Time to end fragmentation of EU healthcare, experts say

Combined with an ageing population and the alarming burden of chronic illnesses, health experts pointed out that only through an enhanced collaboration EU healthcare will systems be sustainable in the long run. [Sarantis Michalopoulos]

This article is part of our special report How can we create sustainable healthcare systems?.

Experts are asking for a more collaborative approach in EU healthcare and greater involvement of the European Commission in order to face rising challenges and put patients at the core of decision-making.

Speaking at the “Life at what cost? Hard choices in healthcare” panel discussion organised on 2 May by the Friends of Europe, Celgene and the European Federation of Pharmaceutical Industries and Associations’ (EFPIA), a number of health experts* pointed out the shortcomings in the sector, saying the fragmentation of EU healthcare is risking its long-term sustainability.

In order to illustrate the everyday challenges the EU healthcare systems face as well as the need for all actor to act together, the organisers presented a short fictional film about an astronaut, Nozomi, who got lost in space and was fighting to find her way home.

>>See more about the movie here.

When NASA ultimately got in touch with her, after she’d been lost for months, it turned out that it was “too costly” to save her and bring her back to the Earth as the funding for her mission had run out.

However, thanks to the insistence of some people, a solution was found through collaboration with other state space agencies which had activities in that space area.

Drawing parallels with the film, health experts emphasised that stakeholders should put an end to the fragmentation of the system and think differently, in a more collaborative way, to find solutions for the “seemingly unsolvable issues”.

The healthcare systems of EU countries are under huge pressure to meet the growing demand for care and simultaneously support innovation in the sector, in the face of an ageing population and the alarming burden of chronic illnesses.

The experts pointed out that only through an enhanced collaboration will EU healthcare systems be sustainable in the long run.

The EU role

According to Lee Heeson, president Worldwide markets, inflammation & immunology at Celgene, the EU plays a “key role” in this direction.

An example of the EU contribution, Heeson said, is the Health Technology Assessment (HTA), which reduces the duplication of the clinical assessments among member states.

He noted it was crucial for the EU to understand what the countries and patients need, and this is where the system needs provide harmony.

Heeson explained that in order to achieve a sustainable healthcare system in the EU, all relevant stakeholders, ranging from the member states and hospitals managers to the pharmaceutical industry, should identify the common objective.

“One of the most important things is to really understand one each others’ perspective so that we can visualise and understand the challenges that face each of us. And then we should take a step higher and see what are we aligning on as a whole group and how to find a solution together,” he told EURACTIV.

Follow-up is crucial

For Penilla Gunther, a member of the health and welfare committee in Sweden’s Parliament, the European Commission should monitor more closely the implementation of the EU-wide strategies and guidelines it draws for certain diseases.

“What I have experienced is that no follow-up and real evaluation takes place at all because […] these strategies need to be constantly updated,” she said.

Gunther added that the healthcare quality differs among EU countries, because there may be very good treatments for a disease in one country, while in another one there is a good plan but not necessarily good treatments.

The Swedish politician stressed that EU healthcare systems should develop in such way that will finally “see the patient”.

“I would like to see more collaboration among professionals in healthcare especially when there is a drug development or accessibility of patients in clinical trials. The life-science or the med-tech and the pharma industries should all cooperate and of course, it’s of absolute importance the decision at the political level, saying that this is crucial for the population.”

The ‘unnecessary waste’

In June 2016, EU health ministers called on the European Commission to perform an overview of the current EU legislative tools and incentives that aim to facilitate investment in the development of medicinal products.

EU countries have targeted specific aspects of the incentives granted to the pharma industry in order to decrease drug prices.

On the other hand, many suggest that such an approach would have a detrimental impact on innovation in the pharma sector.

Instead, they say policymakers should focus on other healthcare fields to save costs, considering that official data indicate that the pharmaceutical expenditure has remained stable in recent years.

“Why are the public healthcare systems under huge pressure? Where is the money going? If there is a percentage of waste, and it’s identified as approximately 20%, it needs to go. You cannot waste anything in healthcare,” EFPIA’s Director General Nathalie Moll told EURACTIV.

Pharma boss: Incentives based on outcomes will optimise EU healthcare

An outcomes-based approach for incentives in the pharmaceutical sector would help optimise the entire healthcare systems, Nathalie Moll told EURACTIV.com in an interview.

According to the OECD’s Tackling Wasteful Spending on Health report, one in ten patients in OECD countries was unnecessarily harmed at some point during care, and more than 10% of hospital expenditures went toward correcting preventable mistakes or treating infections received by a patient during care.

Referring to the incentives discussion, Andrzej Rys, European Commission director for health systems, medical products and innovation, said it was a “complex issue”.

He noted that a fair and in-depth evaluation will be made and “hopefully by the end of the next year we will be able to show the results”.

Speaking to EURACTIV on the sidelines of the European Health Forum Gastein (EHFG) last year in Austria (October 2017), EU Health Commissioner Vytenis Andriukaitis said there was a need to understand innovation.

“It’s a very broad understanding as we have a lot of different innovations that we need to develop new economic models,” he said.

Asked whether a shift in incentives should still support innovation he replied: “No doubt. We need to discuss issues in complexity. Some incentives are old; some mechanisms need to be developed.”

“There is only one way – to support innovations and use evidence-based economic models,” Andriukaitis said.

*Penilla Gunther (Member of the Health and Welfare Committee, Swedish Parliament), Lee Heeson (President, Worldwide Markets, Inflammation & Immunology at Celgene), Renaud Mazy (Chief Executive Officer of the University Hospital of Saint-Luc), Nathalie Moll, Director-General of EFPIA, Bettina Ryll (Founder of the Melanoma Patient Network Europe and Chair of the Patient Advocates Working Group of the European Society for Medical Oncology), Andrzej Rys (European Commission Director for Health Systems, Medical Products and Innovation) and Gert Van Assche, (Gastroenterologist and Professor at the University of Leuven).

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