This spoonful of sugar will help the medicine go down!
Podcast interview with Michael Andrade, 07/23/2019
We discuss the current challenges within managing specialty management for both the patients and doctors and how VIVIO is addressing individuals needs by using data, clinical trial information, patient DNA, and ...
Are Specialty Pharmacy Treatment Decisions Really Evidence-Based?
quoted in article by David Wild, 07/19/2019
"Many of the basic assumptions we make about an FDA approval and drugs 'working' are just not true," Pramod John, PhD, the CEO of VIVIO Health ...
VIVIO Health named winner of 2019 Health Value Award for Specialty Drug Managers
Washington, D.C. (April 30, 2019) – VIVIO, a specialty drug management company, won a prestigious first place Health Value Award for improving outcomes while lowering specialty drug costs for large self-insured employers. In 2018, VIVIO reduced specialty drug spend 32% and lowered trend 18% across its book of business. Customers include …
Saying No to the Drug Crisis
quoted in article by Brian Klepper, 11/27/2018
In a recent essay, VIVIO Health’s CEO Pramod John guides us through four sensible drug policy changes and supporting rationales that could make drug pricing much fairer. Reading through it, one is struck by the magnitude of the drug manufacturing industry’s influence over policy, profoundly benefiting that sector at the deep expense of American purchasers. As Mr. John points out, the U.S. has the world’s only unregulated market for drug pricing.
Four Policy Solutions That Would Bring Fairness to Drug Pricing
article published by Validation Institute, 11/01/2018
Other than the grip that the pharmaceutical industry has on Congress and our state legislatures primarily through their lobbying and control of regulatory bodies, pragmatic fixes to the US drug cost crisis are not that elusive. Here are four straightforward policy solutions that would bring fairness to US drug pricing and parity with other industrialized countries.
CVS, Cigna Deals Could Thwart Nascent Pharmacy Benefit Services to higher prices
quoted in Bloomberg Big Law Business, 10/11/2018
The market is “broken,” and concentration already has warped payment incentives, VIVIO Health CEO Pramod John told Bloomberg Law. His company runs a tech platform on specialty drugs, using data analytics to reduce the amount employers spend on expensive drugs for their employees. The combination of a pharmacy and an insurance company creates an incentive to increase drug prices, he said.
Imagine there are no PBMs. It’s easy if you try
SALLY WELBORN and PRAMOD JOHN
article published in STAT, 08/23/2018
If you doubt that pharmacy benefit managers could go the way of the travel agent, start with this statistic: About 9 out of 10 drug purchases in the United States are for generic medications, and these in the aggregate consume about 15 percent of our annual spending on drugs. Purchasers could buy these directly from the generics manufacturers for about a third of that and just give them away. Next, they could “go direct” for the 1 in 10 branded drug purchases by removing rebates.
CHG’s Nicole Thurman featured in Managed Care Magazine
quoted in Bloomberg Big Law Business, 08/06/2018
After receiving a claim for $172,000, Nicole thought it was an error. She soon learned it was not an error but a specialty medication for an employee. ‘My heart sank because knowing that there are more and more specialty drugs being approved and put to market every day, there was no way we could afford spending at that rate,’ Nicole says.
Data Analytics and Outcomes Based Models to Help Employers Control Their Specialty Drug Spend
Discussed in this episode: the problems with the traditional prior authorization process and how VIVIO Health has changed the process to be a data-driven approach to determining the optimal therapy for the specific patient; how VIVIO Health’s data collection process helps an employer to monitor if the drugs that are being prescribed are actually working and effective; and, much more.
’60 Minutes’ Was Right About Huge Drug Prices, But Wrong About The Villain
Forbes article featuring CHG and VIVIO Health, 05/11/2018
Thurman continued to see the problem of very high-priced drugs as a top priority for her company. She hired a startup company called VIVIO Health to manage CHG’s specialty drugs … VIVIO Health also researches the clinical trials and other data to evaluate options with a patient’s doctor. This sounds obvious, but it’s a step often skipped–even in many cases by the FDA. “It’s just ridiculous,” VIVIO Health CEO Pramod John says. “We are the ones looking under the hood for the first time. We still require evidence and data. And just because for political or other reasons the FDA is going to bypass all standards of evidence we would have had normally, that’s not every employer in America’s problem.
VIVIO Health customer CHG Healthcare wins Health Value Award
Washington, D.C. (May 4, 2018) – CHG Healthcare, a leading healthcare staffing agency, won a prestigious first place Health Value Award for its work with VIVIO Health to bring down the cost of specialty drugs for its members while improving service and quality. “VIVIO Health’s specialty solution is exciting and innovative,” says Nicole Thurman, CHG’s Vice President, Talent Management. “They delivered on their dual promise of savings and happier members while helping us change the status quo.”
VIVIO Health, One Year Later
Interview with Mabel Jong, World Congress Correspondent, at World Health Care Congress 2018, 04/29/2018
Pramod John, VIVIO CEO, describes company progress toward improving specialty drug outcomes while lowering costs.
interview by journalist Mabel Jong, 04/09/2018
Mabel Jong: “We spoke last year and I’m very curious about what has happened the past twelve months. What market traction have you been able to experience?” Pramod John: “We’ve had a great first year. We went from one customer at the beginning of the year to four by the end of the year. We have a strong pipeline because the specialty drug problem has become so troublesome for everyone. All the current solutions on the market still are primarily those that do the same thing, only slightly better. On top of that, things have gotten worse with all the big mergers between PBMs and carriers, meaning no-one’s even working on the problem in this space.”
Companies Looking Outside Government Oversight For Lower Drug Prices
interview by Bronson Teichert for Utah Public Radio, 03/13/2018
CHG, a 5,000-employee company in Utah provides healthcare staffing. They have turned to a California company, VIVIO Health, to lower pharmaceutical product prices. VIVIO Health compares the cost and quality of medicines available through a variety of prescription drug providers. This approach has dropped CHG’s employee benefit costs for prescription drugs by 30 percent. “Our company focuses on using market mechanisms and asks the question of what market mechanisms could we use,” said Pramod John, CEO of VIVIO Health.
Cigna’s Express Scripts deal could lead to higher prices
quoted in MarketWatch, 03/09/2018
Independent PBMs essentially worked to create consistency in drug pricing and to restrict drug manufacturers from overpricing — though some have also accused the PBMs themselves of causing drug price inflation. But now with this deal and the recent Aetna-CVS merger, that model is gone. And that means consumers could be worse off. “The PBM industry was born because this is a terrible idea,” said Pramod John, CEO of VIVIO Health, a specialty drug management company. “We’re going backward.
Cigna to buy Express Scripts in $67 billion deal
quoted in Modern Healthcare, 03/08/2018
With all of these insurer-PBM mergers, none of them have shown to benefit the consumer,” said Pramod John, CEO and founder of VIVIO Health, a specialty pharmacy management firm. He added that Optum has some of the highest pricing and is resistant to sharing data. “Now there is less transparency because the lines between payer and provider are being blurred.
3 Tips to Help Tame the M&A Beast
article published in BenefitsPRO, 02/23/2018
Planning on larger mergers to control costs is a fool’s errand. Take a look at UnitedHealth Group (UHG) which owns UnitedHealthcare (UNH) and OptumRx. The company’s structure and scale is on par with a combined CVS and Aetna. UHG owns one of the largest health plan providers, one of the largest PBMs and continues to aggressively acquire other health care services companies. Many corporate customers will tell you UNH is one of the most difficult insurers with which to work because of restricted data sharing and lack of transparency. UNH also makes it nearly impossible to use services other than their own. This is not a recipe to control costs and it’s going to get worse …
Challenging Oncology Therapies With Moonshot Price Tags
article published as a Lundberg Institute Blog, 12/13/2017
New oncology therapies carry astronomical price tags—most people know this. Receiving far less attention is the question of actual therapeutic value. Drug manufacturers spend billions on advertisements and PR, but unfortunately, real-world patient results are frequently unimpressive. Why do high-cost oncology therapies with questionable results continue to be prescribed? Let’s examine a situation my company is dealing with right now …
Specialty drugs that run through pharmacy benefit managers will soon comprise 50% of pharmacy budgets, even though they represent a small number of Rx’s taken by a small number of patients. Vested interests in the industry have a stake in seeing that this trend continues, as their share price depends on current profit margins and opportunities. Enter VIVIO Health, a new kind of plan with a new kind of carve-out benefit design for specialty pharmaceuticals.
appearance on CNBC’s Capital Connection, interview by Nancy Hungerford, 12/04/2017
Past mergers similar to the CVS-Aetna deal had not resulted in better pricing for consumers, says Pramod John, founder and CEO of Vivio Health.
CVS Health to buy Aetna for around $69 billion
quoted in CNBC, 12/03/2017
These high complex-care cost members, the very, very sick, or the ones that are using expensive drugs, tend to be the highest profit for the industry,” said Pramod John, CEO of VIVIO Health, a specialty pharmacy management firm.
What if Amazon Breaks into the Pharmacy Business?
interview by Stacey Richter for Relentless Health Value, 11/02/2017
In this episode, I had the privilege of speaking with Pramod John, who sums up the four structural roadblocks Amazon will face if they decide to gin up a pharmacy division. One of his points I find particularly key – Getting cheap convenient drugs from Amazon is not the point, it’s their huge opportunity to reinvent how Pharmacy works. VIVIO Health’s solution is challenging the current framework of efficacy and extending it to true effectiveness in the real world. It also offers significant drug acquisition savings and simplicity for the patient by integrating the supply chain into a unified and data driven process.
Potential CVS-Aetna merger: Key takeaways for health execs
quoted in Managed Healthcare Executive, 11/01/2017
This is the first significant change to the carrier markets in a long time. This purchase squarely puts CVS Health and Aetna ahead of UnitedHealth Group [M&A activity] on many fronts,” says Pramod John, CEO, VIVIO Health, a specialty drug management company. “CVS Health and Aetna can now play the same game that UnitedHealth Group has been playing for a long time with both medical/pharmacy coverage and manipulating the numbers on both ends to provide the ‘best’ deal and lock out competitors,” John says.
A Test Case on Sanity of Drug Prices
article published in Insurance Thought Leadership, 09/18/2017
American healthcare dwells in never-never land. We have neither explicit price controls through regulation nor implicit controls through a functional market, resulting in the worst of all possible worlds: a system that’s entrenched, opaque and dysfunctional. It gets worse when we narrow our focus on the drug market. We don’t even understand what it is that we are purchasing because buyers neither spend much time understanding drug effectiveness in the real world nor tie effectiveness to payment. … Mavyret, manufactured by AbbVie is the first example of a new brand name Hepatitis C drug that is actually better for patients and costs far less since Sovaldi hit the market at a price point of $1,000 a pill (never mind you can purchase it for $4 per pill in India).
article published in BenefitsPRO, 08/31/2017
Mavyret, manufactured by AbbeVie is the first example of new brand name Hepatitis C drug that is actually better for patients and costs far less. Eighty percent of patients with Hep C can do an eight-week course, versus the alternative, manufactured by companies including Gilead and Merck, which requires a 12-week course. It is the only drug that works for genotypes 1-6 and it has a list price that is less than half of what the competitors charge, even when you factor in the bizarre middleman shenanigans…
The Emperor’s New Clothes: Biosimilars and Cost in Oncology
KEVIN KNOPF, MD
article published on ASCO POST, 07/10/2017
Biosimilars are biologic products similar to the parent (branded) molecule in structure and function—such as erythropoietin and filgrastim (Neupogen). To truly bend the cost curve, we want to see a dramatic economic savings achieved as oncology biosimilars for rituximab (Rituxan), trastuzumab (Herceptin), and bevacizumab (Avastin) – the next expected oncology biosimilars – are introduced to the U.S. market. Although a report from investigators at RAND optimistically estimates that biosimilars in oncology will achieve $44.2 billion in savings from 2014 to 2024 in the United States, this model had overly optimistic assumptions. We think a more likely outcome is to advise oncologists to “curb your enthusiasm…
Do Specialty Drugs Work?
interview with Mabel Jong, 04/30/2017
interview with Mabel Jong, World Congress Correspondent, at World Health Care Congress 2017
Unrigging the High Cost of Drugs
interview with Steve Ambrose of Red Hot Healthcare, 02/02/2017
In this episode, Steve Ambrose and VIVIO Health CEO Pramod John discuss The political process and healthcare consumerism Health insurance vs. Health Drug pricing…is where you ‘pick it up’ Major misunderstandings of the FDAs true role A disruptive model (without a PBM) to get consumers and companies the most effective drugs at the best prices.
America’s Healthcare Challenge (AHC), Radio Appearance
PRAMOD JOHN & T. J. TEDESCO
AHC hosted by Sean McGuire, 09/24/2016
VIVIO Health’s CEO and VP Customer Experience appeared on AHC hosted by Sean McGuire
Epi-Pen Pricing: It’s the System, Stupid
blog article published on LinkedIn, 08/29/2016
Drug manufacturers can’t catch a break, but are they the real culprit? Sure, we could shake our finger at Heather Bresch, CEO of Mylan, but didn’t we just do this to Martin Shkreli from Turing Pharmaceuticals and Michael Pearson from Valeant? The key question isn’t who’s the offender du jour? Instead, it’s why do these pricing ‘scandals’ keep happening, and is our best offensive strategy public shaming? Complaining about Mylan is pointless because as a publicly traded company, they’re doing exactly what we would expect to meet the profit and growth expectations of their investors. Why is it their responsibility to compete against themselves? If this were the financial services industry, Bresch would be hailed as a genius.
Why Our Problem With Drug Pricing Goes Way Beyond Shkreli
blog article published on LinkedIn, 07/15/2016
I’d like you to know about an exciting development in my life. I recently became CEO of VIVIO Health, a company focused on solving one of the biggest problems facing our country today, the out-of-control costs of specialty drugs. Over the past few months, many of us have heard of the abuses surrounding Martin Shkreli (who is in the news again after a judge set a 2017 trial date for his securities fraud case) and separately, Valeant Pharmaceuticals, which was recently under fire for drug price increases. What we haven’t heard is that these sensationalized cases are truly insignificant when compared to the enormity of the problem facing America. Only a few years ago, specialty drugs comprised a reasonable sounding 10% of our overall drug spend. Last year, it bloated to…
Explaining Rising Drug Costs
blog article published In healthreform EXPLAINED, 07/11/2016
According to Pramod John, CEO of VIVIO Health, “in other countries the price for drugs are much lower and in some cases, developing countries are 1/10 of the same price.” Compared to developing countries, the United states is 7-10 times the cost according to Mr. John. “The US is the only unregulated market drug and there is no regulation on how prices are set and studies have shown that the US spends two times more per capita on healthcare than its closest competitor.
AHC hosted by Sean McGuire, 06/11/2016
VIVIO Health’s CEO appeared on AHC hosted by Sean McGuire