Brian Evanko’s on affordable, personalized healthcare

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McKinsey on Healthcare 31 min 2 speakers 5 chapters transcribed 2 months ago
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Celia Huber 0:04
Welcome. You're listening to the McKinsey on Healthcare podcast, where we explore issues and ideas shaping the future of healthcare. I'm Celia Huber, a senior partner in McKinsey's healthcare practice and a leader of our North American board services practice and your host for today's episode. This episode is also being distributed in partnership with Modern Healthcare, a leading source of industry news. I'm joined by Brian Ivanko, President and Chief Operating Officer of the Cigna Group. In this role, Brian oversees all of the company's business units, including its two growth platforms, Cigna Healthcare and Evernorth Health Services, which together serve customers in more than 30 countries. Since joining Cigna in 1998, he has held leadership roles spanning finance, U.S.
Celia Huber 0:57
government programs, international businesses, and today he is a member of the company's enterprise leadership team. Thanks for joining us today, Brian.
Brian Evanko 1:06
Thank you, Celia.
Celia Huber 1:07
I'd love to start with a little bit of your personal journey. So what attracted you initially to Cigna?
Brian Evanko 1:15
I joined the Cigna Group 27 plus years ago now. And this was straight out of university where I studied actuarial science and risk management. And Cigna was a multi-line insurer at the time. And it was a great place for a young aspiring financial person like myself to come and work. Had a long tradition of success for people that had trained in risk management growing into executive positions. So I came here to essentially learn the business, see where my career would go. And as time unfolded, I realized that the company was really good at healthcare. And we made a lot of strategic decisions over the years to de-emphasize other businesses, including selling a number of businesses that were not in the health space.
Brian Evanko 1:54
And we added other businesses that were in the healthcare and health services space. And over time, I realized my passion is around making the healthcare system better for everyone. And this is a great place to do that, which is still why I'm here 27 years later.
Celia Huber 2:09
The industry must have changed so much over that time period. Maybe think about how the industry has evolved. What would be the highlights of that?
Brian Evanko 2:19
The industry has changed tremendously over that 27 years that I've been at the Cigna Group. I'd probably be remiss if I didn't start with some of the good things in terms of things that have changed for the better. And this is for everyone. When you step back and think about the benefits to society, there's been a tremendous amount of device innovation. So think about robots that can now conduct surgeries. assisted by doctors, of course, but robots that can do really complex things that weren't possible in the prior millennium, if you will. And then additionally, pharmaceutical innovation has been unbelievable, right? And you think about all of the curative diseases or curative prescriptions now for diseases that we didn't think were possible in the past, and more recently, GLP-1s.
Brian Evanko 3:01
which originally were used for diabetes, but now are being increasingly used for weight management. And those are having a beneficial impact on society. The converse of all that is affordability. Affordability is problem number one in the US healthcare system. So you go back to the turn of the century, 25 years ago, and healthcare was about 13% of the US economy, 13% of GDP. Now it's about 18%. That's a problem, right? Increasing cost levels year after year, consuming a larger share of the overall economy. That's a big problem. And the converse of all the innovation I talked about earlier, whether it be device or pharmaceuticals, is the cost of that. And so high cost prescription drugs are a big problem for affordability ultimately.
Brian Evanko 3:47
And while only 10% of all prescription drugs in the US are brand oriented, it represents 88% of the spending. And so this small sliver of prescription drug utilization, which in a lot of ways has been breakthrough from the standpoint of innovation, is really expensive. And the way that that's financed and paid for is a real problem for U.S.

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