Using real world data to experience real world success 1

Assessing drug performance on health outcomes, utilization and total costs of care associated with the drug is critical not only for pharmaceutical companies but also payers to ensure value-based outcomes. Data-driven insights become especially important as life sciences companies enter value-based contracts with payers. Performing such analysis needs a strong foundation of data assets, clinical and analytics expertise to truly perform healthcare economics outcomes research validation. With this intelligence, pharmaceutical companies can place less financial burden on patients, while entering more favorable contracts with payers.

EXL’s solution

EXL’s Health Economics and Outcomes Research (HEOR) solution can help meet the challenges associated with proving optimal health outcomes as well as financial success. EXL’s HEOR solution not only brings this valuable real-world data to the table, but it also empowers payers to help life sciences companies effectively leverage this information to improve outcomes and reduce costs by offering.

Perhaps most importantly, EXL works closely with life sciences companies to implement a standardized, proven approach that is highly likely to improve outcomes and costs.

Case study: Comparing total cost of care and outcomes for drugs that treat arthritis and several other conditions

Assessing the challenges

This healthcare organization needed to compare the total costs of care for patients being treated with its drug for rheumatoid arthritis and several other indications to those patients being treated by other drugs as well as to those receiving no treatment whatsoever. The drug had a history of being highly profitable for the company – and leaders wanted to maintain momentum in the market.

Leveraging the HEOR solution

EXL’s solution compared total cost of care and outcomes to an alternate drug that also offered a biologic drug. The solution also conducted a similar cost of care and outcomes analysis to patients who were being treated with non-biologic drugs as well as to patients who were receiving more than one biologic therapy and finally to those who were not on a defined treatment.

Embracing valuable insights

This analysis uncovered several useful observations:

i. Costs

  • Adults with Chron’s Disease had the highest costs followed by Psoriatic Arthritis for Commercial and Medicare populations, for both new & existing patients
  • Prescription expenses for Psoriatic Arthritis and Chron’s Disease was higher than costs for other conditions

ii. Utilization

  • Existing members with Rheumatoid Arthritis had the highest percentage of members taking non-biologic drugs along with biologics for both Commercial and Medicare populations
  • New members with Akylosing spondylitis had the highest percent of members taking non-biologic drugs along with biologics for both Commercial and Medicare populations
  • Members with Rheumatoid Arthritis and Psoriatic Arthritis were more prevalent in Commercial population cohort
  • Medicare members with more than one condition along with Rheumatoid Arthritis preferred the life sciences company’s drug whereas commercial patients preferred a combination of other biologics with the life sciences company’s drug

iii. Compliance

  • Existing members with Ulcerative Colitis and Chron’s Disease conditions showed higher drug adherence compared to members with other conditions
  • The pharmaceutical company’s drug had the highest population days covered medication adherence rate for existing and new patients
  • Existing Ulcerative Colitis and Chron’s Disease patients showed higher adherence with the life sciences company’s therapy, compared to other members with other conditions

Taking action

With these insights and others, the pharmaceutical company was able to emphasize the compliance, utilization and cost benefits of their drug enroute to demonstrating the overall clinical and financial value of their treatment to care providers and patients. In essence, with HEOR, EXL could help the pharmaceutical company sustain the drug’s market leading position by leveraging real-world cost and outcomes data to improve outcomes and reduce costs – and ultimately negotiate better value-based contracts with payer organizations.

Perhaps most importantly, having access to this sophisticated data analysis positioned the life sciences company to better negotiate with payer organizations and to ultimately enter into favorable contracts that reduce the financial burden on patients – an important consideration in this era of value-based care.