By María Velasco. Originally published in ConSalud.es.
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The Roundtable: ‘Sustainability and Value: Challenges for the NHS’, organised by the IE Alumni Lifesciences Club, which regularly organises meetings on current affairs, was held in Madrid. The event was coordinated and organised by the consulting firm EuroGalenus.
The first speaker was Máximo Gómez, Country Manager of Johnson & Johnson Vision for Iberia, who began his presentation by highlighting the differences between the public and private sectors, as well as their complementarity in many regions and treatments. He focused the description of the very current concept of Value-based Healthcare based on Michael Porter’s definition, already in 2006: measurement must always include the patient, who thus becomes the focus. Máximo described the relevance of the International Consortium for Health Outcomes Measurement ICHOM, which has defined 21 medical conditions that already have a measurement standard and gave examples such as cataracts or Inflammatory Bowel Disease. The necessary transparency leads to continuous improvement and value-based purchasing requires all actors to be aligned.
This was followed by a very practical perspective from Maria Vila, President of Medtronic for Spain and Portugal, who also gave very practical examples. She began by commenting on the lower percentage of GDP spent on healthcare in Spain compared to our European neighbours. This fact, combined with the fact that ageing expectations are growing, and with it the need for chronic treatments, poses a challenge to the sustainability of the healthcare system. To meet this challenge, the health system must move from paying for products and services to paying for value: improvements in outcomes that patients value, at a lower cost. There are many opportunities to improve efficiency, and in many cases working to improve efficiency leads directly to improved quality and outcomes for patients.
He also commented on the need for industry to get involved in this search for efficiency, and to provide multifactorial solutions that add value to the complete management of each disease and not just to each part of the disease process. He gave as an example the technology to tackle stroke, which can save lives and eliminate the after-effects of the disease, but requires a comprehensive approach that not only consists of providing technology, but also includes logistics, prevention, rehabilitation and even training and communication to the population. This transformation of the system requires the promotion of new models of innovative public procurement. He offered already successful examples such as remote monitoring of patients with cardiac implants, chronic diabetes care in specialised centres with potential savings of 9% and improvement in the condition of patients, or the integrated management of obesity treatment.
Next, Javier Ellena, President of Lilly for Spain, Portugal and Greece, highlighted the value added in the offer, particularly with the new biological treatments that provide even more innovative and even disruptive solutions, as has been the case with hepatitis C treatments. The patient has become a key player and the sector is moving towards personalised medicine. Increased complexity will lead to higher costs, which will translate into higher healthcare spending, jeopardising sustainability.
Speaking of equity, the differences between Autonomous Communities are striking and the 2020 plan proposes increasing spending, but below GDP growth. There is a gap to keep our health system sustainable. Regarding this gap in health financing, some political parties put the figure at around €8,000 million or propose the need to invest at least 7% of GDP (compared to the 5.57% proposed in the 2020 Stability Plan presented by Spain in Europe).
Finally, as usual during the participative round tables of the IE Healthcare Club, attendees asked questions and debated with interest on these and other related topics, such as innovative public procurement, obsolescence of hospital equipment and the need to focus on efficiency, not just spending figures, as there is already a lot of data available and now it is necessary to elaborate them and use Big Data. It is necessary to search for the insgiht, to identify unmet needs.
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