Spherix Global Insights

April 07, 2021

Specialty Physicians Point to Permanent Changes Introduced by the COVID-19 Pandemic, Highlighting the Challenges that Lie Ahead for Pharmaceutical Manufacturers

Findings from the 16th wave of Spherix Global Insights’ COVID-19 research indicate that telemedicine is firmly entrenched, industry interaction remains largely virtual, and many practices are unlikely to return to pre-pandemic volumes

EXTON, Pa., April 7, 2021 /PRNewswire/ — Since late March 2020, Spherix has been surveying specialty physicians (dermatologists, gastroenterologists, nephrologists, neurologists, and rheumatologists) in the United States to track the impact of the COVID-19 pandemic on their practice operations, personal concerns, interaction with the pharmaceutical industry, and outlook for the near term. In all, Spherix collected feedback from more than 4,000 respondents via online survey, and the culmination of the report series, Special Topix™: Multi-Specialty Impact of COVID-19 (US), was released last week – highlighting the evolution of the past year’s events.

The 16th wave, which is based on the responses of 267 US specialists surveyed on March 12, 2021, provides a unique year-over-year view of the impact of COVID-19. Here’s where things stand today:

  • Only 39% of all specialists report that their practices are operating at normal (or above) capacity.
  • 42% report that it is impossible to return to pre-pandemic levels while complying with Centers for Disease Control (CDC) mandates around social distancing and sanitation.
  • Specialists continue to report reluctance on the part of many patients to enter healthcare facilities.
    • In-person, outpatient visits are still 29% below pre-pandemic levels, with telemedicine unable to close the gap.
    • New prescription volume continues to lag typical pre-COVID-19 levels.
  • Ninety-two percent of the specialists are actively utilizing telemedicine, though only 5% offered this service to their patients pre-pandemic.
    • The vast majority (75%) intend to continue offering telehealth services, pending reimbursement remains intact.
    • After a bumpy start, many of the challenges associated with telemedicine have been worked out, and overall, physicians express satisfaction with the outcomes they achieve with virtual visits.
    • That said, 38% would prefer not to do any telemedicine, and the physicians are divided as to whether virtual visits are ever acceptable for new patient assessments.
    • Dermatologists are the most resistant to telemedicine out of all specialists included in this coverage.
  • More than half of surveyed specialists agree with the statement, “In the past six months, I have begun to feel more burnt out.”
    • 16% report that, if they could do it over, they would not choose a career as a physician in their specialty.
  • 42% are very satisfied with President Biden’s handling of the pandemic – a far cry from the 15% very satisfied with President Trump’s handling of crisis when measured in October 2020.
    • More than half (53%) are highly satisfied with Dr. Fauci.
    • Only about one-quarter (27%) are highly satisfied with the American Medical Association; satisfaction ratings are higher for specialty-specific organizations such as The American College of Rheumatology and The American Society of Nephrology.
  • Specialists are particularly divided about their satisfaction with the vaccine rollout.
    • 30% are satisfied, 38% are neutral, and 32% are dissatisfied with how the rollout has been handled.
    • The top concerns among specialists have varied widely from wave to wave; at present, the greatest concern collectively is related to COVID-19 variants and whether the vaccines will be effective against them.
    • Although almost all specialists are now fully vaccinated, personal exposure remains a concern as does the impact on the economy.
    • Specialists are divided, however, on which is a greater concern – being able to return to normal (55%) or maintaining virus mitigation strategies including masking and social distancing (45%).
  • Interaction with industry is making a slow comeback.
    • Many physician offices that had regular engagement with pharmaceutical representatives in the pre-pandemic world remain closed to industry today.
    • Among those that are interacting, most of the engagement remains virtual at this point.
    • The need to balance face-to-face, virtual live, and non-personal promotion presents considerable challenges for companies, especially those attempting to launch new products.

Each specialty faces unique challenges which are explored in the reports. Dermatologists and gastroenterologists have taken the largest financial hit – owing to the dependence on elective procedures which have been suppressed throughout the pandemic. Indeed, there has been an incredible acceleration of gastroenterology practice consolidation, as more and more practices move to management services organizations (MSOs) fueled by private equity. This trend is further explored in Spherix’s latest publication done in collaboration with Fraser Healthcare, Special Topix™: The Business of Gastroenterology (US), which quantifies the surge and outlines the ramifications for pharmaceutical companies – specifically those with products used to treat inflammatory bowel disease.

Rheumatologists are gradually returning to an in-person patient model, with 74% of their patients treated with advanced systemics being seen in-person in the past month. However, the vast majority report having biologic-eligible patients (either rheumatoid arthritis, psoriatic arthritis, and/or ankylosing spondylitis) whom they are delaying initiation. Additionally, since the announcement of the failed ORAL Surveillance safety study of Pfizer’s tofacitinib in late January1, perceptions about the JAK class have become decisively more negative.

Neurologists report a wide range in terms of the degree of disruption in neurological disorders caused by the pandemic. Patients diagnosed with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder are among the most impacted, while epilepsy and migraine/headache disorders have fared better. For MS, a notable number of neurologists have reduced their use of B-cell therapies, such as Genentech’s Ocrevus and Novartis’ Kesimpta, due to concerns that patients may be more susceptible to developing severe COVID-19 if infected or that COVID-19 vaccine efficacy may be attenuated. In these cases, the b-cell therapies are losing share to fumarate or glatiramer acetate agents or Biogen’s Tysabri.

Nephrologists have been more buffered than other specialists, as their practice operations also include dialysis and in-patient consults – both of which were relatively unscathed from a volume perspective.  However, the patients they manage are complex. Many are on immunosuppressive therapies for post-transplant management or for the management of diseases like lupus nephritis, and overall, the chronic kidney disease patients tend to be older with a greater comorbidity profile than age-matched peers – placing them at increased risk. This, coupled with COVID-induced acute kidney injury, has made for a very difficult year for nephrologists.

In general, pharmaceutical companies have been challenged during the pandemic, as practitioners were far more preoccupied with imminent issues than they were with keeping current on drug therapies.  Overall, specialists found drug manufacturers to be “moderately supportive,” acknowledging that there was not a clear role for industry to play other than to be available if needed. Standout companies during the pandemic included AbbVie for dermatologists, rheumatologists, and gastroenterologists, Biogen for neurologists, and AstraZeneca for nephrologists.

After a year of tribulations, however, specialists are optimistic. With more than 90% of specialists fully vaccinated by early March, only 11% anticipate a worsening situation in the next couple of weeks (though most feel that things are on the right track). Spherix will conduct a follow up survey in May 2021 to assess the progress (or lack thereof) toward complete re-opening, with quarterly tracking continuing throughout the year.

 About Special Topix™
Special Topix™: Multi-Specialty Impact of COVID-19 (US) is an ongoing series of monthly/quarterly monitoring that evaluates the impact of COVID-19 on physicians and their practices – including, but not limited to, the utilization of telemedicine, at-risk patient groups, key concerns, support from industry, and future changes in prescribing patterns. Specialty reports are available for dermatology, gastroenterology, nephrology, neurology, and rheumatology.

 Learn more about our services here.

 About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select immunology, nephrology, and neurology markets.

All company, brand or product names in this document are trademarks of their respective holders.