Highmark Health's CEO Talks 'Miracle' Drugs, 'Superpower' Data

The president and CEO spoke about pharmaceutical pricing, value-based care, and technology.

The efforts to reduce drug prices announced in recent days by the Trump administration are a promising development for the future of American healthcare, the top executive for Pittsburgh-based Highmark Health said Tuesday.

"It's a step in the right direction," President and CEO David L. Holmberg said during an interview with The Washington Post broadcast live online.

"The challenge we all have is we're on the verge of miracle drugs," Holmberg added, "and the problem we all have is those miracle drugs are going to have a miracle price."

• Spending: Holmberg said about 22% of healthcare spending goes to pharmaceuticals. "That's not necessarily sustainable," he said. This figure makes prescription drugs the largest category, barely edging out physician services, according to the America's Health Insurance Plans Center for Policy and Research.
   
• Value: When discussing drug pricing reforms, it's important to take a step back and look at the bigger picture in the context of value-based care delivery, Holmberg said. "We really have to think about the whole healthcare system differently," he added. That's why Highmark Health signed an outcomes-based contract for Symbicort. The rebate will be tied to the drug's efficacy.
   
• Technology: When it comes to leveraging technology in healthcare, leaders need to ensure that each application solves a defined problem, Holmberg said. Technology for technology's sake will just get in the way. "There's a reason why healthcare has been such a tough nut to crack," he said.
   
• Data: One of the key areas in which technology can solve problems for healthcare is in data integration and analytics, Holmberg said. As both a health system and an insurer, Highmark Health has access to a significant amount of clinical and claims data.
  
  "The real superpower that we're focused on—particularly with our partnership with Carnegie Mellon and Johns Hopkins and Penn State—is, 'What do you do with that information? And how do you turn it into predictive data?'" Holmberg said. "So our goal is for our folks to be able to reach out to somebody and say, 'You're on the verge of having diabetes,' not see them after they have an emergency room visit and they have a crisis."