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July 1, 1998
by Kathleen Kimball-Baker
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Improvements in healthcare are impossible without patient outcomes data. So are R&D efforts at pharmaceutical companies. But if providers and drug companies can throw their energies together, the result may be a giant leap forward in outcomes research.

Like everybody else in healthcare, drug companies need information to compete. But short of undertaking the overwhelming job of following patients around to check their drug regimens, their compliance and their outcomes, drug companies have had no way to get the kind of information that would tell them how to better produce and market their products. Enter healthcare IT.

The pharmaceutical industry’s interest in healthcare IT revved up when the Clinton administration began blaming it for surging costs during the early days of healthcare reform. "Pharma was a major whipping boy back in 1993," says Mark Zitter, president of the Zitter Group, a San Francisco-based healthcare conference, training and publishing firm. In defense, pharmaceutical companies looked for ways to do more than sell pills, especially with managed care threatening to hammer down profits with the dreaded "f" word: formulary. But they needed more information. Specifically, drug manufacturers needed answers to such post-marketing questions as: What exactly were doctors prescribing their products for? Were there new indications to pursue with the FDA? If patients picked up their prescriptions, did they actually take them? Were patients satisfied and getting better with their treatment? And the hardest question of all: Were the drugs cost-effective?

Pharma heavyweights such as Glaxo Wellcome and Pfizer began testing the concept of disease management, bringing to market their knowledge of disease processes in hopes of collaborating with providers or adding value to their products. Others, such as Merck, Smith Kline Beecham and Eli Lilly bought pharmacy benefits management businesses as a way to diversify and sniff out some answers. Forward-thinking companies began exploring the need for a computer-based medical record, often infusing much-needed funds into fledgling companies. Over time, every self-respecting pharmaceutical company had launched a Web site, with widely varying degrees of quality and interactivity.

But now, some five years later, drug companies are still seeking the same information--and still not getting much of it.

Pharma’s perception problems
Part of the problem has been perceptual. "Pharma has been frustrated by its ability to work with the healthcare data world to get information of benefit without being seen as unnecessarily mercenary," says Ronald Waife, president of the Massachusetts-based healthcare consulting firm Waife and Associates. Managed care organizations have been slow to cozy up to large-scale disease management programs crafted by drug companies, often preferring to retain traditional relationships--meaning: "just give us the lowest price on drugs, thank you."

In pharma, one tried-and-true method of changing perceptions has been the decidedly low-tech means of hosting or paying for events--meetings, conferences and seminars. Providers, drug companies have found, will attend pharma-sponsored learning events on such topics as disease management, outcomes and clinical information systems. In fact, Mark Zitter’s Center for Outcomes Information, whose clients include both providers and pharmaceutical manufacturers, has twice been named by Inc. Magazine as one of America’s fastest growing companies. Zitter markets as a strength his firm’s ability to foster information exchange between the two groups.

And Zitter isn’t the only one making the most of IT learning events. Last fall, Hoffman-La Roche together with the Smithsonian Institution sponsored a high-brow symposium entitled "Parallel Revolutions: Managing Improvement and Quality in the Information Age," and invited to it healthcare IT thought leaders and CEOs, CIOs, CFOs and other senior executives of major healthcare organizations throughout the country. The proceedings will be preserved in the Smithsonian’s permanent research collection on information technology at the National Museum of American History in Washington, DC.

Why did Roche go to such lengths? "It’s our bias that data sets and clinical pathways between people are more important than any of the bricks and mortar in healthcare," says Richard Evans, vice president, business policy and account management at Roche. To compete, he says, companies like Roche must deliver quality at the best cost, and "to do that, we feel we can no longer approach every patient without reference to patients of a similar type," which means mega needs for crunchable data."We wanted to check our view," says Evans, "and advance the industry dialogue."

A few months later, Bristol-Myers Squibb sponsored the second annual Conference on Integrated Patient Care in Washington, DC, as part of "an ongoing initiative to transform our current healthcare system with its many disparate and disjointed parts into one in which all sectors work in concert for the benefit of the patient," according to promotional literature. Information technology, of course, is key to such an approach to care.