The new Health Trends Report 2020 from CVS Health indicates changes in upcoming health care markets, including kidney care, digital health, drug cost transparency, the loneliness epidemic, and the self-care market.

The most important force to watch are patients who are more engaged than ever in the transformation of the health care sector, driven in part by the higher stakes that come with rising out-of-pocket costs, according to the report.

Digital Medicine
A CVS Health program launched in 2016 used data to determine when to send text messages to patients with a handful of chronic conditions, such as chronic myeloid leukemia and rheumatoid arthritis. Messages contained information about adverse effects and symptom management, timed to arrive when the information would have the greatest effect on behavior. Results showed that participants were up to 6.3% more likely to refill prescriptions and achieve optimal medication adherence.

The report highlights the importance of guidelines around data stewardship. Patients need to have trust health care systems in order to make their data available to advances that need this availability. Additionally, companies must also be aware of concerns such as a rise in hacking and breaches in health care data. Cybersecurity must therefore be a priority.

Kidney Care
Approximately three-fourths of chronic kidney disease (CKD) cases are caused by hypertension and diabetes, and the population of US adults with diabetes is predicted to nearly triple by 2060, according to the report. US Department of Health and Human Services Secretary Alex Azar recently noted that chronic kidney care accounts for more than 1 in 5 Medicare dollars spent and that these funds are disproportionately focused on treating patients with later-stage disease instead of early interventions.

The report noted that some countries and health systems using a holistic approach to treat patients with CKD have seen better health outcomes and lower costs. Innovation is centered on CKD identification, targeted patient engagement, and ongoing education to help slow disease progression, facilitate more kidney transplants, and expand home dialysis to optimize care for patients.

Health System and the Loneliness Epidemic
Conditions that foster social disconnectedness have been steadily on the rise. More than one-quarter of Americans now live alone, more than half of US adults are unmarried, and 1 in 5 have never married. Loneliness and social insolation are risk factors for depression, impaired cognitive performance, progressive dementia, compromised immune systems, cardiovascular disease, and hypertension.

At the greatest risk of social isolation are older patients. The report indicates the need for social connectedness within the health care industry through adequate transportation, walkable locations as well hot meals and caregiver visits to older patients with chronic conditions. For example, consultants available to Aetna Medicare Advantage plan members and their caregivers can refer members to local services in a wide range of areas, including some that address socialization needs, such as classes and recreational activities.

Community Care
Poorer Americans are more likely to be uninsured or underinsured, go without preventative measures, or wait until an illness is severe before seeking care. Critically, many also live in areas with far fewer hospitals and primary care physicians, according to the report.

Retail points of care, such as pharmacies, are a way to fill the gap in access. Recent programs have pharmacists performing expanded services, including education and behavioral counseling, according to the report. Pharmacists are also vital in preventative screenings, which can help detect risks for chronic conditions such as diabetes, hypertension, and heart disease.

Drug Transparency
The US health care system has been examining methods to expand drug transparency, with 1 proposed rule seeking to force pharmaceutical companies to publish the list price of drugs in their television ads; however, such legislative efforts have been difficult to pass.

An estimated one-third of the prescriptions are never filled and unexpected costs contribute to that figure, even though most patients would ask for a lower-cost alternative instead of foregoing treatment if they had the option, according to a CVS Health study. The report states that real costs would be beneficial to patients when discussing a new medication with their physicians.

CVS Caremark, the pharmacy benefit management business of CVS Health, has launched tools that allow physicians to check via electronic health records whether a drug they are prescribing is covered for their patient. The database also identifies up to 5 lower-cost, clinically appropriate alternatives or therapeutically equivalent generics that are specific to the member’s formulary and pharmacy benefit plan.

Scrutiny in Self-Care Market
Americans are spending more than ever on fitness, personal care, and health eating, according to the report. However, concern over the ingredients in dietary supplements has been rising steadily over the past few years.  

In 2019, CVS Pharmacy rolled out its Tested to Be Trusted program, a first-in-the-industry initiative that requires approximately 1400 supplements sold by the company in stores and online to undergo third-party testing, either with USP, NSF, or another third-party testing company approved by CVS. Certain products the company has tested since the program was announced did not pass initial testing.

This program is just the latest showing that health care retailers can play a critical role in informing the consumer about the ingredients in their products, according to CVS.

The report concluded by noting that the direction of health care is no longer a topic limited to a few industry leaders, becoming a national conversation instead for health care experts and patients alike. Trends noted in the report will continue to shape the professions on the front line of hospitals, clinics, and every organization that helps to coordinate and support patient wellness.

Reference
Health Trends Report 2020. CVS Health. Accessed January 21, 2020.