The Affordable Care Act, the health reform law better known as Obamacare, is quickly changing the medical care landscape. Gone are the days when insurers could deny coverage for preexisting conditions; now there are laws that beef up the minimum benefit requirements of health plans for all individuals that want health insurance, preexisting conditions or not.
Between the third quarter of 2013 and the third quarter of 2014 Obamacare has pushed the uninsured rate from 18% (which was the highest on record since Gallup-Healthways began keeping track of health insurance data in Q1 2008) to 13.4%, a low since 2008.
The obvious implication is that having more people insured will give consumers a greater incentive to visit their primary care physicians and get preventative care. Admittedly, though, preventative care isn't the only reason Americans visit the doctor. Many, like me, have to be dragged in kicking and screaming against their will. The World Health Organization in 2011 noted that there are more than 12,400 disease and health-related ailments, so our reasons for visiting the doctor can be widely varied.
The most common reason people visit their doctors
With this in mind the Mayo Clinic undertook a study between 2005 and 2009 that examined 142,377 patients to precisely determine why they went to the doctor. Understandably, some people went to see their doctors for more than just one reason, so all of the disease indications applied in the Mayo Clinic study. Following its multiyear study, the Mayo Clinic was able to aggregate its data to determine what the most common reasons are for people to visit their doctors.
Do you have any guesses what ailment was the most common reason cited?
Did you say a headache or having the flu? I know personally this might be why I visit the doctor most often, but these weren't the top reasons given in the Mayo Clinic study. Headaches and migraines ranked ninth on the list while upper respiratory conditions, excluding asthma, were fifth.
How about chronic conditions like diabetes, cholesterol, or high blood pressure (known as hypertension)? These are diseases that require constant management and regular checkups, so it's plausible they could be the most common reason for visiting a physician. Not quite according to the Mayo Clinic. Diabetes ranked 10th, cholesterol problems were the fourth most common reason to visit a doctor, and hypertension was eighth.
Surprisingly, the most common reason Americans visit their doctor is for skin disorders, including cysts, acne, and dermatitis. Skin disorders were responsible for 42.7% of all office visits according to respondents, well ahead of osteoarthritis and joint disorders, back problems, cholesterol, and upper respiratory tract disease visits, which rank No. 2 through No. 5.
Staying in touch with consumer concerns
The reason we might visit our doctor for a skin disorder is wide-ranging. In our youth it could be for acne or other skin blemishes. However, as we age more serious issues could arise, including visits for precancerous and cancerous lesions.
According to the Skin Cancer Foundation, of the seven most common types of cancer melanoma is the only one whose incidence actually increased between 2000 and 2009, rising by 1.9% per year. In a general sense, nearly 5 million people in the U.S. are treated for skin cancer on an annual basis. Also, nonmelanoma skin cancer treatments increased by nearly 77% between 1992 and 2006. Long story short, there's a laundry list of statistics that point to a growing need for medicines aimed at helping serious skin disorders, including skin cancers.
The good news is drug developers realize this and we saw a number of game-changing new medicines hit the market last year.
For example, advanced melanoma patients received two new medications that could have positive effects on their quality of life. Merck's (NYSE:MRK) Keytruda and Bristol-Myers Squibb's (NYSE:BMY) Opdivo are part of a new class of cancer drugs known as immunotherapies, which work with the body's immune system to help it recognize and attack cancer cells that would otherwise go undetected. Both drugs are currently approved as somewhat of a last line of defense after other treatments have failed, or patients stop responding to them.
In clinical trials that led to the drug's approval by the Food and Drug Administration, Keytruda induced tumor shrinkage in 24% of patients that lasted anywhere from 1.4 months to 8.5 months. In Opdivo's case, it demonstrated tumor shrinkage in 32% of patients, with one-third exhibiting a durable response of more than six months. Understandably that may not sound like a lot of time, but when we're talking about a third- or fourth-line treatment giving one in four or one in three patients sustained disease control for this length of time it's truly incredible.
But drug developers aren't focusing solely on cancer, either. Eli Lilly (NYSE:LLY), for instance, could have an exciting new psoriasis medication hitting the market within the next year. Its currently experimental drug, ixekizumab (say that three times fast!), met all primary and secondary endpoints in a phase 3 study this past summer and was shown to be statistically superior to Amgen's Enbrel (a potential competitor) on all measures of skin clearance in its moderate to severe plaque psoriasis studies. Based on trial data, after just 12 weeks 41% of patients treated with ixekizumab had clear skin. A regulatory filing is expected sometime during the first half of this year.
Drug developers still have a long way to go in the research department, but knowing what drives consumers to see their doctors should give drug companies clearly defined diseases to focus on treating moving forward.