I heard someone say the other day, “Practicing medicine without pharmaceuticals is like running to the ten-yard line, putting down the ball, and walking off the field.” So, it’s pretty imperative that providers and Pharma know how to work together to get the best outcomes for patients. In this context and in this podcast, when I say “get the best outcomes for patients,” I kinda mean it. There’s a sweet spot in the middle of “won’t let those [expletive goes here] pharma reps in the building” and blatant conflicts of interest.
I wanted to find out from someone who would know what a great collaborative relationship with a pharma company looks like for a large health system from their point of view. How do two, in general, gigantic bureaucratic organizations find ways to help each other help patients?
No one would disagree that finding the best collaborative strategy with a health system is going to depend a lot on how that health system rolls in general. One aspect of how they roll is to take a look at their so-called level of control. This means how centralized decision-making is.
For example, on the far one end of the control or lack thereof spectrum, you’ll have your more controlled systems of care. These systems have centralized decision-making. Most of them will tell you that this centralization signals a bunch of things like, for example, a commitment to total care of patients.
More control can mean that patients can have confidence if they walk in, there’s a system of care that is standardized across all the sites of care and any drugs prescribed, for example, not only have been FDA approved but also vetted at the health system level. They’ve gone through some rigorous evidence-based decision-making.
In this health care podcast, I’m talking with Troy Larsgard, who is the category manager of pharmaceuticals at Johns Hopkins Medicine. He held a similar role at Intermountain for a number of years also. As part of his role, Troy has sat on and sits on P&T (Pharmacy and Therapeutic) committees as a nonvoting member. Basically, Troy is the guy that drug companies want to meet with.
Here’s a point that Troy Larsgard makes during our conversation that I found really enlightening. And I guess this could pertain to either a more open or closed health system. It would just happen at a differing scale. Some suppliers, pharma companies, have a “boots on the ground” strategy for large health systems—lots of representatives running around who don’t necessarily have a strategic framework to coordinate their efforts.
From a health system perspective, this is what Troy considers not a strategic approach. As Troy says, all things being equal, he likes to work with companies who meet him where he’s at and who understand the needs of his organization.
In this conversation, I paid particular note to the ways that pharma companies who are really good at crafting their collaborative strategic approach get a leg up over competitors who cling to a more transactional, maybe legacy, pharma approach. Point of note: While this whole conversation is technically about pharma company collaborations, everything that we talk about in this episode is almost wholesale applicable to others looking to work with health systems, like medical device manufacturers, purveyors of digital health technologies, etc.
You can connect with Troy on LinkedIn.
Troy Larsgard is a health care professional specializing in pharmacy supply chain. After working six years at Intermountain Healthcare in Salt Lake City, Utah, he joined The Johns Hopkins Health System Corporation in Baltimore, Maryland, in January 2020. One of his most rewarding career experiences is taking an active role with key stakeholders in planning for and operationalizing the COVID-19 vaccine at Johns Hopkins.
After thousands of meetings, proposals, and presentations from pharmaceutical companies, he is convinced there are better ways suppliers can work strategically with large health systems. He welcomes forward-thinking ideas and engagements to move beyond the transactional and create strategic alliances and value-added opportunities. He has put this philosophy to practice helping to remove barriers and working together with suppliers to make industry changes.
04:16 What’s the rationale behind trimming the supplier list for pharmacists?
05:35 What’s the difference between a strategic model and a tactical model?
06:49 “A lot of effort goes into developing drugs and bringing them to market, but sometimes the thought of how to interact with the health system beyond that isn’t always thought out.”
09:06 “I think there’s opportunity to be more seamless.”
10:48 “Those who inform early, often, and are transparent … save much more face.”
11:04 What do account managers need to know about health systems and vice versa for them to work together?
14:15 How do drugs on formulary fall into these pharma/health system collaborations?
16:46 How do physicians know when a drug is on formulary?
19:32 Are downstream medical costs being assessed?
21:29 Why would a health system choose to collaborate with a pharmaceutical company in this system?
22:31 “What does partnership mean to you?”
26:15 “Outcomes-based contracts sometimes are called risk share, and I like to joke sometimes it’s all risk, no share.”