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Monthly Archives October 2015

Open Payments Wabi-Sabi

Cracked Face

Unlike the Western World’s cultural devotion to “perfect beauty”, in Japanese art and culture the aesthetic of “Wabi-Sabi” – beauty that is “imperfect, impermanent, and incomplete” is much admired. As beauty is in the eye of the beholder, perhaps Open Payments is thus a delight for Japanese data analysts!

Open Payments had a difficult birth – the initial release in September 2014 contained payments for just the last five months of 2013 and was maimed by problems correctly identifying recipient healthcare providers, leaving 2/3rds of the over $3 Billion in payments as “de-identified”, making the dataset pretty useless for solid analysis.

The second release of Open Payments, on June 30th 2015, corrected that very ugly flaw, for both the revised 2013 and new 2014 data, boasting that all the payments were now “matched with total confidence to a particular covered recipient”. But there are plenty of lessor flaws that can trip up the unwary analyst.

Uncommon Teaching Hospital Names, Chopped or Not

Payments to around 1,200 teaching hospitals are in the dataset. CMS chose to use Open payments2the “PECOS” name of the hospital that had been originally registered with Medicare. Unfortunately these names can be quite different from the well-known hospital names we know today. For instance, you may be looking for payments to the famous Memorial Sloan Kettering Cancer Center. But its PECOS name is Memorial Hospital for Cancer & Allied Diseases. And that’s the name you will have to search for in the 2013 data. But to make it harder still, for the 2014 data CMS decided to truncate the names down to 36 characters (and upper case them), so you need to change your search to “MEMORIAL HOSPITAL FOR CANCER AND ALL” to find Sloan Kettering in the 2014 data.

Unique IDs, With a Catch

But, you may reasonably argue, CMS keeps a unique ID for each teaching hospital, right? Argh, yes and no! In their infinite wisdom they decided to change all these “unique” IDs for the 2014 data, so Sloan Kettering has ID 102 in the 2013 data, but ID 1265 in the 2014 data!

Non-covered Entities Munch on the Research Dollars

For research, as well as payments to physicians and teaching hospitals, payments to other “Non-covered Entities” are collected. These are typically hospitals, including, strangely, teaching hospitals. The thing is these mysterious Non-covered entities, in pac-man-esque fashion, are munching the vast bulk of research dollars:Research Payment Recipients

But Where’s the Beauty?

Despite its pretty darn ugly flaws, Open Payments can produce very interesting results, if analyzed carefully to avoid the booby traps. Here are some of the types of valuable analysis that can be performed:

  • By drug: Identify the most highly paid physicians in certain activities for a target list of drugs, categorized into speaking, consulting, and research engagements.
  • By competitors: Analyze your competition – see how your competitors compare in their marketing budgets, and where and on whom they spend their money.
  • By KOLs: Analyze the work of your own KOLs, find who else is funding them, and how you stack up against them.
  • By Institutions: Discover which institutions are receiving major research funding in your areas of interest, and from which of your competitors.
  • By Partners: Find new partners for your business plan, and analyze current partners, by identifying companies making complementary products who are spending in your target areas.
  • Trend Analysis: Find trends in your area of interest – who are the rising stars, and which types of work is becoming more valuable, and for which drugs.

How Do I Do These Tricky Analyses?

Snowfish offers a white paper, Healthcare Big Data: CMS Open Payments, covering the Open Payments database and its possibilities in more detail, and also have a real example of an analysis in Excel. The example shows the 30 most highly paid psychiatrists and neurologists, where we calculate the total payments made to each physician in each of a number of categories, and show not just the companies making the payments but also the associated drugs for the payments.

If you are interested in learning more about Snowfish’s industry-leading approach to healthcare data discovery and mining, and how we can help with your custom Open Payments analyses, please feel free to reach out to us.  This is the time to capitalize on this fascinating new opportunity.

Martin Snowden is Director or Technology at Snowfish. He is an expert at database integration and analysis. Snowfish integrates, clinical, analytic, and business insights for life sciences companies. We have worked with nearly three dozen companies for over a decade and leveraging big data to help increase a company’s competitive advantage. Snowfish can be reached at (703) 759-6100 or via e-mail at info@snowfish.net. We are also on the web at www.snowfish.net.

Posted by Melissa Hammond  |  0 Comment  |  in Brand Management, Management Consulting, Medical Affairs, Product Development, Strategic Partnering

Beyond KOL Identification & Mapping, What’s Next?

For decades, we have regarded physician key opinion leaders (KOLs) as the “rock stars” of the life sciences industry. Like the musical ones, these leaders have influenced trends and packed rooms. The press would chase them to get a window into what they are thinking. I guess one key difference is that they tend not to destroy hotel rooms.

Similar to a star musician’s impact on a large record label, the life science industry has long depended upon these influencers who were predominantly physicians, to ensure a therapy’s success.

Enter social media and other drivers of product uptake. The music industry has witnessed songs being made available digitally via an immeasurable number of sources and thus easily shareable. The artists themselves are no longer the main promoters of their product as others (mainly fans) through their endless articles, blogs, Tweets and reviews carefully guide our tastes in music. Technology has also opened a path for lesser known independent artists to gain widespread exposure.

Comparable dynamics are observed in the world of medicine. The physician is no longer the sole gatekeeper to access to the product of medical care. We all know that payers can make or break a particular treatment through their level of willingness to cover it.

Other clinicians such as nurse practitioners and pharmacists have been stepping up for some time now, to provide care and counseling. Widespread availability of information has patients more informed than ever. They are sharing their knowledge electronically as well as banding together to advocate for greater access and policy changes. Societies representing patients and professionals sponsor guidelines and position statements to guide disease management. Additionally, there is the role of research consortiums, support groups, social activities, technological modalities (such as telemedicine), and even home care and government-provided services to consider.

Physician KOLs, while still important, must be regarded as a key entity of a larger ecosystem of critical stakeholders. As every disease state or therapeutic area has its clinical specialists, it also involves the cooperation of other groups that are essential to ensuring that a disease is well managed and treatment takes place. Snowfish has worked with clients to define the larger ecosystem. Our analysis has spanned a broad and diverse constituencies including:

Centers of Excellence Mid-Level Practitioners
Payers Celebrities
Competitors                                     Think Tanks
Patients                                              Government/Policymakers
Caregivers Private/Public Partnerships  
Societies                                              Diagnostic Providers

Physician KOL mapping is ubiquitous within the life science industry. This is clearly not enough. Utilizing sophisticated analytics while taking a creative and forward thinking approach to data sources will help to zone in on the most important stakeholders which will not only build momentum around a product but an entire offering.

While our industry still has our obvious “rock stars” and needs to continue to cultivate them, it is evident that there are others who are exerting their influence in less than obvious ways. Identifying and engaging them will best ensure that for any given company, the music will never stop.

Melissa Hammond, MSN, GNP is Managing Director at Snowfish, LLC, a commercial insights firm. Snowfish has expertise in analysis of non-physician stakeholders and KOLs. Snowfish offers stakeholder identification and profiling to help companies understand who to engage not only today but ten years out. 

Please go to www.snowfish.net or call +703-759-6100 to learn more about our services.

Posted by Melissa Hammond  |  0 Comment  |  in Brand Management, Medical Affairs, Product Development, Strategic Partnering

Coca Cola and the Sunshine Act

Have a Coke and a smile. Drink Coke and teach the world to sing. Everything tastes better with Coke.

Those iconic jingles back in the 70’s and 80’s the Coca-Cola Corporation conveyed the life-enhancing benefits of Coke. In response, the world lapped it up like, well…soda.
Fast forward to the 2000’s and things are quite different. Finally catching up with common sense, science has realized that sugary drinks including sodas have been an integral contributor to our global obesity problem. Coke and other soft drinks are no longer something to feel good about but potentially hazardous to our health. In fact since 1998, sugar-sweetened soda consumption has been on a downward trend since 1998.

Ironically, despite the perceived health concerns associated with its product, a number of medical societies and institutions have been accepting millions of dollars in grant money from Coca-Cola. According to a recent New York Times article, the organizations such as the American Academy of Pediatrics, American College of Cardiology have been recipients. A list published on Vox Science and Health notes that funding has even gone to Brigham and Women’s and the Baylor College of Medicine. Much of this has gone toward research and educational programs focused on the value of physical activity.

Why is this relevant to the Sunshine Act?

A review of the Centers of Medicare and Medicaid Services (CMS) Open Payments website fails to find any mention of financial relationships with big food or drink companies. This is because the Sunshine Act a provision of the Affordable Care Act, this measure mandates that only financial relationships between the pharmaceutical/medical device industries and individual physicians and institutions are publically reported. The ultimate goal is to prevent the influence of these monetary exchanges on treatment decisions and help the public understand which physicians and institutions where there may be such potential.

Does it make sense for big food/drink to report relationships in Open Payments?

There is no clear evidence that funding from pharmaceutical or medical device companies will influence practice any more than that from other sources. Additionally, omission of companies like Coca-Cola from Open Payments fails to acknowledge the role that lifestyle choices play in disease management and the influence that physicians and premier medical institutions have on these decisions.

If the objective is to ensure that unbiased management decisions are made in the clinical setting, the limitation of CMS Open Payments to the pharmaceutical and medical device industries fails to appreciate the complete ecosystem involved in the prevention and management of disease. This is also evident in the decision to omit prescribers such as nurse practitioners, nurse midwives and physician assistants from the reporting mandates.

In face of the changes in attitude toward soft-drinks and other processed foods, Coca-Cola still appears to still want the world to sing in harmony. When health practitioners and researchers, it should be required that we know who the voices are.

Can I leverage Open Payments?

Open payments provides a wealth of competitive data that can be leveraged. The ability to categorize the competition’s spending by category and physicians is tremendous. The data can also be integrated into KOL identification and mapping projects. To learn more please contact the Snowfish team.

Melissa Hammond, MSN, GNP is Managing Director at Snowfish, LLC, a commercial insights firm. Snowfish offers a sophisticated analysis of Open Payments to help companies gain multiple insights on expert-industry relations. We can also augment this with other data not available in Open Payments for a more complete picture.
Please go to www.snowfish.net or call +703-759-6100 to learn more about our services.

Posted by Melissa Hammond  |  0 Comment  |  in Management Consulting