Now that you have interest in the integrated delivery network, there are a few things to know from the pharmacy side. When contacting the right person, you are working with a person that is a director level and above- and often at the Vice President level. The individual hospital pharmacy directors will know this person well.
The conversation is much different... at the individual hospital pharmacy director level, they are interested in policy and products that specifically interest one hospital. The Director of Pharmacy then can diffuse the information's relevance to the purchasing staff based on local policy and procedure. The local formulary is the guiding principle. Inventory management is critical as the hospital staff is observed and critiqued on budget management and inventory turns.
Working at the IDN level, these items are important, but nearly so as the overview and what your company can do for the whole customer. Don't get bogged down into the minutia of trivia, but show your customer the grander view of how you can help their system.
Tuesday, April 16, 2013
Monday, April 1, 2013
Supporting an IDN
The IDN is a huge buzz word in pharmaceuticals and in the healthcare industry. With consolidation and the Affordable Care Act, hospitals are looking for more ways to join forces and acquire products less expensively. Several years ago no one heard much about Integrated Delivery Networks.
I've had the chance to be ahead of the curve for the last few years and will be writing on this subject in the next few weeks. You cannot cover an account like an IDN as you would a single location account. You do your prospect / customer a disservice unless you pay special attention to this complex sales cycle.
~m~
I've had the chance to be ahead of the curve for the last few years and will be writing on this subject in the next few weeks. You cannot cover an account like an IDN as you would a single location account. You do your prospect / customer a disservice unless you pay special attention to this complex sales cycle.
~m~
Tuesday, February 12, 2013
Wednesday, January 30, 2013
Rugby Laboratories...
I have to confess that when I had initially heard that we had purchased Rugby I was apprehensive. New products, new items to learn, etc.
After working through a few bids this week, all that I can say is that this addition to the Major product line has been nothing short of spectacular and well done!
They bring to the table a few interesting products - two that come to mind are the broad choices of nicotine relief gums / patch products as well as Nephro-Vite. This is a great product adding B-Complex vitamins as well as other vitamins to assist as a supplement for patients on dialysis.
Many of these items are on GPO agreements as well as wholesaler's source programs. Consult with your institutional buyer for more information.
After working through a few bids this week, all that I can say is that this addition to the Major product line has been nothing short of spectacular and well done!
They bring to the table a few interesting products - two that come to mind are the broad choices of nicotine relief gums / patch products as well as Nephro-Vite. This is a great product adding B-Complex vitamins as well as other vitamins to assist as a supplement for patients on dialysis.
Many of these items are on GPO agreements as well as wholesaler's source programs. Consult with your institutional buyer for more information.
Tuesday, January 8, 2013
Gray Market Pharmaceuticals
I am going to keep this one brief.
There is a big difference in the use of the term "Gray Market" in pharmaceuticals. To understand the terms you must understand the sales channels and terms. The three largest pharmaceutical distributors in the U.S. are Amerisource Bergen ( @Healthcare_ABC ), Cardinal Health ( @ cardinalhealth), and McKesson ( @McKesson). They hold the lion's share of business in the acute and non-acute trade with the largest segment of their business being the retail sector. Hospitals would do well to heed that the big three sell more to retail than to them.
The next tier of wholesalers are large businesses that can handle the acute market. The two that immediately come to mind are H.D. Smith and Morris Dickson which both handle hospital business and significant pieces of retail and long term care.
Below this are other wholesale resources that are completely legitimate including another operation of our parent company called the Harvard Drug Group.Beyond this tier there are dozens and dozens of distributors with many being legitimate and some not.
If you are setting at the HD Smith / Morris Dickson / Harvard Drug level, anything below them is usually considered gray market sales. This is because they are point of need distributors that often raise the price of products by several hundred percent to make a quick profit. While completely legitimate, they are used to making quick hit profits from single transactions on hard to get items, and have given themselves notoriety in the market.
If you are a hospital or one of the big three wholesalers, the term used for any distribution below those big three is usually gray market, which couldn't be further from the truth because they all provide drug pedigree for products purchased.
Your view of the market depends on where you are looking at it from.
There is a big difference in the use of the term "Gray Market" in pharmaceuticals. To understand the terms you must understand the sales channels and terms. The three largest pharmaceutical distributors in the U.S. are Amerisource Bergen ( @Healthcare_ABC ), Cardinal Health ( @ cardinalhealth), and McKesson ( @McKesson). They hold the lion's share of business in the acute and non-acute trade with the largest segment of their business being the retail sector. Hospitals would do well to heed that the big three sell more to retail than to them.
The next tier of wholesalers are large businesses that can handle the acute market. The two that immediately come to mind are H.D. Smith and Morris Dickson which both handle hospital business and significant pieces of retail and long term care.
Below this are other wholesale resources that are completely legitimate including another operation of our parent company called the Harvard Drug Group.Beyond this tier there are dozens and dozens of distributors with many being legitimate and some not.
If you are setting at the HD Smith / Morris Dickson / Harvard Drug level, anything below them is usually considered gray market sales. This is because they are point of need distributors that often raise the price of products by several hundred percent to make a quick profit. While completely legitimate, they are used to making quick hit profits from single transactions on hard to get items, and have given themselves notoriety in the market.
If you are a hospital or one of the big three wholesalers, the term used for any distribution below those big three is usually gray market, which couldn't be further from the truth because they all provide drug pedigree for products purchased.
Your view of the market depends on where you are looking at it from.
Tuesday, December 4, 2012
60 Minutes
As many did, I watched with interest the HMA spot on "60 Minutes" Sunday evening after the close Raven's game. There seemed to be plenty of people with opinions about how HMA operates their business and what they say about admissions.
According to 60 Minutes and other follow up, there is no problem with the health care that was received at HMA facilities by patients. Neither "60 Minutes" nor the physicians interviewed identified any admission decision in which a physician's medical judgment was overridden by an HMA executive, much less to defraud Medicare. The reliance on the comments by former employees was the corpus of the piece.
With the concern of liability on the hospital's part, there should be a tendency to err on the side of the best interest of the patient. In fact, the overall data doesn't appear to reflect that HMA is admitting more patients than its peers, and the data can't really be used to refute individual allegations made by former employees.
As an overview, the larger issue is how our current healthcare system may be moving to the Accountable Care Organization (ACO) connecting health care provider's reimbursements with the total cost of quality and care - with reimbursement being tied to results.
Does this mean that HMA is wrong? Not necessarily- they provide quality care to patients without complaint and seem to be averaging numbers consistent with their peers. In my opinion there were too many open comments being made about a situation when no court has ruled and prior to sworn testimony given.
According to 60 Minutes and other follow up, there is no problem with the health care that was received at HMA facilities by patients. Neither "60 Minutes" nor the physicians interviewed identified any admission decision in which a physician's medical judgment was overridden by an HMA executive, much less to defraud Medicare. The reliance on the comments by former employees was the corpus of the piece.
With the concern of liability on the hospital's part, there should be a tendency to err on the side of the best interest of the patient. In fact, the overall data doesn't appear to reflect that HMA is admitting more patients than its peers, and the data can't really be used to refute individual allegations made by former employees.
As an overview, the larger issue is how our current healthcare system may be moving to the Accountable Care Organization (ACO) connecting health care provider's reimbursements with the total cost of quality and care - with reimbursement being tied to results.
Does this mean that HMA is wrong? Not necessarily- they provide quality care to patients without complaint and seem to be averaging numbers consistent with their peers. In my opinion there were too many open comments being made about a situation when no court has ruled and prior to sworn testimony given.
Wednesday, November 28, 2012
Changes in the hospital landscape
I have spent considerable time with high level decision makers in the last few years reviewing our products, but mostly getting a feel for how this business is changing. With the new Affordable Care Act now law, the acute care business will begin to look different in the next few years. Some of this may be old news to you, but to many its not.
As the cost and coverage implications of the ACA Medicaid expansion is reviewed, it appears that there will be a reduction in the number of uninsured IF all states participate. Participation in DSH (Disproportionate Share Hospitals) programs will certainly increase as hospitals serve more of the population that was previously uninsured but now being covered by ACA provisions. From the pharmacy perspective, hospitals gain a benefit in reduced prices via GPO contractual vehicles when they participate in a DSH program, but maintaining the percentage of eligible patients has been key to status. It appears that the ACA should make it much easier for an acute facility to comply. According to Government Data Services in 2012, about 60% of the DSH payments are aggregated between the Mid-Atlantic, Southeast, and Western portions of the county, so DSH growth in these areas should be expected by October 1, 2014.
Another trend is the integrated delivery network's (IDN) high level of interest in regional clinics. Over the last two years these "doc in a box" operations have flourished, and the trend will be expected to increase further as task forces on preventative services become more interested in wellness rather than treating after the fact. We anticipate that health educational services at clinic level outlets will explode especially with IDN's that are affiliated with universities. With re-admissions being a part of pay for performance at the acute level, hospitals now have a vested interest in keeping a discharged patient improving after they leave especially if they have acquired an ailment as inpatient. As a key feature, the ACA intends to reduce payment to hospitals with high rates of "hospital acquired conditions" (HAC's) therefore the IDN could engage post visit staff (maybe at the regional clinic level?) to make certain that the patient is following their regimen of meds and other close monitoring needed. The importance of partnering with or purchasing these local clinics can't be underestimated, and the amount of news centered on re-admissions shows that this is a hot topic for 2013.
So what does this mean to the drug marketplace? GPO's contracting vehicles will need to expand to include these new clinical operations under the acute facilities' umbrella. The present environment seems to make the operations mutually exclusive, but having a uniform formulary between acute and clinic ops and utilization of the same wholesale channel will lessen the issues of the pharmacy executive and make medication management at the business level easier.
Hot buttons? Clinics associated with hospitals - especially teaching hospitals. Wellness programs implemented via doc in the box operations. Unified pharmacy contracting for acute / non-acute.
So much for now. My next entry will focus on the hospital's involvement with discharge prescriptions as a revenue source.
As the cost and coverage implications of the ACA Medicaid expansion is reviewed, it appears that there will be a reduction in the number of uninsured IF all states participate. Participation in DSH (Disproportionate Share Hospitals) programs will certainly increase as hospitals serve more of the population that was previously uninsured but now being covered by ACA provisions. From the pharmacy perspective, hospitals gain a benefit in reduced prices via GPO contractual vehicles when they participate in a DSH program, but maintaining the percentage of eligible patients has been key to status. It appears that the ACA should make it much easier for an acute facility to comply. According to Government Data Services in 2012, about 60% of the DSH payments are aggregated between the Mid-Atlantic, Southeast, and Western portions of the county, so DSH growth in these areas should be expected by October 1, 2014.
Another trend is the integrated delivery network's (IDN) high level of interest in regional clinics. Over the last two years these "doc in a box" operations have flourished, and the trend will be expected to increase further as task forces on preventative services become more interested in wellness rather than treating after the fact. We anticipate that health educational services at clinic level outlets will explode especially with IDN's that are affiliated with universities. With re-admissions being a part of pay for performance at the acute level, hospitals now have a vested interest in keeping a discharged patient improving after they leave especially if they have acquired an ailment as inpatient. As a key feature, the ACA intends to reduce payment to hospitals with high rates of "hospital acquired conditions" (HAC's) therefore the IDN could engage post visit staff (maybe at the regional clinic level?) to make certain that the patient is following their regimen of meds and other close monitoring needed. The importance of partnering with or purchasing these local clinics can't be underestimated, and the amount of news centered on re-admissions shows that this is a hot topic for 2013.
So what does this mean to the drug marketplace? GPO's contracting vehicles will need to expand to include these new clinical operations under the acute facilities' umbrella. The present environment seems to make the operations mutually exclusive, but having a uniform formulary between acute and clinic ops and utilization of the same wholesale channel will lessen the issues of the pharmacy executive and make medication management at the business level easier.
Hot buttons? Clinics associated with hospitals - especially teaching hospitals. Wellness programs implemented via doc in the box operations. Unified pharmacy contracting for acute / non-acute.
So much for now. My next entry will focus on the hospital's involvement with discharge prescriptions as a revenue source.
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