At this time of year, there is the expected stream of top-notch analyses about trends in health – from innovations to watch to people to follow. The #1 go-to trend word of 2023 was artificial intelligence. GenAI is the hottest technology transforming the entire health ecosystem – from drug development to patient diagnosis to determining who is at risk for illness – and the conversation around the technology’s implications and use cases will only accelerate in the new year.
Medika Life published a piece titled The Top 20 AI Voices to Watch some months ago, and most of the thought leaders, influencers, and theorists featured have continued to demonstrate why they lead the AI conversation.
But AI isn’t the only significant advancement, problem, or concern clouding the future of innovation and patient care. We can’t allow the AI boom to distract from the other issues that should be on sector leaders’ radar screens while we read about the hot trends and people to follow in 2024.
[Hear first hand Michael C. Mann, host of Planetary Health First, Mars Next, and Gil Bashe discuss the importance of this Top 10 Health Issues list.}
It All Ties Back to the Cost of Health – Election Year 2024
Get ready for the 2024 election cycle! Presidential and down-ballot candidates will be the loudest voices trying to appeal to public sentiment and pinging voter pain points.
Congress has several health issues influencing drug innovation and affordability on its radar screen. There is little doubt that Congressional staffers from both parties have made the cost of prescription drugs a front-and-center policy focus so that medications are more affordable for constituents. Measures that empower Medicare to negotiate drug prices and increase transparency make good press. But in the US health system, when you fix one thing, you will break another. Our system is fragmented. One sector executive has little idea of how another’s business model works.
Drugs are a relatively small piece of the overall health puzzle that hit employees and consumers. Still, they’re apparent pocketbook issues and popular targets for elected officials seeking simple solutions to complex health cost problems. Take, for example, the Inflation Reduction Act (IRA) of 2022. The IRA is the significant legislative effort that connects drug pricing to Medicare reimbursement. This piece of pivotal legislation has industry executives and investors up at night considering the law’s provisions on direct negotiation, Part D coverage and the inflation price cap.
Utilization Offsets Price Reductions – We Hope
As industry champions navigate (or confront) legislative issues, those same stakeholders must collaborate with payers, policymakers, providers, and patient communities to ensure that future policies result in a health system that supports innovation and provides greater access. That was a core reason pharma companies came to the Obamacare table enthusiastically. Greater access translates into more utilization, which offsets price reductions.
Biopharma industry advocates’ biggest fear is that pricing flexibility and profitability loss will negatively affect drug discovery and development investment. Policymakers hopefully recognize that there’s some truth in this pushback. Lawmakers must explore ways to incentivize drug innovation, such as tax credits and grants for research and development in critical areas while promoting cost-cutting and affordability measures.
Top 10 2024 Public Health and Legislative Issues to Watch
- Access
Policies to reduce healthcare disparities and improve affordability expand access to care for underserved populations, while initiatives to incentivize healthcare workers to serve in underserved communities improve access. While addressing cost, drug pricing reforms impact pharmaceutical companies’ ability to invest in research and development, potentially affecting the availability of new treatments.
There can be no “villains” in fixing the access conundrum. Collaboration is a must! No one can debate in good faith that a healthier population reduces overall health costs. But does anyone care enough to act? The US health GDP is unsustainable as it nears 20%. That does not mean we should turn away from expanding access. It requires Congress to finally accept that the Affordable Care Act isn’t going anywhere and look to refine it, making timely access that keeps disease at bay a bipartisan ideal.
While the IRA will reduce the burden of cost around insulin and other medications for seniors, it does not resolve the access to care challenge for millions of Americans. Payers must consider their role in helping people with chronic conditions and reduce the chaos resulting from non-medical switching.
- Affordability
Affordability remains the chief concern of the public, legislators, and the health industry. Rising health costs put immense pressure on patients, payers, and providers. Public policies are expected to address this issue through price transparency, cost-control mechanisms, and expanded access to affordable health options. The heat on biopharma companies will continue to increase.
- Climate Change and Health
The intersection of climate change and public health is inescapable. Policies addressing climate change and its health impact will lead to peer-review research and climate technology approaches in health, such as adapting infrastructure to deal with extreme weather, air-quality warnings, and debunking myths that climate change has no human health impact. Bottomline, the planet doesn’t need people! People need the planet. Keep planet earth healthy!
- Data Security
Health data is going digital – all the way. With the increasing digitization, protecting people’s data is paramount. Stricter data privacy and security regulations require companies to invest in advanced cybersecurity measures, pumping the brakes on some innovations due to compliance needs. Prioritizing cybersecurity requires technology, training, and investment. How can hospitals keep pace with digital health innovation and meet their skilled staff and resourcing needs? Federal policy leaders will need to consider special appropriations to make that feasible. Otherwise, more community-based hospital systems will go broke.
- Drug Access and Equity
Ensuring equitable access to medications is pressing. Policymakers must focus on reducing disparities in drug access, potentially through IRA-like pricing reforms, which will negatively impact the pharmaceutical industry’s profit margins. We must also closely examine how pharmacists can play a more significant role in dispensing medications for specific medical conditions. Pharmacists are in almost every community – hospitals can be hours away.
Addressing healthcare disparities, particularly in underserved and rural communities, cannot be lip service. Rural communities have higher burdens of preventable conditions such as obesity, diabetes, cancer, and injury compared to urban populations. Public health policies must prioritize improving women’s health, preventive education and health access and increasing representation in clinical trials. This requires mobilization from varied government agencies working with the private and nonprofit sectors to deploy resources to hotspots suffering from limited access to health care providers and social services.
- Health Worker Burnout
The healthcare workforce is strained due to an aging population and increased service demand. According to one recent survey, one in three workers planned to leave their position, with 14 percent of respondents saying they were prepared to go the discipline entirely in 2024. Public health policies must address workforce shortages and pilot innovative training, telemedicine, and technology approaches to support the physician/patient relationship beyond simply pressuring doctors by increasing workflow to see more patients daily.
- Innovation Vulnerabilities
Lawmakers are looking closely at reforming the patent system to prevent abuses that stymie generic drug competition. Stricter regulations on patent extensions and exclusivity periods encourage competition and lower drug prices. However, the problem has been that the largest generic drug companies deploy vast legal teams, challenging innovator patents and using these suits as “blackmail” to secure deals, positioning early market generic entry. “Pay for delay” is a double-edged sword. Congress must strengthen patent protection if it elects to lower the bar for generic companies to compete.
- Mental Health
The COVID-19 pandemic brought the mental health crisis to the front pages. It took a taboo topic and gave families permission to go public with their burden. Mental health stigma is an obstacle to treatment. Schools and employers must champion public health policies that continue prioritizing mental health services. Likewise, policymakers must push for long-needed action in higher and primary education settings, digital mental health platforms and through increased accessibility to mental health care.
- Pandemic Readiness
We failed! Communication is always part of the health delivery and access process! The shadow of the COVID-19 pandemic revealed a systemic lack of preparedness, underscoring the need for better response strategies based on the learnings from acknowledged failures. Public health policies in 2024 are likely to prioritize investments in research, vaccine distribution, and infrastructure to ensure readiness for what is almost certain a stream of future pandemics. This will drive innovation in vaccine development, distribution systems, and, yes, the need to add public health communication expertise.
- Telehealth
Telehealth has seen explosive growth in recent years, driven by the pandemic, patient-care convenience, and a need to reduce carbon impact. Policymakers must balance the accessibility and convenience of telehealth with ensuring quality of care and data security. Stricter regulations impact the telehealth and digital health industry, and watchdog groups must prioritize access, avoiding the quicksand of reimbursement disadvantages and physician styles. Telehealth must be prioritized to ensure it’s not just about urgent access but also about making care easier for the consumer. Face it, the consumer – while certainly core to all the top issues – is rarely the center of attention of the system. That must change and telehealth is a clear benefit for patients.
Election 2024 Will Place Health and Cost In the Spotlight
These health issues ought to be at the forefront of Congress’s agenda to strike a balance between fostering continued waves of drug innovation and ensuring Americans can access medications at affordable prices. 2024 promises to be transformative for the health industry, driven by public health policy issues and filtered through the distorting lens of an election year. Innovation is about more than discovering and developing new products. It translates into access to care with policies targeting affordability, tackling health disparities, and increasing mental health services.
Driven by technological and health information advancements, changing demographics, and shifts in public health priorities, the life science industry is constantly evolving. Public policy makes Presidential and state candidate debates entertaining – and worrisome. Suggested policies that shape the operating landscape for hospitals, biopharma companies, and digital health companies are designed to protect the public interest. But the public’s needs and business must not conflict.
What can we expect will happen? Check your crystal ball!
