Multiple Morbidities and the Growing Rise of Complex, Costly Care

By McCann Health Managed Markets 

In the United States, the prevalence of multiple morbidities is increasing and expected to become further dire in the near future. Multiple morbidities are two or more medical or psychiatric chronic conditions that last for a year or more and which exist in the same patient.

Such shift in the epidemiology of multiple morbidities stems from the rise in aging adults, increases in survivorship and life expectancy due to public health and medical interventions, and ongoing lifestyle risk factors that contribute to the diagnosis of chronic conditions. For pharmaceutical and biotechnology manufacturers, this urgent challenge presents a pivotal opportunity to address the care and cost complexities that emerge from patients who have multiple morbidities.

What are the key multiple morbidity trends in the United States?
 

Epidemiology
 

An image with text that reads "Chronic conditions are the leading cause of death and disabillity"
An image with text that reads "4/10 Americans have two or more morbidities."
An image with text that reads "Multiple morbidities are more prevalent among older adults."
An image with text that reads "3/4 Americans aged 65+ have multiple morbidities."
An image with text that reads "Women are more likely than men to have multiple morbidities."
An image with text that reads "12% of Americans have five or more morbidities."

Common chronic conditions conducive to multiple morbidities include: heart disease, cancer, chronic lung disease, stroke, Alzheimer’s disease, diabetes, chronic kidney disease (key examples: cardio-oncology morbidities, cardio-metabolic conditions, psoriatic arthritis/cardiovascular disease, schizophrenia/diabetes, nash/diabetes)

Expenditures


An image with text that reads "Chronic conditions cost the nation $3.3 trillion each year."
An image with text that reads "71% of all health care spending is toward Americans with multiple morbidities."
An image with text that reads "93 cents per dollar are spent on treating multiple morbidities."

Annual average out-of-pocket (OOP) costs and number of prescriptions increase substantially for patients with multiple morbidities. 
 

An image with text that reads "No multiple morbidities = 3.5 prescriptions."
An image with text that reads "Three multiple morbidities = 23 prescriptions"
An image with text that reads "Five multiple morbidities = 50 prescriptions"

What is the impact of multiple morbidities to key health care stakeholders?


Implications for payers, health systems and providers

  • High-cost care and wastage, especially if therapy management is not well-coordinated
  • Unestablished pathways to patient identification and risk assessment
  • Limited evidence base on treating patients with multiple morbidities
  • Involved care coordination across multiple therapeutic disciplines
  • Complex medication management and polypharmacy
  • Onerous access and reimbursement hurdles

Implications for patients

  • Fluctuating day-to-day functioning and diminished quality of life
  • Greater risk of treatment complications, adverse outcomes, hospitalizations and death
  • Conflicting, confusing, and complex care communication from multiple providers
  • Increased burden of health care spend
  • Persistent need for caregiver and ancillary support

What role can manufacturers play to address multiple morbidities?
 

  • Design data-generating programs that evaluate the clinical and economic impact of multiple morbidities (eg, clinical trials, real-world evidence) and subsequently demonstrate how the brand can bring value
  • Invest in value-based initiatives for health system customers that support population health management and care coordination needs
  • Partner with professional organizations to assess, enhance, or develop guidelines and standards of care that involve multiple morbidities
  • Demonstrate value and outcomes from multiple morbidity management programs on total cost of care to health system and payer customers
  • Create patient solutions and services that expressly address the complexities of multiple morbidities (eg, adherence management, access support, caregiver resources)
  • Generate support resources for office staff on managing patients with multiple morbidities (eg, reimbursement tools, communication protocols, policy education)

Manufacturers have an important and timely opportunity to demonstrate leadership by providing solutions across therapeutic areas within their portfolios that are commonly subject to multiple morbidities.

How McCann Health Managed Markets can help
 

Turn to McCann Health Managed Markets to help you with developing your strategy and solutions in addressing the care and cost complexities of multiple morbidities, so that ultimately patients can better navigate their health.

 

Resources

Agency for Healthcare Research and Quality

Buttroff C, Ruger T, Bauman M. Multiple Chronic Conditions in the United States

Centers for Disease Control and Prevention

Centers for Medicare & Medicaid Services

Whitson HE, Boyd CM.  Managing Multiple Comorbidities

United States Department of Health and Human Services