Dan Mendelson on the Shift to Value-Based Care and Prescribing Patterns

Dan Mendelson, MPP, founder, Avalere Health, discusses the impact that the shift to value-based care has had on prescribing patterns so far.


Is the shift to value-based care starting to change prescribing patterns? Or will it take a few more years for change to come?

I would say here that the prescribing patterns are, today, largely being driven through traditional means, in, by the way, traditional detailing. So, what we’re just beginning to see in some of the more integrated markets, where physicians are accountable to fewer plans, is that their patterns are starting to change and they’re starting to understand what it is the plans want from them much as in a fully capped setting like Kaiser or one of the other fully integrated models, you see a very different style of prescribing.

One of the things that is, I would say, increasing physician sensitivity, is the fact that copays have gone up so much for patients. So, if the physician prescribes a drug and then the patient is just going to get to the pharmacy counter and reject the copay price, it’s not really going to do a lot of good. So, you see physicians more attuned to copays and more attuned to the kinds of pressures that patients are under with respect to costs.
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