Friday, February 27, 2009

Hide or Seek?

It’s Time for the Healthcare Industry to Find New Footing
There's plenty of blame to go around these days. We’ve all seen angry fingers pointed at the tobacco companies for pushing products they knew to be hazardous and additive. There were hearings before Congress, lawsuits and some new restrictions on marketing to teens.

HMOs came under fire for denying medical claims and access to potentially life-saving interventions. Lawsuits and some high-profile reversals in coverage decisions ensued.

Big oil and oil speculators had us over the figurative barrel when a gallon of gas went over $4.00 a gallon. With the collapsing economy, gasoline prices have fallen by more than 50 percent (though the price of oil has fallen by more than 70 percent).

The list continues with the biopharmaceutical industry. Despite cost assistance programs, there are still too many patients who choose between filling a prescription and buying other necessities. They may not have insurance or their co-pays for medications may be enough to tip a limited budget into the red. There has been some relief with the implementation of the Medicare drug benefit and more has just been promised by President Obama in his address to Congress.

Now, there’s another group to vilify – the financial industry. Predatory lenders, over-compensated CEOs and Ponzi-scheming money (mis)managers.

Though sometimes pushed from the front page by competing bad news from the banking and housing crisis, there are still plenty of stories out there that help fan the flames on healthcare. And they’re not just about cost and access: law suits and investigations on drug promotions, side effects, data disclosure and fraud help to keep the fury fresh. (We all know that a healthy fraction of the drug, device and diagnostic industries’ low reputation is self-inflicted, but that’s a whole other discussion.)

All of this has helped to divert some attention away from the issues and concerns of those healthcare sectors that are involved with discovery and innovation. Indeed, true healthcare reform – expanding access, and improving care and efficiency – will be difficult to achieve unless we enhance our ability to detect, treat, cure and prevent diseases.

So, what kind of visibility should the biopharmaceutical, device and diagnostic sectors be seeking right now, especially when the chairs are empty at HHS, FDA, NIH, CDC and CMS? One option is to do nothing and enjoy the relative calm (compared to what the financial sector is experiencing). To some, it’s schadenfreude – a nice change to see public anger and resentment trained somewhere else. Another option is to fill the void with new ideas, new approaches and reengage our publics.

For a snapshot of the current messages coming out of the key industry trade associations, I went to their web sites. The most prominent feature on PhRMA’s homepage highlights Meredith Baxter’s battle with breast cancer. Also, there are links for prescription assistance, healthcare reform and medicines in development. Likewise, the AdvaMed web site has a number of links to interesting content. However, neither have a clean, clear set of rallying points. BIO is a little closer to at least part of what I think we need. There’s a CNBC interview with association president James Greenwood from their CEO & Investor Conference. He makes a clear connection between healthcare and the economy – the need to “expand access to health care while expanding incentives to innovate.”

Like housing, banking and automobiles, biotech is in a crisis. Perhaps this is one of the messages that needs to be amplified and expanded to gain more relevancy with more audiences. The scary facts are that a quarter of biotech companies have six months or less of cash. Half have 12 months or less. The editorial in the February issue of Nature Biotechnology remarks that “many promising products now face financial oblivion.”

Yes, we need healthcare reform to expand access. Yet, without the underpinnings of new research, and new diagnostics and therapeutics, we will lose the capacity to consistently improve health. The transformation from trial-and-error approaches to DNA-guided medicine, ensuring that we get the right medicine in the right dose, will be pushed back by who knows how long. And, our economic competitiveness, our lead in innovation, will wane.

Certainly, the public doesn’t want to hear that healthcare, like the other sectors mentioned above, is looking for a bail-out. But some heads need to come together and think about new ways to build support for a remarkable but hobbled industry.

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