The CDC has defined social determinants of health (SDoH) as “the circumstances in which people are born, grow up, live, work, and age.” Those circumstances also include the systems in place that offer healthcare and services to a community. In turn, all of the foregoing conditions are shaped by a wider set of forces: economics, social policies, and politics.
In a recent Call To Action to address SDoH, the National Quality Forum’s President and CEO Shantanu Agrawal, MD, MPhil, noted, “Addressing social determinants of health is key to driving meaningful health improvement across populations.”
SDoH have become an important concern for payers and health systems. These stakeholders acknowledge outcomes and costs depend on factors that go beyond medical care. They are transforming their delivery systems to address social risk factors, aiming for better community engagement and clinical and financial outcomes in an environment that is increasingly incentivizing value-based performance.
Pharmaceutical and device manufacturers have a timely opportunity to help overcome the barriers that managed care organizations and practitioners face when trying to tackle socioeconomic factors, particularly in addressing medication and device adherence. For example, with U.S. pharmaceutical manufacturers annually losing an estimated $250 billion in potential revenue due to medication nonadherence, manufacturers should be interested in capturing additional revenues through support of adherence.
If so, manufacturers are likely to find collaborators in plans, PBMs, IDNs, health systems, and ACOs seeking resources and support to address SDoH. In a Precision for Value survey conducted this year of key access decision makers, all respondents reported they already have, are planning, or are willing to consider future collaborations with pharmaceutical and device manufacturers in addressing SDoH.
Based on results by survey participants, the social risk factors guiding their planning with manufacturers include:
- Access to affordable healthcare services and medications (93%)
- Access to mass media and emerging technologies (89%)
- Services to support health literacy (89%)
- Telehealth services (82%)
Given this shared interest in lowering social barriers to care among plans, organized providers, and manufacturers, opportunities for ambitious, innovative solutions exist. For example, hub services offer opportunities for the delivery of patient-centric care, meeting patients’ growing expectations for acutely consumer-sensitive, “Amazon.com-like” care.
As noted by Nicholas Basta, editor-in-chief of Pharmaceutical Commerce, while hub services have historically focused primarily on helping patients and providers navigate the prior authorization process to obtain reimbursement for a therapy or device, hubs have been expanding their functions to “wrap-around services,” facilitating access to needed therapies or devices and addressing barriers to adherence. Precision Xtract industry consultants recently postulated this expansion is likely to accelerate in concert with the emergence of more complex therapies such as gene and cell therapies.