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Health care trends: Changes in drug pricing, cancer therapies, and treating mental health patients

Aug. 23, 2016
JoAnn Gurenlian, RDH, says health care, research, industry, technology, patient needs, politics, and market trends impact the health-care system.

By JoAnn Gurenlian, RDH, PhD

Health care, research, industry, technology, patient needs, politics, and market trends impact the health-care system. The year is two-thirds over, and we have seen some interesting changes in health-related industries, research, and corporate collaborations. Some key trends to monitor are highlighted below.

Drug-pricing solutions are a top trend this year. Concern over the cost of medications has reached an all-time high. Even generic drug costs have increased on average 9% since 2014. No longer will consumers accept attempts such as Turing Pharmaceuticals to raise drugs such as Daraprim by nearly 5,500% overnight. Health-care CEOs, Congress, and even Wall Street are examining reforms for drug pricing. Pharmaceutical companies are exploring alternative financing models, which would spread out payments for expensive drugs, making the costs for consumers easier to manage. Other companies are considering outcomes-based reimbursement agreements in which the pharmaceutical companies and insurers or health systems will link payment for a drug to the health outcome. Lastly, costs of drugs may be affected by the development of biosimilars. These drugs are near substitutes for an original prescription medication and may serve as a new cost-containment strategy if the original biologic has become cost prohibitive.

Another exciting trend is cancer immunotherapies. Already, Opdivo and Keytruda have helped improve response rates and survivals for patients with advanced nonsmall cell lung cancers. Avelumab is the newest immunotherapy being evaluated as part of solid tumor studies. This cancer therapy "personalizes" treatment and may be a game changer for more effectively locating and fighting some types of cancers.

Although one out of five American adults experiences mental illness, behavioral health care tends to take a backseat to other health-care issues. Fortunately, employers and telehealth technologies are partnering to prioritize opportunities to support mental health awareness, prevention, support, and treatment in the workplace. Employers and health plans are beginning to support collaborative, team-based models that link primary care with behavioral health-care specialists using telehealth models. Almost three-quarters (72%) of individuals age 18-44 were willing to use telehealth services, such as videoconferencing, to access mental health-care providers, while 43% of those 45 and older felt similarly inclined (Healthcare consumerism: Top health issues 2016: PwC at

Consumers are beginning to manage their health care similar to how they manage their retirement plans. Financial advisors are helping consumers guide decisions on how best to allocate health-care finances into long-term financial planning. Further, and interestingly, health-care payment and billing are being inserted into other types of consumer experiences such as rewards, frequent flier miles, discounts, and points. Consumers may receive life insurance premium discounts and accumulate reward points for engaging in health lifestyle behaviors and smart health-care shopping. Some companies are establishing transparent health-care marketplaces, allowing consumers to shop for routine care at competitive prices. Consumers can review total out-of-pocket expenses, provider reviews, online payment portals, and financing systems in advance of appointments and better manage their health-care spending.

What do these trends mean for the world of dental hygiene and dentistry? It may well be that we will start to see the medication part of the health history change. Patients may be able to access information about all of their needed medications. They would be better informed as they take their medications and then receive the full benefit of them. Some patients may be undergoing immunotherapy and surviving cancer once thought to be untreatable.

Other patients may finally be receiving the mental health care they needed. Depending on their treatment, we may be able to access their health-care provider, via telehealth, to ensure there are no oral implications from medications prescribed for their condition. Finally, if consumers can customize their long-term health care, it would be terrific if, at some point, there was recognition that oral health care was as important as general health care, and that long-term oral health care was integrated into that plan. I think that is worth at least some frequent flier miles, don't you? RDH

JOANN R. GURENLIAN, RDH, PhD, is president of Gurenlian & Associates, and provides consulting services and continuing education programs to health-care providers. She is a professor and dental hygiene graduate program director at Idaho State University, and president of the International Federation of Dental Hygienists.