EXPLAINER ISSUE 1 | SEPT 27, 2024
What do Healthcare Providers Think About Drug Pricing, and Where Do They Go to Share It?
New analysis shows HCPs primarily blame PBMs and regulators for higher drug prices; utilize social media to elevate health equity in pricing debates; encourage U.S. to look abroad for better pricing models
In the U.S., drug pricing stories in the media often frame a “patients vs. pharmaceutical companies” debate, especially since the passage of the Inflation Reduction Act in 2022. Rarely does top-tier news cover what healthcare providers (HCPs) think about pricing: whether they believe prices are too low, too high, or in between, how prices might influence care and the impact of pricing on patients. As we head into a U.S. presidential election this November, we wanted to better understand how HCPs feel about the traditionally partisan issue of drug pricing, where they go to share their views and what relevance this might have for the biopharmaceutical industry.
We turned to social media to see what HCPs have to say and found lively discussions. HCPs tended to fall into one of three categories based on their social info-sharing behaviors: advocates, data sharers, and commenters. Across categories, HCPs don’t generally hold pharma and biotech as responsible for high prices as they do pharmacy benefit managers (PBMs) and regulators. These HCPs are important vectors for real-world evidence on the patient-care impact of pricing and reimbursement policy, often highlighting health equity issues caused by highly priced new treatments for common diseases. And, perhaps unsurprisingly in the globalized world of academic medicine, HCPs also tend to suggest pricing models from other high-income countries as examples the U.S. could follow.
What does this mean for health communicators? Firstly, we can reject the idea that HCPs don’t think very much about drug pricing, as has been alleged;[1] our research shows many HCPs care greatly about it. Secondly, it’s important to listen to HCPs themselves on pricing, not just their representative associations (such as the American Medical Association, or AMA), as they may have different interests.[2] And while we know HCPs are often invited to consult with biopharma companies on pricing, the low volume of HCP commentary in pricing news coverage may indicate they are an underutilized source of fresh public perspectives. Equipping HCPs for informed public debates on pricing may be a smart way to help explode the tired, misleading “patients vs. pharma” binary.
Key Findings
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Among HCP social media users commenting on drug pricing, three behavioral categories emerged: Advocacy Amplifiers, Data Distributors, and Eager Engagers.[3]
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HCPs held three drug pricing perspectives in common: which drug pricing stakeholders are most responsible for change, the link between drug prices and health equity, and where U.S. pricing stakeholders, including policymakers, can look for potential solutions to apply here.
1 Politico: The Real Reason Why Drugs Cost So Much-And Do Too Little
2 Medpage Today: Why Are Physicians Silent About Outrageous Drug Prices?
3 Report analyzed 80,000 social media posts on X (Formally Twitter) shared by U.S. HCPs from May 2023 to April 2024 and mentioning drug pricing
HCP Behavior Changes
In our analysis, three categories of HCP social media users emerged around drug pricing topics:
Lending their voices to medically underserved communities and calling attention to ways higher prices may restrict access to lifesaving vaccines and medicines. Active in discussions about ways to boost drug accessibility for patients, including policy reforms and clinical trial design.
Sharing recent historical data about pricing, usually citing statistics from major media outlets. Often create organic (non-promoted) social posts containing facts and figures about the pricing discussion, framed around inclusion and access for medically underserved communities.
Responding to content from others more than creating their own. Willing to agree or dissent to others’ posts about drug pricing but don’t express their own opinions outright – instead restricting contributions to policy implications for patients.
Regardless of their behavior category, HCPs across the social media conversation on drug pricing seemed to align on a few key perspectives.
HCP Perspective #1
Today’s drug pricing landscape too often prioritizes profit over unmet patient needs, and government and private payers hold the keys to change.
Many HCPs shared stories about people struggling with high out-of-pocket costs and how these prices can interfere with proper care. Notably, they don’t blame the pharmaceutical industry. Instead, HCPs call on insurers (payers) and PBMs to change reimbursement practices, and on the government to introduce legislation that discourages behind-the-scenes price negotiations while supporting innovation. While HCPs agree that policy reform is needed to lower drug prices, they tend to hold insurance companies and PBMs responsible for rising costs – for example, as an outcome of so-called “secretive” pricing negotiations between insurers and PBMs. Additionally, HCPs note that drug prices are increasing much faster than inflation, which is making it even harder for patients to get the care they need.
Notably, the top-tier news media conversation around the role of PBMs in drug pricing has picked up with stories such as this June 2024 article from the New York Times headlined “The Opaque Industry Secretly Inflating Prices for Prescription Drugs.” If this trend continues, and PBMs become better known and understood by non-experts, we may see more stakeholders openly aligning to the HCP perspective. This could create new opportunities to frame and share biopharma industry points of view.
HCP Perspective #2
HCPs are socially conscious and eager to share that drug pricing and patient access are linked to equitable health outcomes.
HCPs expressed that higher drug pricing tends to exacerbate health inequities in general, and especially for historically underserved communities, such as those with sickle cell disease and other rare diseases. They believe that expensive and selectively covered drugs jeopardize access to lifesaving medicines for patients who need them for the long-term, increasing the risk of delayed treatments and other high-stakes consequences.
They also point out unmet patient needs that persist at state and national levels – such as drug shortages, lack of specialists, and laws that limit the care HCPs can provide in specific parts of the country. On social media, HCPs are strong supporters of new legislation around drug pricing, actively sharing posts from policymakers advocating for government regulation and oversight.
HCP Perspective #3
We can find pragmatic next steps in ex-U.S. models.
Many HCPs point to other countries for ideas to address rising drug prices, asserting that healthcare systems abroad have found effective ways to put patients at the center. Many high-income countries offer some form of universal coverage or have introduced legislation to reduce health disparities, making healthcare more affordable for patients. A recent review by the Commonwealth Fund looked at how eight of these countries address health inequities. HCPs shared the review on social, suggesting ideas to improve U.S. policies and practices, including Canada’s EQUIP model for equity-oriented care and various ways to reduce racial prejudice in care delivery.[1] While not all of these are feasible within the U.S. system, biopharmaceutical companies could identify and help HCPs champion the most workable ideas.
On social media, HCPs emphasized that insurers and public policy play a significant role in the impact drug pricing has on patients, by covering only certain drugs or therapies and thus contributing to treatment delays or inappropriate treatment choices. By looking at public health policies and coverage plans in other countries, HCPs believe the U.S. can strengthen its healthcare system’s offering to better serve patients.
What does this mean for biopharmaceutical industry communication?
Based on our analysis, there is opportunity for biopharmaceutical companies to help HCPs share their pricing perspectives: by providing accurate, contextualized pricing information in shareable formats and potentially by engaging with HCPs more consistently as credible voices on the patient impact of pricing.
HCP influencers could be helpful contributors to pricing strategies, and HCPs seeking a higher social media profile may be open to thought leadership collaboration. Even HCPs not willing to directly partner with industry could give insights via qualitative studies research on HCP attitudes to pricing.
Whether biopharmaceutical companies choose to engage with HCPs on pricing or not, understanding their sentiments – and those of other stakeholders – is critical. From a best practice standpoint, we always recommend biopharma companies engage with and actively listen to stakeholders across the healthcare continuum. Whatever companies’ pricing strategies, it’s important to understand their reputational and real-world impact from many angles. HCPs are more than willing to share what they think about pricing and may show support for companies that show they want to listen.
We’d love to continue the conversation about what this could mean for you. Reach out to Sarah Dick, SVP of Strategy, at IECommsStrategyTeam@inizioevoke.com.