The J.P. Morgan Healthcare conference is proudly undemocratic. It is a conference of haves and have-nots. Those who have managed to win a coveted invite to the conference are able to rub elbows in crowded hallways. Everyone else is literally left out in the street; security guards prevent non-attendees from even entering the Westin St. Francis. where the event is held.
That means the audience is, by design, almost exclusively the money guys. Everyone else — even in the media — is an afterthought. Though the meeting is about “health care,” huge chunks of the industry are almost invisible. Some larger health systems get a spotlight, but docs are in the conference’s blind spot. And patients? Patients are mostly data points in presentations.
The forgotten patient is an issue for the health care industry. It’s not an issue because health care is fundamentally about patient care (though it is). It’s not an issue because we all want stories of inspiration and the human experience (though we should). It’s an issue because patients may end up having the last word on some of the most pressing issues — financially — that biopharma will deal with in the decade to come.
I looked through all of the 11, 500 tweets tagged with #JPM14 for those rare instances where patients entered the discussion. They came up in the Aetna conversation, where the insurer noted that 41 percent of health care dollars end up being spent directly by patients, a number the insurer expects to rise to over 50 percent. Talk about skin in the game. The Cleveland Clinic’s CEO, keynoter Tony Cosgrove, talked about the importance of reaching out to patients (which helped drive a huge increase in patient satisfaction). The digital health people extolled the need for engagement with the patients.
In short: patients are spending more of the own money. They’re investing more of their own time. And, like everyone else at J.P. Morgan, they’re going to demand returns on those investments.
Will patients tolerate future price increases? Will novel drug-delivery approaches find commercial success? Can the current economic model, where treatments for rare disease and cancer fetch premium prices while research into other areas languishes because of a lack of return, hold in an era of growing patient advocacy? Those are big questions that will have an enormous impact on the industry over the medium- to long-term. And J.P. Morgan attendees received precious little insight.
The velvet ropes outside the St. Francis did their job, effectively sealing off the conference from those who would turn it into something other than a focused discussion on the investment prospects of health care industry, generally, and the 300-odd presenting companies, specifically. But it’s becoming increasingly clear that the patients discussions taking place outside those ropes — far outside of those ropes — may be the most important conversations of all.