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Blog
COVID-19 and lasting trends that are redefining U.S. healthcare
First in a two-part series
Sep 02, 2020
COVID-19 has transformed the U.S. healthcare landscape, introducing challenges that would have been unfathomable even a year ago. Over the past several months, IQVIA has closely monitored the impact of COVID-19 on patients, healthcare providers, and the healthcare ecosystem, to determine how the industry responded, and what enduring trends will live on even after the pandemic abates.
This post is the first in a two-part series on this topic and will examine trends and impacts in stockpiling, telehealth, and the patient backlog. The second blog in this two-part series presents trends and impacts to promotion, launch & commercialization, and market access.
Telehealth
Earlier this year, IQVIA conducted primary and secondary research to understand the impact of telehealth on the healthcare ecosystem during the pandemic, and to better discern the long-term impact COVID-19 will have on the adoption of this tool for future healthcare consumption.
Prior to the COVID-19 pandemic, telehealth was almost exclusively used for mental health conditions. In the early days of the pandemic depression, anxiety and ADHD treatments rapidly accelerated via telehealth, possibly reflecting the impact of the virus on the overall population’s mental health. As stay-at-home restrictions remained in place, the composition of telehealth diagnoses slowly began to mirror that of the broader population; hyperlipidemia, hypertension, diabetes and the like quickly made their way to the forefront of the telehealth usage. On the flip side, there has been minimal use by specialties such as Oncology and Pediatrics.
The patient dynamics for telehealth are complex. Patient age, underlying condition, and geography all play a role in use of telehealth, but so do internet access and technology fluency. Younger patients have been more rapid telehealth adopters; it is a natural extension of their digital lives and many of their conditions are more easily treated remotely. Older patients are more complicated. Telehealth can be a salvation for many who are afraid of leaving their home for fear of contracting COVID-19, but it is also difficult for many older patients to use the technology.
Telehealth also impacts prescribing productivity, especially for new-to-brand (NTB) prescriptions. NTB productivity was and remains significantly lower for telehealth than in the office. This is influenced by factors like patient mix - when replacing office visits with telehealth, the patient mix skews towards existing patients. There also appears to be less willingness to initiate new therapy remotely, especially as lack of diagnostics such as vitals and labs are impeding the diagnosis of new conditions.
COVID-19 and the subsequent social distancing measures, as well as the reduction of reimbursement issues, prompted a much wider adoption of telehealth tools during the pandemic. In the future, hands-on or machine-based diagnostics, or in-office treatment may be limiting factors for broader telehealth adoption. Instead, the adoption of hybrid telehealth models may be more likely. Follow-up visits and appointments that don’t require in-person care may be conducted virtually, while administered treatments and new diagnoses may be completed in a traditional healthcare setting. This fall, we will be publishing a deeper analysis on the long-term role telehealth will play in healthcare.
Stockpiling
Early in the pandemic patients began stockpiling medications out of fears of shortages, loss of coverage, and limited access. This led to an uptick in adherence but also caused a surge in plans rejecting claims.
These rejections were quickly overcome and pharmacies began dispensing medication via mail order and providing extended supplies. At the same time, NTB prescriptions plummeted, as did total prescriptions. Much of the volume decrease was tied to lower use of antibiotics, while specialty branded products performed well during the pandemic.
Patient Backlog
Within a month of the pandemic, a growing patient backlog developed as patients went undiagnosed, untreated, and undertreated due to skipping routine or follow-up healthcare.
The inability to access their providers led to a decline in lab testing, which slowed treatment recommendations, and reduced patients’ ability to undergo elective surgery. Even as states and providers resumed elective procedures in the spring, a lag in elective surgeries continued as diagnostics and other assessments have not returned to pre-COVID-19 levels.
It is estimated that in 2020 there will be 1 billion+ fewer patient visits*. This will result in decreased patient outcomes and additional healthcare system pressures.
A Catalyst for Positive Change
The COVID-19 pandemic has had an unprecedented impact on our industry. While it has been an event that we hope to never experience again, it has proven that in times of crisis, our industry works together to find new, innovative ways to ensure all patients’ needs can be met.
To learn more about lasting U.S. trends related to COVID-19, listen to the related podcast series, U.S. Post COVID-19 Scenario Planning & Commercial Implications.
* Sources: IQVIA Real World Data, Medical Claims, 2019-2020, Custom Methodologies
Podcast Series: U.S. Post COVID-19 Scenarios and Commercial Implications
Explore potential scenarios that the U.S. healthcare industry could face post COVID-19, and the strategies for where and how to compete in this evolving landscape.