A relentless commitment to the blame game
Looking at the recent Politico articles quoting Dr. Clemens Auer, Director General at the Austrian Federal Ministry of Health and Women’s Affairs, I am struck by the perpetual polarisation of the healthcare debate. Demand for healthcare services is rising at an unprecedented rate across Europe, driven by increasing chronic disease and an ageing population. Yet the response to these challenges, from many, seems to be a relentless commitment to the blame game.
“Industry charges too much for its innovative new treatments”
“HTA bodies don’t consider life time and societal value”
“Payers focus on cost containment not outcomes”
“Governments don’t make adequate provision for healthcare”
And so it goes on, and on, and on.
It certainly makes for snappy headlines, it allows us all to play to our home crowd but it doesn’t move us forward and ultimately that means that we are not doing the best for patients.
To really address the significant challenges faced by our healthcare systems and our society will require new levels of collaboration, new types of partnership. We need to focus on improving patient outcomes, particularly when they vary significantly across countries, even within health systems. We need to direct resources at the interventions that make the most difference to patients and identify and eradicate waste.
Spending on medicines has remained constant at around 20% of total healthcare budgets while OECD estimates that waste in our healthcare systems at between 20% and 40%. As they will assume the Presidency of the EU in the second half of next year, let's take Austria as an example. The Commission’s country report on Austria in the 2017 European Semester points out that "Austria’s healthcare system is characterised by a large and costly hospital sector which, together with projected ageing of the population, threatens its long-term sustainability.” Despite being relatively affluent, it has the third highest hospitalisation rates for diabetes across OECD countries, it lags behind most of Europe in the number cataract surgeries performed on a same day basis. According to OECD Health at a Glance 2017, for foot or leg amputations for diabetes patients there is a 14-fold difference between OECD countries. For example, Italy, Finland and the United Kingdom report rates lower than 3 per 100 000 general population whereas Austria reports rates above 14. These represent real opportunities to do things differently, to work across sectors to see how we can make care more efficient, deliver better outcomes for patients and create the financial headroom for innovation in healthcare systems including innovative new treatments that are providing new hope for people living with diabetes, cancer and a host of other diseases.
Industry has a clear role to play in delivering the kind of new treatments that can transform the outlook for patients and how we manage our healthcare. But also in how these new medicines are introduced in to the health systems.
Stepping out of the blame game, we absolutely recognise the challenges faced by healthcare systems trying to introduce new transformative treatments and cures in to the system. The costs are borne upfront, in year one, exclusively from the medicines budget. Yet the return on that investment is often delivered across the lifetime of the patient, in primary and secondary care, across social care and even the wider economy. Small comfort if you are solely responsible for the medicines budget.
At the recent European Health Forum Gastein speaking with many policy makers including Dr Auer, I called for an end to one sided positioning in favour of a constructive discussions. I underlined our commitment to work with all actors in the healthcare equation to enhance the long term sustainability of our healthcare systems including looking at flexible solutions to medicines pricing, particularly introducing new curative treatments. That means real dialogue, based on solid data and evidence to find collaborative solutions. It means looking at our healthcare as a whole and it means stepping out of the blame game. It's the conversation I hope we can have with Dr Auer and colleagues from Austria as they take over the Presidency of the EU in July 2018.