13-May-2009

Integrated Care Organisations: an opportunity or a threat for pharma?

Summary

Integrated Care Organisations (ICOs) are the new kids on the block, and tipped as the natural successor to practice based commissioning.

Last Updated: 27-Aug-2010

On 01 April the Department of Health announced sixteen integrated care pilots (ICPs) www.dh.gov.uk. They are led by a whole range of organisations from practice based commissioning clusters through community and NHS foundation trusts to specialist substance misuse teams and local councils. This is a deliberate ploy as the main goal is to evaluate the organisational models and principles behind ICOs; and quantify the costs and benefits they deliver. They are being championed by David Colin Thorne who rarely backs a duff horse, and if they are successful, policy enablers to encourage ICO development are sure to follow.

The NHS loves a new organisational model. This one is especially attractive as sits on the supply side. Although GPs see the political benefits of being commissioners, in reality they are far more comfortable as service providers. And the most entrepreneurial amongst them see ICO status as the ultimate prize. Because if you are an ICO and you make a budget saving, you get to keep it. This may explain why there were 700 expressions of interest for just 16 pilots.

Often the early focus for ICOs is reducing emergency admissions and more carefully managing the drugs budget (often described as ‘medicines management’). Clearly, there is a link between the two.

If prescribing new medicines helps reduce hospital admissions, there are savings to be made. These medicines need to be built into new ICO care pathways. By the same token, if people do not comply with their medication or are prescribed medicines that cause side effects, they can end up in hospital unnecessarily; and that can be prevented by intervention by a pharmacist.

Despite the research showing this to be the case, ICOs are inevitably focusing on harvesting the low hanging fruit; generic switching and costs focused medication review. They need to be educated to think differently.

That is something we at PDC can help our clients to do. We will be monitoring developments in ICOs to make sure PDC Healthcare can work with ICOs on your behalf, and you can help patients and the ICO health system get the best out of your prescription medicines.