In a recent short report, I highlight the entry of the pharmacy benefits manager (PBM), Medco Health Solutions, into the life science ecosystem with their acquisition of United BioSource Corporation.  Just a few years ago, this acquisition would have passed with little interest, with most people not knowing who either of these companies are and wondering why the announcement was made with a focus on the life sciences.  Times are changing, however, and the relevance of the announcement heralds a changing life science ecosystem.  United BioSource Corporation is a leading health economics and outcomes research (HEOR) vendor in a world that is increasingly requiring justification for the reimbursement of increasingly high priced new drugs.  As part of its role as PBM, Medco Health Solutions works on behalf of healthcare payers as an intermediary to distribute pharmacy benefits.  With multiple healthcare payers under its umbrella on one hand and a large network of contracted pharmacies on the other hand, PBMs negotiate the best volume buying on drugs.  This first step at drug price negotiation may be of initial interest to pharma companies, but with no direct product competition, isn't yet a game changer.  As part of their benefits delivery effort, they also monitor prescription utilization (i.e. "scrips").  This scrips data is seeing increasing interest in the shadow of Vioxx, with the government's Sentinel program hoping to uncover drug safety issues more quickly and effectively.  Combining HEOR insights with early insights into potential drug safety issues is part of the new landscape that life science companies will need to embrace if they are to operate effectively in the future.

Rumblings fom Whitehall certainly indicate that one of the largest national IT programs ever undertaken in the UK is about to come to an end, at least in its current form.  The much touted and highly controversial National Program for IT (NPfIT) is big, expensive, and has failed to deliver on its promises.  Because the costs and complexities involved in terminating existing contracts are probably too much for the government to even contemplate, the program is likely to be overhauled rather than killed completely. 

On June 9, 2010, the $1.3 billion acquisition of Eclipsys Corporation by Allscripts-Misys Healthcare Solutions, Inc. was announced.  Eclipsys is a vendor of primarily inpatient, but also ambulatory EMRs, while Allscripts has focused on the ambulatory market exclusively.  In thinking about the upcoming  merger, the ambulatory EMR picture just sounded really confusing.  While we published a Perspective report last week covering what we feel will be the implications of the merger for hospitals and practices using Eclipsys and Allscripts products, we found that listing and counting the ambulatory EMRs started to make the picture (and the potential issues for end users) a little clearer.  

In reference to physician adoption of technology, ONC deputy national coordinator for programs and policy at the Office of the National Coordinator for Health IT called for "bold incrementalism" in statements in June 2010.( Wednesday, June 16, 2010 ONC Official Calls for 'Bold Incrementalism' in Health IT Adoption, iHealthBeat). The statements suggested that physicians would likely have to adopt new technologies in an incremental fashion, but that the step-wise process should not deter forward movement. Healthcare payers are facing challenges that also suggest an incremental technology management strategy may become more mainstream.

It's all about the stimulus funding here in Chicago.  Every vendor is trying to craft a story to capture future stimulus funding from the ARRA.  While the EMR vendors are the obvious beneficiaries, vendors from every segment are trying to grab a piece of the pie.  Networking, security, hardware, software and services vendors are all talking about the role they should play in the new digital healthcare environment.  While optimistic about ARRA, end users said over and over again that they lack the details necessary to begin to spend, and they are looking for more guidance and information on the actual certification and reimbursement process.  Several large vendors (Oracle, Cisco, GE) have stepped up with support for the customers by hiring grant writers, and offering capital to help accelerate customer investment.  Never before have large enterprise vendors offered the customers this type of support.  Should end users take advantage of this opportunity?  Should other vendors jump on board with programs like this?  Let us know what you think.