Healthcare report receives cool reception

An expert panel report calling for more competition to improve efficiency and transparency of healthcare systems has received a cautious welcome from stakeholders.

The report 
Financing Sustainable Healthcare in Europe: New Approaches for New Outcomes, drafted by various public health experts, was handed to Commissioner Günter Verheugen on 13 February 2007. 

The report’s four separate studies on topics that affect the sustainability of healthcare financing set out a number of policy options for the delivery of continuous healthcare improvement “through increased efficiency, enhanced choice and innovative models of healthcare financing”.

The report calls in particular for increased transparency and openness in financing healthcare in Europe. “It is shocking how little hard evidence there is across Europe about where the money goes,” said Pat Cox, chairman of the project’s steering committee. 

To overcome this situation, the report states that market price-based mechanism is likely to be “the most efficient route” to introduce necessary information about the use of healthcare resources in appropriate incentives for patients, governments and healthcare systems in Europe. “We should start to explore the power of the market as a way of achieving much better value for money,” added Cox.

A big part of the report is dedicated to health-technology assessment (HTA). Health technology means any method used to promote health or prevent and treat disease, such as drugs, equipment, procedures and screening programmes.

The conclusions of this section highlight the link between innovation and the needs of the healthcare system. “Products that provide the most value for investment must be identified and supported. Manufacturers of such products must be rewarded with appropriate reimbursement and pricing schemes.” 

The authors also call for further clarification of the scope of drug reimbursements and swift approval and reimbursement of new medicines.

Having read the summary and key findings of the report, the chief executive of the European Hospital and Healthcare Federation (HOPE), Pascal Garel, said he was "anxious" to read the rest of the report and looked forward to reading where the authors found basis for their recommendations. "We were never consulted or asked to contribute to this study," he said. He also finds it "too black and white" to say that there's no data on how the healthcare money is used. "We have more and more comparable criteria and data on hospital care. We are aware of what we produce," he added. 

The European Consumers' Organisation BEUC is surprised that the report was presented to the commissioner with responsibility for industrial policy and not health. "This may reflect the unfortunate fact that the Commission treats medicines largely as industrial products, by assigning to DG Enterprise the lead role on medicines policy in the EU." 

"Currently, in many countries, the healthcare services purchaser and provider are one and same entity, such as a commune. This leads to non-transparency on how the healthcare money is finally used. The orderer and provider of healthcare should be separated in order to bring processes and prices into daylight," explained Laura Niemi from Sitra, the Finnish Innovation Fund.

"Healthcare is currently extremely non-transparent. We don't have the slightest idea of its prices, nor the products. We need to start doing some serious cost and expenditure analysis on what the money is spent, what kind of patients are cared for, whether the patients are cured, what the results are, and so on. A price-based mechanism in financing healthcare would mean that we know all this. Once we know the prices and products, we can start to explore the power of the market with regard to the provision of healthcare," said Hannu Hanhijärvi, from Sitra, the Finnish Innovation Fund.

Claude Hemmer, chief advisor to the Luxembourg health minister said that in today's Europe, bringing innovations to patients takes too long. "Europe needs to mobilise innovation more openly, systematically and transparently. Constant and ongoing evaluation and reappraisal are critical to assessing the value of new technologies in healthcare – decisions about innovations can be cast in stone far too early and sometimes for much too long."

The 'Financing Sustainable Healthcare in Europe' conference in October 2005 launched a one-year investigation into sustainable healthcare financing. Under scrutiny have been four topics affecting the sustainability of healthcare financing:

  • Protecting equity while improving efficiency;
  • ensuring value for money in healthcare;
  • patient empowerment and efficient health outcomes, and;
  • issues affecting the sustainability of health financing in south east Europe.

Coinciding with the current debate on patient mobility and access to cross-border healthcare in Europe, the report is set to advise governments on how to invest their resources to provide the best quality healthcare for citizens.

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