Milliman understands the key issues—finances, output of data analysis, and care management practices—of payers, who have come to us for help on these issues for many years. We bring that valuable perspective to our work with the pharmaceutical industry as well. When drug manufacturers want to talk to payers about health economics or evidence-based medicine, our expertise helps avoid a communication and credibility gap.

Modeling hypertension and treatment compliance

Milliman can develop models that present the cost and morbidity impact when a medical condition is effectively managed with drug therapy. For example, a pharmaceutical company asked us to develop an actuarial model of how inadequately treated hypertension affects people, and outline steps payers and employers can take to promote better treatment.

Our model showed the need for better hypertension control by presenting the compelling prevalence, risk, and cost data associated with uncontrolled hypertension compared to the risk and cost of the disease when controlled. Milliman’s findings reinforced the need to increase patient adherence with drug therapy and made a believable economic case without the hyperbole that often characterizes advocacy positions.

Our work also summarized for health plans and employers the current thinking about health promotion, benefit design, and disease management as it relates to hypertension.

Forecasting biotechnology costs

Emerging biotechnology treatments promise better treatments, but many biotechnology products can be very expensive. An industry trade organization asked Milliman consultants to estimate future biotechnology spending and to put that cost in the context of overall healthcare spending for commercially insured benefits plans. We projected Wall Street forecasts onto commercial population utilization to develop “apples-to-apples” scenarios of current and future cost impacts. We also developed actuarial equivalent benefit plans and trade-offs that would not result in net cost increases.