Shot in the Heart

I am sure that like me, many of you read with outrage about the steadily rising cost of the EpiPen by the pharmaceutical company, Mylan. According to a recent article from CNN.com, Mylan has increased the price of the lifesaving device 15 times in the last seven years. Today, the price of a two-pack of EpiPens is just over $600—a 400% increase from 2007. How does a single mom with four kids, one of whom has a deadly peanut allergy, possibly pay for this critical treatment?

While I was dismayed by the exorbitant rise in cost, what had me just as infuriated was Mylan CEO Heather Bresch refusing to take responsibility for the price increase and instead blaming the health care system. While I don’t think the industry is perfect and I know there is a great deal we can do to make it better, in this instance the dramatic price increase lies directly at the feet of the pharmaceutical industry and Mylan. 

Mylan, which has an estimated 95% share of the market, continued to increase the price even after their main competitor took their product off the market last year. Furthermore, the company is clearly making a healthy profit. According to an article in USA Today, “the company turned a profit of $847.6 million in 2015 on $9.45 billion in revenue, representing a net profit margin of 8.9%. To be sure, however, Mylan is profiting more heavily off of EpiPen than it does other drugs. The company's operating margin on EpiPen is about 55%, according to at least one analyst, and its overall operating profit margin is 20%.”

I don’t begrudge the company for making money, but there has to some kind of middle ground here. And while I am glad that Mylan has responded to this outrage by launching a generic version of the EpiPen at a 50% discount and well as made a promise to offer discount cards to those who have to pay for the device out of pocket, the wholesale price needs to be cut and this type of price-gouging needs to be regulated.

Congress has launched an inquiry into Mylan and its pricing practices. I hope this incident serves as a catalyst for change across the board. It is not fair to the millions of families affected by deadly allergies or other life threatening illnesses. It’s a shot in the heart to all of us.

Untangling the Mess

A few weeks ago I received a call from a close friend asking for some help. As he is currently undergoing treatment for cancer (thankfully with an excellent prognosis), I assumed he wanted my advice on a medical decision.

I was relieved to hear his treatment was going well, but was taken aback at his request. He wanted me to help him untangle his mountain of medical bills. He was staring at a pile of paper itemizing his every test, diagnostic procedure and treatment and could not figure out what he was being charged, what his insurance had paid and what he would ultimately owe. It took me hours to review his bills and to this day, I am not sure that I fully understand all of the charges.  I can only imagine the fear and frustration that all of our patients feel when they receive medical bills they can’t understand. The plea for help from my friend served as a wakeup call for me. If a CEO of a medical center can’t untangle one person’s tab, how can we expect our patients to figure it out?

There’s interesting action on this front. The federal government is now looking for ways to standardize medical bills to make them easier to understand. The U.S. Department of Health and Human Services launched a contest for companies in the medical industry to design a bill that can eventually be used across health care making it easier for patients to understand. Winners will be announced next month and I am anxious to see the solutions offered.

If we expect patients to become responsible and cost conscious “consumers” of health care, the industry needs to deliver a medical bill that people can actually understand and a billing process that makes sense.

Apple of Health Care

Those who know me, know I am a fan of Apple—the company and their line of products. Like most people, I find their devices highly intuitive, user friendly, fun and engaging. I love that they offer a complete portfolio of technology that meets all my needs. But most importantly, I admire how their products are completely integrated—my phone syncs with my watch/personal fitness monitor which talks to my iPad which then backs up to my personal computer—allowing all of my information to be accessed from one device. When you purchase an Apple product you step into a complete and closed system of technology and entertainment and rarely need or want to leave. In the business world, this is known as vertical integration. Whatever you call it—it’s a savvy strategy for developing loyal, lifelong customers.

At Jupiter Medical Center, we are striving to be the Apple of health care right here in Palm Beach County. By that I mean, our goal is to provide our patients with services at every point along their health care journey and do our best to make sure the care is seamlessly integrated along the way—decreasing time and costs while improving outcomes and value. We want our patients to be able to step into the Jupiter Medical Center system and get all the things they could possibly need from a flu shot, to maternity and pediatric care, to imaging and diagnostics or world-class oncology treatment, should they need it. Beyond building a robust set of services for patients, each time they come in contact with Jupiter Medical Center at any entry point, their health information is captured, electronic medical records sync, and this essential data can be accessed by members of the care team everywhere up and down the line.

In technology, Apple has championed vertical integration. Applying this model to health care will not only help remedy the sometimes fragmented and dysfunctional way care is currently delivered, it will ensure a more satisfying "user experience."