Anthem dips toes into drug comparative effectiveness
Amid an intense debate about the cost and value of drugs, a big payer and a big pharma company are promising to comb through their collective evidence and deliver new knowledge that may improve patient outcomes.
Eli Lilly and Anthem, two corporate healthcare giants based in Indianapolis, have formed a five-year "real-world evidence research collaboration."
The companies say they will investigate "areas of mutual interest," although the project could become a model for comparative effectiveness studies, given the pressure to make healthcare in general, and medications in particular, more affordable and beneficial in the long-term.
Anthem, the issuer of Blue Cross plans in 14 states, and Eli Lilly, pharmaceutical company focused especially on diabetes and oncology, say they each have unique assets to bring to the research collaboration, including large data sets that aren't available to many researchers.
The collaboration, facilitated by Anthem's HealthCore subsidiary, will cover a range of diseases and incorporate surveys and other data from providers and patients.
"The need has never been greater to translate an ever-increasing amount of complex data into targeted and meaningful information that enables better decision-making by patients, healthcare professionals and industry," said Tim Garnett, MD, senior vice president and chief medical officer at Eli Lilly.
"This collaboration with Lilly, and ultimately patients and providers as well, will enable us to answer fundamental questions in science and clinical care," said Sam Nussbaum, MD, Anthem's chief medical officer and executive vice president. "By using this research and knowledge to address gaps in care, we can improve patient health and reduce the human and financial impact of illness."
Nussbaum and Garnett said they believe that physicians, patients and payers are all looking for the "most holistic evidence" on treatment options, including clinical trial information and evidence "from the real world" that has either not been collected digitally or studied.
Patients have more options than ever before for treatment of chronic diseases like diabetes and life-threatening ones like cancer. But doctors can still only offer approximations of what their experience will be like. And insurers, public and private, still have to rely on incomplete data when crafting formularies and treatment protocols.
"We're looking at practical approaches to accelerate the speed at which we can develop evidence in the general population, as well as specific populations, so we can get this information in the hands of clinicians and benefit patients earlier," said Mark Cziraky, vice president of research at HealthCore, the outcomes research subsidiary of Anthem, Inc.
The idea of ongoing comparative effectiveness has long been an ideal for drugs -- a way to see how new drugs fare compared to existing and older treatments, not just a placebo, said America's Health Insurance Plans President Karen Ignagni.
There is a need for this kind of real-world monitoring, particularly in oncology, where new drugs can come with prices of $100,000 annually and with what critics call only marginal benefits.
In cancer therapeutics, there is a "pursuit of marginal indications and a me-too mentality thats stifles innovation and creativity," wrote Tito Fojo, MD, a senior investigator at the NIH's Center for Cancer Research in the Journal of the American Medical Association.
"The modest gains of Food and Drug Administration-approved therapies and the limited progress against major cancers is evidence of a lowering of the efficacy bar that, together with high drug prices, has inadvertently incentivized the pursuit of marginal outcomes and a me-too mentality evidenced by the duplication of effort and redundant pharmaceutical pipelines."
Whether commercial insurers like Anthem have enough individual or collective clout to raise the efficacy bar remains to be seen.
Anthem and Eli Lilly have not specified any particular disease or drugs that will be investigated, but an examination of Lilly's portfolio would cover a number of high-profile drugs -- including the lung cancer treatment Alimta, gastric cancer treatment Cyramza, and Erbitux and Gemzar, drugs used in multiple cancers.
Another area of focus for Eli Lilly, diabetes, a disease for which the company sells 12 different products, is also an area being investigated in a research collaborative with Humana that began last year.
