Over the past 5 years, our research indicates that IDNs have become a major influencer in the U.S. provider market, especially for high-cost specialty medications.
Today 800 IDNs influence access to nearly 70% of all 7,000 hospitals around the country, and for specialty diseases they have an even greater sway. In cancer, they influence access to nearly 75% of all U.S. oncologists! 
The rapid growth of this channel is forcing biopharma to innovate and redesign sales & marketing strategies. The old sales “rep + MSL” model will not longer be effective in the new value-based environment. Why? Customer decision-makers have changed! They are no longer just physicians – IDN business managers are increasingly getting involved.
As a result, pharma needs to understand whether their direct competition is behind or ahead of this wave of innovation. Competitive intelligence can provide critical insights for brand teams.
To help better understand the size and structure of this critical new channel, especially for specialty drug marketers, we have developed some top-line stats.
Currently there are around 800 IDNs:
- 100 pure IDNs, not associated with ACOs
- 160 that are both IDNs and ACOs, and
- 540 pure ACOs
Although there are far more ACOs than pure IDNs, ACOs tend to be smaller. On average, ACOs have only 4 hospitals associated with their networks, while IDNs have 11. As a result, IDNs infleunce access to roughly the same number of hospitals as ACOs.
Analytics reveal that IDNs have networks of hundreds if not thousands of physicians in both in hospital practices and separate clinics.
In terms of physicians, the IDN channel is estimated to control access to around 250,000, or a third of the total 800,000 physicians practicing in the country. For specialty practices, this influence significantly increases, and for many disease areas, IDNs have become the dominant channel and are increasingly looking to define centralized treatment protocols through agreed-upon care pathways.
The fact that these 800 institutions can influence such a significant slice of the prescribing physician base across the country underscores just how important it is to understand the dynamics of this channel.
From our ongoing work in this area, we know it can be critical to understand how your competitors are attacking this market. So we ask three key questions:
- Do you know how your direct competitors are marketing to IDNs?
- Do you know if they are doing it well or poorly?
- Do you know how to exploit their shortcomings to your advantage?
 Our definition of Integrated Delivery Network (IDN) includes Accountable Care Organizations (ACOs). IDNs focus on all ages; ACOs on over 65s and Medicare patients
 Data from IMS Health