug adherence in a chronic population may contribute to improved health outcomes PROJECT Observe a population of Aetna members with chronic, life threatening condition Compare adherence levels based on Rx data (PDC measurement) End points of interest include frequency of subsequent severe events TIMELINE 3-5 months PROPOSED FOLLOW-UP PROJECT: ISSUE Sub-population of interest has encouraging, but insignificant, correlation between adherence and outcomes PROJECT Observe sub-population of same initial chronic source, but into future Build additional evidence for or against retrospective hypotheses Test same endpoints of interest and/or subpopulation specific endpoints TIMELINE 1 year+ RESULT Significant, encouraging correlation between drug adherence and health outcomes OBJECTIVE: EXTEND learnings from larger retrospective study to sub-group KEY ENABLER: CONTINOUS POPULATION ACCESS AND ENGAGEMENT 7

8 Scenario 2: Rare disease trial, biotech client INITIAL PROJECT: OBJECTIVE Determine if existing investigator sites for rare disease trial are well-located PROJECT POPULATION IDENTIFCATION Identify a qualified population based on trial inclusion/exclusion criteria Map location of the population and relevant health encounters Examine radii around sites to determine number of qualified patients in range TIMELINE 3 weeks CONTINUATION PROJECT: OBJECTIVE Outreach to qualified patients and their providers to educate and offer opportunity to participate in clinical trial PROJECT PLAN OUTREACH Create content to be sent to each qualifying member and his/her provider(s) Conduct targeted outreach by , letter, call center (within new site footprint) Connect interested volunteers to trial sponsor client directly TIMELINE 1-3 months KEY RESULT Found multiple locations with trial-qualified patients but no site coverage RESULTS Ongoing engagement of healthcare providers and patients KEY ENABLER: CONTINOUS POPULATION ACCESS AND ENGAGEMENT 8

9 Scenario 2: Populations identified geographically can later be engaged as potential trial volunteers Trial-Specific, Encounter-Based Heat Maps with Link to Later Outreach 9

10 Illustrative Aetna/Healthagen Outcomes Work in Pharma/Biotech/Device Space Project Partners Description Clinical Trial Recruitment Clinical Trial Recruitment Global CRO and Pharma/ Biotechs (CONFIDENTIAL) Established Global Biotech (CONFIDENTIAL) For select partners; multiple pharma/biotech-sponsored trial opportunities across multiple disease states Late stage biotech for high prevalence, chronic condition Clinical Trial Analysis/Recruitment Development Stage Biotech (CONFIDENTIAL) Late stage drug for rare cancer Market Evaluation Personalized weight loss & care management program. Testing the benefits of Vivus s newly launched weight loss drug Market Evaluation Mini-Sentinel Surveillance Platform European Pharmaceutical Company (CONFIDENTIAL) Retrospective market analysis assessing the viability of new product proposals Ongoing drug safety surveillance project with Aetna providing data, analysis, and support to national drug safety efforts In-depth analytical capabilities enable partners to substantiate, formulate, and execute strategic healthcare decisions *List not exhaustive 10

11 Additional Slides

12 Healthagen suite of population health solutions Healthagen Businesses Healthagen Outcomes Smart Networks Solutions for: Population health technology Care management Accountable care Patient and provider engagement Cost transparency Advanced analytics 12