Using real world data to experience real world success 3

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: Bringing cost data into the mix when comparing asthma drug outcomes

Assessing challenges

This organization was interested in assessing the total cost of care and health outcomes associated with patients taking their asthma drug versus those taking similar therapies from other drug companies. As such, the company needed to identify the key clinical and demographic attributes for patients suffering from respiratory disease conditions, including asthma and severe asthma.

Leveraging the HEOR solution

To accomplish this, EXL’s HEOR solution examined cohorts of patients that were taking their drug versus those taking drugs from competitors across various lines of business, including commercial health plans, Medicare Advantage and Medicaid. EXL’s HEOR solution was able to zero in in on how their drug compared to another biologic drug that competed directly with their offering. These insights would help the pharmaceutical company develop and leverage a more complete profile of patients, which could lead to the strategic and tactical implementation of programs to improve healthcare outcomes for respiratory disease patients.

Embracing valuable insights

Through the HEOR analysis, the life sciences company learned:

  • Total costs of care for patients being treated with its drug were higher than costs of care for patients being treated with the therapy from another drug
  • Higher costs were attributed to differences in the treatment protocol
  • Despite minor differences in absolute values, prospective risk of the drug users fell into the middle range of the commercial and Medicare Advantage users
  • The drug had patients with the highest prospective risk in the Medicaid population
  • While the distribution of chronic comorbidities is almost identical across users of all products, patients taking the company’s drug and those receiving treatment from its closest alternative had larger chronic disease burden
  • Healthcare costs of the company’s therapy were higher than those of its alternative option in spite of similar demographics mix
  • This difference was attributed to the substantially larger spending in ancillary services