The Future of Healthcare: “Drug price transparency will help us take back control of our health” with Dr. Sean Karbowicz

As a part of my series about “The Future of Healthcare” I had the pleasure of interviewing Dr. Sean Karbowicz. Dr. Karbowicz is the Founder and General Manager of MedSavvy. From dispensing medications in retail and hospital pharmacies to implementing health plan pharmacy benefit programs, he has seen the benefits and burdens of medication therapy. He is […]

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As a part of my series about “The Future of Healthcare” I had the pleasure of interviewing Dr. Sean Karbowicz. Dr. Karbowicz is the Founder and General Manager of MedSavvy. From dispensing medications in retail and hospital pharmacies to implementing health plan pharmacy benefit programs, he has seen the benefits and burdens of medication therapy. He is a passionate innovator in pharmacy.

Throughout his career, Dr. Karbowicz has worked to champion best practices that evaluate scientific evidence on the performance of medications. These protocols have been used by health plans across the country to identify which medications work best for people. Dr. Karbowicz founded MedSavvy because he saw an opportunity to put this powerful information in the hands of patients and providers. He understood that presenting this information in a way that is easy to use could help reduce the hassles of getting the best medication at the lowest possible cost. He describes himself as a ‘ruthless advocate for patients, so they can understand the benefits, risks and costs of treatments with eyes wide open’ and is always looking to empower health care consumers.

Dr. Karbowicz received his Bachelor of Science degree in pharmacy from the University of Connecticut School of Pharmacy, his Doctor of Pharmacy degree jointly from Oregon State University and Oregon Health and Science University, and he completed a residency in Drug Information at Oregon Health and Science University

Thank you so much for joining us! Can you tell us a story about what brought you to this specific career path?

It’s been the culmination of a lot of factors and experiences. For example, when I was the clinical pharmacy director for Cambia’s regional health plans, I spoke at a policy summit about how some of the new cancer medications had gaps in their evidence — and how it was causing uncertainty around effectiveness. While the audience was comprised mostly of physicians, nurses and pharmacists, one gentleman stood up and shared that he was a cancer survivor. He expressed how valuable that information would have been when he was weighing his treatment options. For me, that was such a powerful moment, a reminder that patients are the impetus for everything that we do as pharmacists.

Patients, their families and caregivers, along with doctors, need access to evidence-based information so they can weigh all the variables and make informed decisions about treatment options. I created MedSavvy because I was inspired by that cancer survivor, and by the thousands of encounters I had helping patients as a pharmacist for twenty plus years. MedSavvy is the first online medication comparison service for consumers and practitioners. We provide a side-by-side comparison of medications and treatments, assigning them letter grades (A, B, C, D, F or I — for incomplete) based on safety and effectiveness. MedSavvy also compares the prices of medications and enables patients to have direct communication with pharmacists to help answer their questions and concerns.

My goal with MedSavvy is to inform and empower patients to make better decisions and to help them navigate a system that is very complicated and daunting at times. Coincidentally, I am currently undergoing cancer treatment myself. I can say with 100 percent certainty that while I have outstanding doctors, my family and I are ultimately responsible for making decisions about my care, and we need access to unbiased, research-based information to do that.

Can you share the most interesting story that happened to you since you began your career?

As a pharmacist, one of the most common things I have come across is that many patients feel confused, overwhelmed, and trapped by their prescription medications and they don’t know where to turn for help. For example, I had a patient come in with pneumonia and the medication prescribed cost $700. Living on a limited budget, the patient was understandably extremely upset by the cost. I suggested a lower-cost medication that I knew to be equally effective and safe. I then contacted her physician who approved the prescription change. This helped her understand that she did have a choice and can ask for alternative medications.

For many, navigating the various aspects of health care is complicated, intimidating, time-consuming, and expensive. MedSavvy was designed to alleviate as much of that as possible and to create something that is easy-to-use and helps patients advocate for themselves.

Can you tell us about your “Big Idea That Might Change The World”?

MedSavvy, is a licensed, online pharmacy service for patients, caregivers and doctors. We are the only consumer and practitioner facing solution that delivers personalized price comparisons and coupons, evidence-based grading of medications and treatments, and the ability to communicate directly with pharmacists. Note that we do not sell or dispense medications. As I mentioned previously, MedSavvy assigns evidence-based letter grades (A, B, C, D, F or I — for incomplete), based on a medications safety and effectiveness for a specific condition. We have a team of pharmacists who carefully review scientific studies of medications to determine fact from fiction and provide people with the insights they need to make more informed decisions.

Consider the fact that an FDA approved medication has been proven during a study period to offer some benefits and that the risks don’t appear to outweigh the benefits. It’s also important to understand that pharmaceutical companies are not required to show that their medication is safer or more effective than other medications already available for a specific condition. To be granted an FDA approval, drug makers must prove that the medication offers more benefit than a placebo.

MedSavvy grades and pricing information fill in the gaps, providing patients and practitioners all the information on how well a treatment works, so it can be compared against other options.

How do you think this will change the world?

As the national debate on the pricing, safety and effectiveness of prescription medication continues to evolve, consumers are becoming more and more frustrated with the lack of choice and transparency. While technology has made great strides in improving patient diagnosis, treatment and outcomes, the system remains broken in many ways — especially when it comes to prescription medication.

To put this into perspective, prescription medications, without a generic substitute, rose 142 percent between 2006- and 2014. Those with a generic option rose 57 percent (Washington Post 11/26/18). Given this reality, it’s not surprising that a Kaiser Health Tracking Poll from March of 2018 found that 80 percent of Americans feel that the cost of prescription medications are unreasonable (Kaiser Family Foundation 3/23/18)

Simply put, prescription medication costs are out of control because, until now, there was no place where consumers and practitioners could compare prices or make choices based on evidence-based safety and effectiveness.

It’s time for us to take back control of our own health care. My goal with MedSavvy is to alleviate stress and confusion by providing transparency and a true marketplace that encourages competition, lower prices, safety and quality — all of which benefits consumers and the health care system as a whole.

Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this idea that people should think more deeply about?

I don’t see us creating any drawbacks or concerns for consumers or practitioners. As for the industry, there is bound to be some apple carts disturbed, but that is all part of change and evolution. Because consumers are not able to compare prices, safety and effectiveness, pharmaceutical companies have the power to charge whatever they want and to market inferior products. MedSavvy will assign a low grade to medications that lack historical evidence, or because their proof of safety does not meet the standards that they should. Patients, their families, caregivers and doctors have the right to know this information.

Just as Amazon, Uber and Airbnb have revolutionized industries, MedSavvy aims to change the landscape of ours. We are trying to effect real and positive change within a health care system that is clearly broken and only getting worse. MedSavvy was created to help consumers who are becoming more and more frustrated and concerned with the lack of transparency, choice, safety and affordability of prescription medications. We are approaching this from the perspective of doing something for the greater good, changing the status quo by putting people before profits.

Was there a “tipping point” that led you to this idea? Can you tell us that story?

We built a system to review and analyze studies and product information that enabled us to assess the effectiveness and safety of any given medication. Using this system, it quickly became apparent that we were on the right path. For example, we called into question Avastin for breast cancer, which eventually had its FDA approval withdrawn. Another example would be the first alpha tests we conducted, educating men about the safety risks of testosterone replacement. Shortly after our test went out, the FDA issued new warnings. These types of successes gave us confidence that our assessments of medications were correct — which created the foundation to build MedSavvy.

What do you need to lead this idea to widespread adoption?

I truly believe that it will be a matter of enabling consumers and practitioners to experience MedSavvy for themselves. This will be a grassroots, word-of-mouth experience that will open people’s eyes to the fact that they don’t need to be kept in the dark about the safety, effectiveness and prices of medications. The sad reality is that there’s a lot of money to be made by maintaining the status quo of keeping people uninformed about their choices.

It will be important for practitioners, employers and health insurance providers to understand the benefits of MedSavvy. They should not only make it available, but promote it as a tool to improve health and wellness. MedSavvy is something that should be implemented for the greater good and as a step in the right direction for health care reform.

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

  1. There is a tremendous amount of inertia in health care. While we knew that taking on the status quo would be extremely complex, I didn’t realize just how reluctant some players in the industry are to make changes. Not all health care companies will be motivated by “doing the right thing for consumers”. Sometimes, it’s not enough for a new solution to save consumers money; that solution needs to make a potential partner a lot more money over other initiatives to gain attention and prioritization.
  2. Change takes time no matter how great an idea is. Health care comes with a lot of baggage and broken promises. The sales cycle is extremely long. We don’t have to just worry about making our services great, we must overcome a history of those other failed services to earn the trust of potential users.
  3. It’s a common perception that the tools and services practitioners use need to be part of or fully integrated into their workflow systems to be utilized. However, we’ve observed that if a solution delivers enough value, practitioners will use it no matter where it lives. Conversely, if it provides no value, it will be ignored, even if it’s part of a current workflow system. We also know that workflows are not the same and that medical record formats are different, and in some cases, they even vary within the same health system or practitioner group.
  4. Point solutions are dead-on-arrival. Solutions and services need to be integrated with other health care services to be sustainable.
  5. We within the health care industry significantly overestimate the enthusiasm and interest of everyday people to be active in their own health care.

The future of work is a common theme. What can one do to “future proof” their career?

Be curious and bold. Follow your passions, don’t wait for others and don’t be afraid to fail. When it comes to consumers in health care, there will always be challenges to solve. Listen carefully to what they want and learn how you can meet their needs.

Based on the future trends in your industry, if you had a million dollars, what would you invest in?

Companies like MedSavvy that are focused on changing the status quo and providing consumers with a better way to manage their health care.

Which principles or philosophies have guided your life? Your career?

  • Be a professional skeptic and always relentlessly pursue truth
  • Credibility and the trust of your colleagues and customers is your greatest asset, which makes it crucial to always do the right thing, even if no one is looking
  • Don’t be afraid to make mistakes and, when you do, take responsibility for them
  • Ensure that credit is given to all who contribute to a project, regardless of the size of the contribution

Can you share with our readers what you think are the most important “success habits” or “success mindsets”?

  • Follow your passions and beliefs, and don’t give up if you’re doing the right thing, because others will eventually catch on.
  • Listen very carefully to your customers because they will always tell you if you’re doing the right thing.

Some very well known VCs read this column. If you had 60 seconds to make a pitch to a VC, what would you say?

Consumers and practitioners alike are frustrated and concerned with the rising costs of prescription medications and the lack of transparency in health care. MedSavvy is creating a window necessary to see through the current system and it benefits everyone. Consumers have access to the information and options they need to make informed decisions. Practitioners have a reliable source for evidence-based analysis of medications and the costs to their patients. The health care industry gets a marketplace that will create competition and innovation.

How can our readers follow you on social media?

On Twitter at @seankarbs and @BeMedSavvy.

Thank you so much for joining us. This was very inspirational.

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