Since 2016, InCrowd has conducted an annual survey asking physicians about their priorities and expectations for the year ahead. Not surprisingly, healthcare access and affordability have remained common themes among respondents. However, while a range of solutions are being volleyed by policymakers and presidential candidates, results indicate that physicians aren’t banking on big changes for 2020.

Drug Prices and Coverage

Innovation is the lifeblood of the pharmaceuticals industry, and the demand for new treatments remains high. However, after a year of market consolidation and increasing drug prices, physicians seem less concerned with the development of new therapies and more focused on affordable treatment and access to care for patients. “Reduced drug costs” (68%) and “improved coverage/less prior authorization” (18%) top the respondents’ wishlist for 2020.

As one North Carolina-based PCP put it, “A great new drug is worthless if patients can’t afford it.”

Moreover, respondents are frustrated with what they perceive to be profit-driven behaviors from the pharma industry, such as price gauging (cited by a third of respondents) and marketing, sales and direct-to-consumer advertising costs (called out by half of respondents). And nearly 30% of physicians predict rising drug prices in 2020, which is the highest percentage of mentions on record since InCrowd’s inaugural survey.

A specialist in Missouri expects, “An overall increase in the price of medication, with decreased production of generics resulting in more expensive generics or brand-named drugs being forced on consumers.”

Healthcare Reform

Likewise, while a majority of respondents believe the Affordable Care Act (ACA)—and its preexisting conditions mandate—will remain in place through the end of 2020, 80% believe the ACA is likely to continue to be defunded. The crowd was split on the impact of potential ACA eradication, with some physicians fearing for Americans left without coverage and others citing the practical shortcomings of the legislation as it stands.

Many physicians have vocalized support for a universal healthcare model, supporting a gradual rollout that builds on an existing system, allows for both public and private options to coexist, and provides for adequate physician reimbursement. However, very few believe 2020 will yield the support required for implementation.

“Despite the rhetoric out there, there are too many players in the health industry that stand to lose big if change were to occur, so I expect those forces to resist change,” said one Texas-based specialist. “I anticipate that it will be more of the same in the future.”

Strengthened technology was noted by several respondents as a key component of a new healthcare model, although striking a balance between protection and access to patient information remains a challenge. Over two-thirds of respondents believe that 2020 will bring about more patient privacy issues due to growing use of technology in medicine. While several physicians see a data breach as an imminent threat, many others stress that the sharing of medical data is critical to effective care and should not be thwarted by privacy concerns.

The Opioid Epidemic

Perhaps the only area where physicians are showing signs of optimism is the opioid crisis. On the heels of multiple lawsuits and settlements involving opioid manufacturers and distributors and the first decline in drug overdose deaths in almost two decades, nearly two-thirds of respondents predict that opioid addition will stabilize or wane in 2020. Respondents advocate for better mental health programs, removal of satisfaction surveys, and proliferation of alternative medicines to further address the epidemic.

The Final Word

While it is clear that physicians aren’t predicting 2020 to be a year of transformative change for healthcare, they also aren’t leaving progress up to external forces alone.

Similar to previous years, physicians believe their peer group can take action to reduce costs for patients. Respondents recommend that physicians stay informed of cost-saving prescription practices (37%), limit use of expensive tests and scans (21%), and prescribe generics when possible (20%), so that change can be made however possible, for now—little by little, patient by patient.