When it comes to winning in basketball, there are two competing schools of thought: “Offense sells tickets; defense wins championships” and “A good offense always beats a good defense.” Which statement is true? Many will say that it depends, choosing one or the other depending on the strengths and capabilities of the teams. Others will say that neither statement is accurate.
Similarly, when it comes to winning efforts to manage drug costs, two overarching strategies can be seen as defensive or offensive, respectively:
- Development of policies by legislators, the HHS, and organizations to lower prescription drug costs and increase competition
- Health systems and new entrants building and leveraging infrastructures, innovations, and capabilities to manage drug costs
As drug cost prices escalate, many people are asking, “Which strategy will work?”
Defensive Focus: Policies and Politics
Consider some of the best defenders in NBA history—Dikembe Mutombo, Ben Wallace, Hakeem Olajuwon. One of their key goals was to prevent the offense from scoring by either blocking a shot or preventing a shot from being taken.
Over the past several years, legislators and the HHS have proposed and approved policies to prevent or significantly reduce the increase in prescription drug costs, as well as changed processes at the FDA to spur competition. Over the past two years, the administration has taken a “no sacred cows” approach when it comes to implementing new policies and initiatives to prevent or minimize increases in healthcare and drug spending. It has moved forward with some of these substantial changes despite significant opposition.
Offensive Focus: Programs and Practices
While defensive strategies focus on preventing an increase in drug costs, offensive strategies target ways to effectively manage drug costs. Many organizations and new healthcare and pharmaceutical entrants are focused on leveraging teams and technology; implementing new infrastructure and business capabilities; developing and operationalizing new models and practices; and maximizing the skills, scope of practice, and strengths of team members to build effective practices and programs. Offensive strategies are just as important as defensive strategies because they operationalize the ideas that will help in lowering drug costs and improving patient outcomes. What would basketball be like without great offensive players like Michael Jordan, Kobe Bryant, or LeBron James?
Which Way Is Better?
At the beginning of this article, we asked which way of thinking was more effective. The answer is neither one. For a payer or for a health system, in the quest to address drug costs focusing on offensive or defensive strategies by themselves may yield only an occasional victory. To have consistently successful, scalable, and sustainable drug utilization action and management capabilities, interdependence and balance between offensive and defensive strategies are key.
It is important for manufacturers to understand how payers and health systems implement defensive and offensive strategies to manage drug costs. Gaining insight into government policies as well as payer and health system programs offers opportunities for manufacturers to create proactive solutions and possible partnerships. Managing drug costs benefits all stakeholders in the complex US healthcare system. And regardless of offense or defense, it takes a team to win.