Lupin 2023

GSK Rx division responds to shift toward value-based health care

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PHILADELPHIA — GlaxoSmithKline is changing the way it operates, both internally and in terms of how it interacts with other health care stakeholders.

“We recognize that we cannot force-fit old business models in a new health care environment,” said Jack Bailey, senior vice president of policy, payers and vaccines for the company’s U.S. operations, at the National Association of Chain Drug Stores Annual Meeting in Palm Beach, Fla. “We must work together, as partners, in order to succeed, and we must realign to focus on what customers are looking for and what patients need.
“One of the changes that we are most proud of at GSK relates to how we’ve incorporated the shift from a volume-based to a value-based health care system within our own organization.”

Among the multitude of changes the evolution of the company’s strategy has brought about is the creation of a unit dedicated to retail pharmacy professionals, which it refers to as the Community Pharmacy Team.

Launched a little over a year ago, “this new team is focused on collaborating with pharmacists to promote appropriate utilization and adherence to chronic disease medications, especially with regard to counseling at the critical first prescription,” Bailey told attendees at the NACDS event. “With the introduction of the community pharmacy team, GSK is engaged at every level of retail pharmacy support — from pharmacy chain headquarters to the individual pharmacists and technicians who interact with patients every day. Ensuring top-down support and developing customized plans for each retailer has been critical to the success of our community pharmacy team.”

The group, which includes 82 clinically trained professionals, most of whom are licensed pharmacists, works directly with customers to provide education and resources specific to the retail pharmacy professionals in therapeutic categories where GSK is strongest, including asthma and chronic obstructive pulmonary disease (COPD), very high triglycerides, benign prostatic hyperplasia (BPH) and vaccines. The point of contact between pharmacy professionals and customers is the focal point.

“Our goal is to make sure that the pharmacist-patient interaction is meaningful and impactful, because we know that anywhere from one-third to one-half of medications aren’t used properly,” said Bailey in a subsequent interview. “Research shows the problem costs the health care system $290 billion a year. At GSK, we want to do what we can to help pharmacists address this important issue.”

In addition to providing educational materials and other support for pharmacists to assist with their patient counseling interventions, GSK is offering them information and support for immunizations, including such adult vaccines as Tdap. In recent years state regulations have been altered to enable pharmacists to administer flu shots and other vaccines.

“That’s another shared area of interest for our pharmacy customers and for GSK,” Bailey noted. “We’re the global leader in vaccines, and we feel it’s incumbent upon us to assist in building out this adult immunization infrastructure, both from a public health standpoint and to achieve our mission of helping patients do more, feel better and live longer. The stars are aligning with where pharmacies want to go.”

The GSK initiative has been well received by retailers. According to a customer value metrics study administered by a third party, the company’s community pharmacy team is rated No. 1 among eight major pharmaceutical companies across multiple dimensions, according to Bailey. “From the customer standpoint, the execution metrics and, over time, the impact on patients and the business, we feel very good about where we are with this one year out of the gate,” he said.

Another sure sign of the new thinking at the company is the way it compensates its sales force. “In 2011 we became the first pharma company to decouple the pay of our sales representatives in the United States from the number of prescriptions issued,” explained Bailey. “Instead of measuring performance against territory or individual sales targets, we assess performance and determine bonuses on three factors — selling competency, customer evaluations and the overall performance of the business unit they support. The new program aligns more closely with our commitment to investing in our people, helping our customers improve patient outcomes and putting greater emphasis on the ways in which our sales professionals interact with our customers.”

The realignment of GSK’s business coincides with the restructuring of the U.S. health care system. The Centers for Medicare and Medicaid Services reported that health care spending accounted for 17.9% of gross domestic product, or some $2.6 trillion, in 2010, the last year for which figures are available. Although those costs grew at the relatively low level of 3.9% that year, there’s widespread agreement that the system remains on a fiscally unsustainable course.

“We all have to ask ourselves how we move from volume to value,” noted Bailey. “How do we align as a player in the health care system to make sure, in our case, that patients are getting the right drug and using it properly? Chronic diseases are the biggest cost drivers in health care, and they can be managed most effectively by prescription drugs.

Medications and community pharmacists clearly have a big role to play going forward.

“At GSK we’ve rewired our R&D model so that we have a flow of innovation that’s deemed the best in the industry, but we have to be able to effectively launch that best-in-class late-stage pipeline into this changing and evolving health care system. What we’re doing with the community pharmacy team is a big part of that. It does no good to have great innovation if it isn’t accessible to patients. In order to succeed, we have to work very closely with customer groups, especially folks like community pharmacists.”

Finding the best way to provide value is a central consideration for GSK. It affects decision making in every part of the company’s business, beginning with research and ­development.

“We’ve committed to gearing the pricing of our products to value,” Bailey said. “It’s part of the reason we have payers look at our assets in development. At the end of the day, we want to make sure we deliver demonstrable value backed with tangible evidence.

“We’re going to go where the science takes us, and we certainly look for areas where there is an unmet medical need. But even with those considerations, we want to make sure that our customers — the payers, who ultimately are reimbursing a significant portion of that innovation — find value in what we do based on its ability to offset costs by lowering absenteeism and improving productivity in the workplace. We always want to provide a better option than what currently exists in whatever therapeutic area we’re targeting.”


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