Three Minutes with Dr. Joseph Leach

Joseph Leach, M.D., brings several critical perspectives to his role as Prime’s new senior vice president and chief medical officer.

He’s a practicing physician with more than 20 years’ experience and continues to practice part-time. He understands the challenges of coordinating with health plans and pharmacy benefit managers and the balance of effectively treating patients while managing costs. He’s an oncologist, well-versed in prescribing some of the newest, most innovative – and costly – specialty medicines.

Dr. Leach, who joined Prime in May, recently shared his thoughts on how Prime is changing to help reduce friction in the health care system, as well as his views on innovative, new medicines and the importance of managing their costs while optimizing outcomes.

Innovative new immunotherapies have been called “miracles” for cancer treatment. Why?

Even just five years ago, if you were diagnosed with stage 4 lung cancer, your time on earth sadly was likely limited. Immunotherapies have changed what had been a death sentence into what can for some be a very treatable, chronic disease. And unlike traditional chemotherapy, we don’t see side effects like fatigue, nausea and a weakened immune system with the new immunotherapy treatments. Recently, we saw the results of the longest study to-date conducted on immunotherapy patients being treated for stage 4 lung cancer. Before immunotherapy, about 1 in 10 patients were still alive two years after diagnosis. Now, with immunotherapy, about one-third of patients are still alive five years after the diagnosis. So, for some patients, these drugs truly are miracles.

Immunotherapies are some of the most expensive treatments in existence. What can Prime do to ensure they are used both effectively and efficiently?

First, we need to ensure these medications are being used in appropriate, evidence-based ways. I have heard doctors comment that no one should die of advanced cancer without trying immunotherapy – even in the absence of any evidence that the therapy is effective for that specific patient’s cancer type. We have to resist a “just in case it works” mindset. It’s important to understand the immune system is a ‘living treatment.’ It doesn’t stop working after treatment is ceased; the benefits seem to carry on well after the immunotherapy is completed. And there’s more and more evidence that if a patient’s cancer is controlled after two years of treatment, it may be appropriate to stop the treatment. We need to continue to monitor the data and we need to listen to treating physicians to determine when they are comfortable stopping treatment.

Aside from immunotherapies, are there other breakthrough therapies you are watching?

CAR-T therapies can be incredibly impactful when they work. They are also very expensive, so we are watching CAR-T therapies closely. Targeted therapies, while not new, are also something we are paying attention to. This year alone we have already seen seven new, targeted agents approved for use in oncology. These are typically oral drugs that turn off a specific genetic alteration that is causing a cancer to grow.

Making health care work better by reducing friction for health care providers and consumers is one of your priorities. What are some ways Prime can do that?

We’re working closely with our Blue Plans on this, as they have the strongest relationships with providers, and they understand the local market dynamics and unique issues. Asking providers about their experiences and ideas and really listening to what they have to say is important. For example, as we work on improving prior approval processes, we want to hear from physicians. We know the amount of prior approval work doctors have to do is significant. The burden is substantial. That’s one area, among others, where we will work to streamline, simplify and reduce friction.

Another area where Prime is improving is our ability to provide insights from having the right data at the right time. Prime’s recent hiring of Urvi Randhar as chief information and technology officer, Sam Mohanty as chief data officer, and Sarah Taylor as chief analytics officer, brings tremendous experience to our organization. Together they will help us leverage data to reduce pain points across the health care system and make our mission – getting people the medicine they need to feel better and live well – more efficient and ultimately deliver better outcomes.

What future trends are you thinking about?

Looking ahead, I’m focused on how we can strengthen partnerships between Prime, health plans and physicians. One of the many ways we’re seeing stronger partnerships is through accountable care arrangements, where plans and providers partner to work on reducing costs and share in the financial risks of providing treatment. Given the increasing proportion that drug spend has in overall health care cost, Prime has a significant role to play in enhancing the success of these arrangements. A key component will be providing plans and providers with actionable data. Enhancing our data and analytics capabilities will be crucial in assisting our plans and providers to maximize health care value. Finally, I think we need to explore new models to partner better with providers and I’m excited about some pilots that we’ll be launching in early 2021 that I think have a chance to be a significant improvement for our plans and most importantly our patients.