With 30 years experience in senior positions across a number of sectors including pharma, biotech and genetics, Rob Koreman was most recently President & CEO of Global Specialty Medicines at Teva Pharmaceuticals.

We asked Rob to share his perspective in the following areas, which are predicted to have a major impact on the industry over the next few years: changes in care, chronification, outcomes-based pricing, and the shift in power between stakeholders in healthcare.

In the 30 years I’ve worked in the healthcare industry, people have consistently assured me that a big change was about to happen; that our industry was facing a tipping point with unexpected winners and losers. Clearly the power of different stakeholders has changed substantially and it will continue to do so.

Healthcare payers are taking a decisive role and strongly influencing access to medicines. Physicians are losing their previous dominant role and patients are becoming the key consumers, more informed and willing to have a voice in both the use and cost of medicines. New stakeholders are emerging and driving progress with the availability of real world data on disease progression and cost.

Will there be a real tipping point following which everything will be different, or a more gradual change? This is hard to predict, but I do believe we need to be ready to face the new challenges, opportunities and stakeholders. This will require new skills and insights, new capabilities and probably a new mindset. But I’m convinced we can continue to address the unmet needs of helping patients live better days, and helping to control the cost of healthcare. As fatal diseases become more chronic, those living with them subsequently become greater healthcare consumers.

The financial pressure on healthcare companies will continue to increase. Without clear evidence on patient related outcomes and a balanced impact on payers budgets, market access will be blocked for prescription medicines. Real world data will be key for registration as well as access. In order to address market access, risk-sharing with payers, employers and patients will become even more important. Being able to understand the true impact of a treatment using real world patient-related outcomes and to identify the groups of patients that will benefit most or least is a core capacity for a pharmaceutical or medical technology company. Going forward this will be even more important.

Patients have become much more involved with their disease. They actively look for information on disease, treatment options and physicians. They expect pharma companies to actively engage in communication on their disease, treatment and access, on behavioural aspects of managing chronic conditions and to ensure transparent information on medicines they receive. They will look for means of primary and secondary prevention and we can play an active role in helping healthcare professionals as well as patients in best avoiding or managing disease. For this we will need to step out of the shadow and openly engage.

Many retailers have already committed to being much more of a true partner to patients/consumers. They have not only moved up and down in the value chain but also offer a very comprehensive and direct service to patients. With groups like Amazon entering, retail is set for more change. Pharma will have to engage and participate to avoid marginalisation. I envisage real challenges for many companies to stay relevant. Only very few will have such a unique and relevant product offering that they can continue to do business as usual. I predict other companies will be at risk of becoming less relevant if they only bring a pharmaceutical product to market and will subsequently see less value creation. However, if you do have that truly unique offering that addresses a clear unmet medical need, regulators and payers will continue to restrict patient access and uptake will take much longer then only 3-4 years ago. Again, having evidence on true impact on patients and budgets will be key. Being able to confirm the value early during launch will be equally important to keep pricing, labelling and access.