Merck, Geisinger team up to make sure patients follow doctors' orders

"We believe that health care is most effective when patients are active partners in their care," said Geisinger's Glenn Steele Jr.CLEM MURRAY / Staff Photographer
"We believe that health care is most effective when patients are active partners in their care," said Geisinger's Glenn Steele Jr.CLEM MURRAY / Staff Photographer
Posted: June 20, 2012

The interests of Merck & Co. Inc. and Geisinger Health System intersect enough that the pair announced on Monday a multiyear collaboration to improve the coordination of care and get patients to take prescribed medicine more regularly than they do now.

Geisinger is a physician-led, nonprofit enterprise, based in Danville, Pa., that treats patients and provides insurance for the costs. It is often cited as one of the most innovative health-care operations in the country.

Merck, a drugmaker based in Whitehouse Station, N.J., has operations in Philadelphia's suburbs and 140 countries.

"We believe that health care is most effective when patients are active partners in their care," Glenn Steele Jr., president and chief executive officer of Geisinger Health System, said in a statement. "Our collaboration with Merck will allow both organizations to leverage our individual expertise and joint resources to improve patient engagement, including finding new interventions to increase the likelihood that patients will adhere to their treatment plans."

Neither side offered financial specifics about up-front contributions or hoped-for revenue or savings.

Mark Timney, Merck's president of global human health for the U.S. market, said in an interview that Merck would contribute millions of dollars in employee time and energy, but not product, meaning Geisinger doctors won't be obligated to write prescriptions for Merck drugs ahead of competitors.

"There is nothing specific in this contract about that," Timney said. "A big focus is adherence and this collaboration is agnostic regarding brand or company in what that solution might look like."

Getting patients to actually take medication and refill maintenance drugs — "adhere" to the doctor's prescribed plan — especially medicine for chronic diseases, can help pharmaceutical companies because it means more pills would be purchased. But plenty of health-care professionals with no particular allegiance to drug companies also say that improved adherence dramatically decreases catastrophic health events that result in emergency room visits, hospital stays, and huge costs.

Geisinger has 37 community practice sites and five hospitals (a sixth joins in July), with doctors serving patients in 31 counties in central and northeastern Pennsylvania. It is unusual in that it provides medical services and insurance.

While employing doctors, nurses, and staff to treat patients in clinics and with follow-up calls when they are at home, Geisinger also employs the accountants and actuaries of an insurer. The goal is to improve overall care for less cost than the disjointed fee-for-service system.

Theoretically, that negates, at least some of the time, expense and frustration inherent in the fee-for-service system, marked by constant reimbursement disputes between doctors and insurers with patients stuck in the middle.

About 30 percent of Geisinger patients are covered by its insurance, with patients or employers paying the insurance premium.

The other 70 percent of Geisinger patients are insured by other plans, including government plans such as Medicare and Medicaid. About 55 percent of those with Geisinger insurance see non-Geisinger doctors.

All three sets of patient populations will help test any ideas spinning out of the collaboration with Merck, said Dr. Thomas Graf, chairman of Geisinger's Community Practice.

Geisinger is also way ahead of most health-care systems in using electronic medical records, which is where Merck comes in. The collaboration will start with development of an interactive web-based application that will try to help doctors and nurses engage patients who might be at risk for developing type 2 diabetes and cardiovascular disease.

Merck has medicine for both diseases, but one of its four core strategies is to expand into complementary areas of health care.

"If the solution is successful," Timney said, "perhaps it is something we can commercialize and scale up."

Will the name Merck be on computer screens all the time, acting like advertising?

James Peters, one of the Geisinger leaders on the project, said that Geisinger respects Merck's research in this area, but that the "spirit" of the project was not to create a "Merck-specific" product, adding, "I can't imagine that would make sense."

University of Michigan business professor Erik Gordon said that with the declining access of sales representatives to doctors, Merck and other drug companies are looking for other ways to get their products in front of anyone involved in writing prescriptions.

"Unless you believe that Merck has become an philanthropic organization," Gordon said, "there is a marketing purpose behind this."

Contact David Sell at 215-854-4506 or or Twitter @PhillyPharma. Read his PhillyPharma blog on

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