Monday, January 04, 2010

2010: The Year of Selling Health Care Reform

It may be time to forget auld acquaintance but we still aren't done with health care reform. The biggest political story of 2009 for the biopharma industry in the US will carry over into 2010, and, sometime soon (barring a Democratic Party suicide pact) it will conclude with legislation for President Obama to sign.

Then the real fun begins. The challenge for Obama, the Democratic Party—and the biopharma industry—will become selling reform to a skeptical public.

It says something about the American legislative process that the longer the reform debate went on, the less popular the legislation became. In hindsight, that was entirely predictable. When the year began, polls showed that an overwhelming majority of Americans favored reform—but pollsters like Hart Research’s Allan Rivlin recognized early on that the consensus wasn’t even skin deep. Once real proposals and tradeoffs began, support for reform in general would turn into concern about specific changes in particular.

Heck, that’s kind of how most biopharma industry executives feel. After all, the Pharmaceutical Research & Manufacturers of America cut a deal on health care reform early on—and its reward has been to fight to hold its contribution to “only” $80 billion.

Still, as we’ve said all along, there is a lot for biopharma companies of all shapes and sizes to like about health care reform. There will be more people with insurance. Those with insurance will have (from industry’s perspective) better insurance—more predictable copays, no more caps on coverage, free vaccines, etc. etc. Medicare Part D will be much improved, and not just because of the industry’s contributions to closing the donut hole: there are other changes intended to assure that beneficiaries on therapy can stay on therapy. There will be a follow-on biologics pathway, along with generous exclusivity protections for novel biologics.

But all of that depends on how the bill is implemented. And that in turn depends on whether the public warms up to reform once it passes.

The reform plan is sure to be a central element of the 2010 Congressional election campaigns, and then of Obama’s re-election bid in 2012. And it will make a very big difference to how the health care system evolves if the winners are elected based on the view that the reform elements that matter to pharma are a good thing or a bad thing.

There is no question about it: the biopharma industry is a big winner in the health care reform legislation. But the industry cannot afford to win the legislative war only to lose the peace.

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