It’s time to Power Up health systems

The COVID-19 crisis has put the resilience and agility of European health systems to the test in an unprecedented way. As we are continuing the fight against COVID-19 together we also need to reflect on what this crisis has taught us so far about the state of European health systems, and what could be done better or differently in the future. EFPIA believes that we should take this opportunity to implement an ambitious reform agenda for European health systems, not only to make them better prepared for future shocks but also better suited to tackle our most important health challenges in normal times. Going back to the status quo would not be an appropriate or even realistic option.
Even if health systems are largely governed at national or regional level, the new attention to health policy at EU level and new tools such as the EU4Health program and the recovery and resilience facility creates opportunities to enable a common European agenda where strategic projects are implemented to enact meaningful change on the ground, monitored by the State of Health in the EU process and the European Semester.
EFPIA believes that five key dimensions should be the guide when reforming and investing in our health systems: People, Outcomes, Workforce, Efficiency and Resilience.
People-centricity. The ultimate goal of health systems is to keep people healthy and ensure that patients get the care and treatment they need, when they need it. This might be self-evident, but the organization and delivery of care doesn’t always put people and patients in the centre. The ambition to integrate care services across silos need to continue, and patients should be involved in the design of care pathways and healthcare decision-making and priority-setting at all levels. The industry on its part is increasingly involving patients in the R&D process to ensure that new innovation corresponds to patient needs, and is breaking new ground in personalized medicine to ensure that the right treatment is given to the right patient at the right time.

The performance of health systems can be measured in many ways, but none is more important than health outcomes. Health outcomes is what matter most to patients, be it survival from a deadly disease, pain relief or being able to go back to work and a social life. Despite this, health outcomes are seldom measured in a consistent way across providers and patient groups. If we could measure health outcomes in a standardized way across all European health systems, and make this information public, this would be a huge leap forward in improving care and spreading best clinical practice. The pharmaceutical industry is contributing to this movement, for example through increasing the use of Patient Reported Outcomes in clinical trials, and by partnering in projects such as IMI H2O, building “health outcomes observatories” to collect patient reported outcomes in a standardized format.
Workforce. The health workforce is the backbone of any health system, but has been put under heavy pressure by the COVID-19 pandemic which could risk exacerbate burn-out and staff shortages experienced even before the crisis. We need to invest in our health workforce, including through upskilling and life-long learning, enabling task-shifting for more agile working models and implement digital tools that makes the daily tasks of healthcare professionals easier, not more burdensome. The ability to combine patient care with research activities is another key issue, and the industry is an important contributor through its sponsorship of clinical research undertaken in clinics and hospitals all over Europe.  
Efficiency. Although we need to spend more on health overall, especially in countries in Central- and Eastern Europe, we also need to spend wisely as resources are not unlimited.  Efficiency is not about cutting costs, it’s about spending on what matters. And in the area of public health you often need to spend today to improve outcomes and reduce costs in 5 or 10 years. This is closely linked to the concept of value-based healthcare, where you look at the health outcomes achieved in relation to the overall resources spent over the full patient pathway. Value-based approaches are piloted and implemented in all parts of Europe, and often require new ways of working and new partnerships between the public and private sector. The industry for its part is more and more involved in not only selling products, but also providing tools and services to improve the care process, for instance to improve adherence to medication or to make sure that the right treatment is given to the right patient through the use of biomarkers, data and predictive analytics.
Resilience. COVID-19 has taught us the importance of resilience. Can hospitals withstand a sudden surge of patients in intensive care? Can people living with chronic disease manage their conditions in their own homes, guided by telemedicine and digital tools? Can the industry deliver on a sudden increase in demand for certain medicines? We need to design health services and care pathways with resilience in mind, not just for future pandemics but also to meet other challenges such as the rise of antimicrobial resistance and the slow but steady growth of chronic disease. The supply chains of the innovative industry largely withheld the pressures during the first phase of the pandemic, but EFPIA is bringing forward proposals to further strengthen supply security and monitor shortages. And the ability to rapidly develop and deploy new innovations in response to a crisis is itself maybe the most important aspect of resilience, as the success with the COVID-19 vaccines has clearly demonstrated. This requires both a vibrant innovation eco-system and an efficient and flexible regulatory framework.
Health systems are not static, but in constant transformation driven forward by two powerful catalysts: medical innovation and digitalisation. Innovative therapies and vaccines tackle unmet health needs in cancer, rare genetic conditions and neurological disorders, and of course infectious diseases like COVID-19. But often they also make health systems more efficient by saving resources elsewhere in the system, for example by preventing severe complications for patients with chronic disease and reducing the need for emergency care and hospitalisation. Digitalisation can enable patient empowerment and care integration, and harness health data to inform decision-making and power research and development.
What is needed to make this change happen is political leadership, collaboration and partnership between all health system stakeholders, and strategic investments. The pharmaceutical industry is ready to do our part to make this happen. Let’s #PowerUpHealth together.  

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Thomas Allvin

Thomas Allvin is Executive Director for Strategy and Healthcare Systems at EFPIA. Before joining EFPIA, Thomas...
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