In July 2016, CMS’ announced that it plans to initiate a mandatory bundled-payment program in cardiology that parallels its current orthopedic bundled pricing program. This is another indication of CMS’ commitment to alternative payment models that make delivery organizations financially accountable for the cost and quality of care they provide. As healthcare delivery organizations prepare to operate in this environment, we expect to see continued erosion of individual physician influence on product decisions. In its place, committees that include physicians and administrators will exert more influence that reflects institutional priorities. This has important implications for pharmaceutical manufacturers.

In this environment, delivery organizations are trying to make more structured and scientific attempts to look objectively at the value offered by products. Organizations like ICER and The Evidence Street are designed to help providers develop consistent methodologies for evaluating information presented to them. Marrying these insights with their own organizational priorities, delivery organizations will narrow the list of options they provide clinicians. Demands for economic and clinical data will continue as organizations try to understand the differentiated value of pharmaceutical products.

To succeed in this evolving environment, it is growing more critical that manufacturers challenge the assumptions on which they have built their commercial models. Manufacturers must develop and utilize new capabilities to target an evolving customer base that includes healthcare delivery administrators as well as physicians. This will require a greater emphasis on delivering value that extends beyond the acute care environment. Here are three core ideas pharmaceutical manufacturers should consider in modifying their commercial approach and addressing the changing needs of customers.

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