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In a world of finite resources, we cannot afford an inefficient use of health spending

Around 10% of EU GDP is spent on healthcare (OECD, 2018); yet, as much as one-fifth is spent inefficiently, making no meaningful contribution to health outcomes (OECD, 2017).


With rising demands for health services, notably driven by the ageing population in Europe and increased prevalence of chronic conditions, the sustainability of our healthcare systems is under pressure. Although higher investments in health are sometimes needed, especially in some European countries (European Commission, 2019), this is not always possible in the short term.
 
Tackling inefficient spending would be an alternative way, often overlooked, of making sure that the allocated resources are used in the best possible way.
Conscious of the impact that addressing inefficient spending can have on improving patients’ health outcomes and quality of care, we decided to look closer at a number of areas where good healthcare practices have improved outcomes for patients through the efficient use of resources. The preliminary results of this research were presented yesterday during the issue panel “How Can We Create Headroom for high-value care by Increasing Efficiency in Health Systems?”, at the 2019 ISPOR Europe Conference.
 
We heard patient, industry and regional health authority representatives present their perspectives on a series of innovative case studies, presented by the Office of Health Economics and focusing on colorectal cancer screening, standardised cancer patient pathways and tackling inappropriate polypharmacy in the elderly. We know that patients diagnosed with colorectal cancer in stage 1 have a 90% chance of survival (which goes down to only 10% if the diagnosis is made much later, at stage 4). Still, low screening participation is a huge challenge in Europe, and we are missing the opportunity to save both lives and money, said Stefan Gijssels, Executive Director of Digestive Cancers Europe.
 
Douglas Gregory from Amgen, chair of the EFPIA Healthcare Systems Working Group, highlighted that we need to break the silos in which we work today if we want to tackle the unprecedented challenges healthcare systems face. All health stakeholders, including industry, need to work together to address inefficient healthcare spending to improve patient outcomes and quality of care. We need to look at increasing patients’ outcomes and not at cutting costs. By doing this, healthcare efficiency can lead to better equity and reduce health inequalities between and within EU countries, said Carlos Mur, the Executive Director of the Social and Healthcare Systems Coordination Unit of the Autonomous Community of Madrid.
 
By sharing best practices and engaging in a dialogue with all stakeholders, we can help health systems disinvest in less efficient practices, freeing up resources that could be used for interventions that would bring higher value to patients, healthcare systems and societies at large. This will also help facilitate the shift to healthcare systems that are more outcomes-focused and centred around what matters to citizens and patients, as outlined in 2017 by the Health Ministers of the OECD countries.
 
Improved efficiency in healthcare is not the same thing as cutting costs.
Efficiency means to increase the outcomes achieved from a given set of inputs. The emphasis is on maximising the patient outcomes that can be achieved through a certain health investment, or to save money, while maintaining high quality of care, which can be reinvested in higher value care. This is very different from short-term cost containment measures, which often have a negative impact on health outcomes (as it was the case in many countries in the aftermath of the economic and financial crisis).
 
The challenges faced by healthcare systems cannot be solved unless we break the silos in which we work today.
The collaboration between all actors in the healthcare system is needed if we want to make a difference and move towards more sustainable healthcare systems, and as an industry we are ready to do our part in identifying good common solutions.
 

Roberta Savli

Roberta Savli works as Senior Manager in the Healthcare Systems department of EFPIA, the European Federation of...
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