Pharmacoeconomics: A Tool for Better Decision-Making

Q: How is you company contributing to better decision-making among different players in the healthcare system?

A: Our team is made up of highly trained multidisciplinary professionals who are experts in creating value-based, scientific solutions, which can help the oversaturated healthcare system and institutions to improve services and make them more affordable. We support pharmaceutical companies and healthcare institutions by analyzing new therapeutic solutions and generating science-supported reports that can be used by decision-makers to evaluate new options. We analyze medications, medical devices and procedures. For instance, we supported the introduction of Hepatitis C treatments that improve outcomes by helping patients avoid cirrhosis and liver cancer with 99 percent efficacy. These products not just help to avoid complications but to generate significant savings over a 25-year period.

We have worked to support the introduction of a procedure that helps to tailor certain kinds of cancer target treatments to a patient’s DNA, which helps doctors to avoid unnecessary prescriptions or complications. In another example, we helped to introduce a testing technology to determine which lung cancer patients would better respond to certain medications, which allowed them to receive better treatment and increased their overall life expectancy. Cancer treatments become increasingly expensive as the disease progresses so tackling it appropriately from the early diagnosis and treatment saves the patient significant suffering and reduces expenses for the healthcare system.

Q: What are the main benefits patients, hospitals and the healthcare system obtain from pharmacoeconomic studies?

A: What the healthcare system saves in unnecessary treatments can be used in more medications, medical devices or diagnostic tests for more patients. Our work has facilitated the introduction of new technologies to the healthcare system. While the technologies we introduce might be more expensive than those currently used, they provide better outcomes and reduce hospitalizations and adverse effects. We evaluate state-of-the-art technology and compare it with older solutions to identify those products that are safer, more efficient and better for the financial health of the healthcare system.

We support pharmaceutical companies in generating the scientific reports that prove the results of their products. But we also work with hospitals to compile the results of the treatments. These real-life studies allow us to measure survival rates, adverse effects and overall costs for the institution. We are linked to the main universities in Mexico, which through academic program, students join our projects and the joint academic-industry work to form specialized human capital has been of great importance. It is necessary for all links in the healthcare system, from chemists to hospital administrators, to fully understand the value of economic evaluation using healthcare technologies to make better decisions.  Finally, we also work with doctors as they make 75 percent of decisions regarding the acquisition of a product.

Q: How do your services help Mexico address its epidemiological burden?

A: A major concern for every healthcare system is helping its population to reach a longer life expectancy and better quality of life. But working with a limited budget prevents administrations from providing every treatment to every individual. Healthcare systems must make hard choices to provide the best treatments for as many individuals as possible. In Mexico, this might mean not centralizing technology in the center of the country and providing the best possible treatments to every state.

The OECD recently stated that Latin American healthcare institutions should spend their budgets more efficiently. Helping as many people as possible under a limited budget is a challenge that every healthcare system must address. Mexico, however, is dealing with a demographic transition as the population becomes older and chronic diseases more prevalent, which greatly increases healthcare costs. Introducing models that allow institutions to pay only for results could be a way to improve treatment efficiency to provide care for more patients.

We have also worked to help the introduction of treatments for cardiovascular diseases. While an institution might believe that a new treatment is more expensive, it can help the patient reduce their risk of cardiovascular complications and death. It can also generate savings for the healthcare system in the short, middle and long term. We are also helping to introduce a medical device for diabetes, which is one of the main morbidities in Mexico and often leads to permanent disability and even death. This medical device provided patients with continuous monitoring of their blood sugar, which gave them access to better follow-ups and helped them to avoid costly complications along the road.

Q: The shared-risk model is often suggested to introduce new medications to the public healthcare system. What needs to be done to bring this model to Mexico?

A: The shared-risk model divides the risks of introducing any new medication between the seller and the public institution. Usually within this model, the developer of the new treatment promises certain effectivity in comparison to previous medications and if these goals are met or surpassed, the public institution pays for the medication. If these objectives are not met, the pharmaceutical company covers all costs. While the theory behind these models is sound, there have been some procedural challenges in implementing them within Mexico’s public institutions because internal policies prevent their acceptance. For that reason, it is necessary to implement changes in these policies before adopting shared-risk models.

Q: What measures should public healthcare institutions implement to improve access to healthcare services?

A: The federal administration is making significant changes to increase access to healthcare services while keeping costs down through INSABI, which aims to provide equal access to every Mexican. But it is also implementing several strategies to consolidate its budgets. Some of these decisions were controversial, such as the recent changes to consolidated purchasing schemes and the creation of a compendium of medications for all public institutions. Consolidated purchases aim to reduce the overall expenditure in the healthcare sector but their impact on the healthcare system has not been fully studied. It will be necessary to conduct more studies so the government can be sure that the actions it is undertaking are truly generating the desired results.

Before the compendium, each healthcare institution could choose the medications it needed. To guarantee equal services at different institutions, all of them are now required to buy a predetermined compendium of medicines. This move is expected to bridge the gap in services that exists within public healthcare institutions, as the treatment a patient receives at the moment can vary widely depending whether the hospital belongs to IMSS, ISSSTE, SEDENA or SEMAR.

Q: How is the COVID-19 pandemic changing healthcare models in Mexico?

A: While most of us are trying to protect ourselves against COVID-19, many people will get the disease. If the number of sick individuals rises too fast, it might surpass the capabilities of the healthcare system. Until a vaccine is developed and available to most of the population, the healthcare system will have to learn to live with the disease and its consequences. There are still many challenges to address. For instance, many medications have been used experimentally to try to cure COVID-19 but so far there is no conclusive evidence on which one works best. The healthcare system’s hands are tied because the opportunity cost of addressing COVID-19 meant that many other regular medical procedures had to be postponed, which will translate to future financial struggles. Proper evaluation of healthcare technology can be a tool to evaluate the best solutions for every patient whenever the system is stressed. The challenge for the healthcare system is optimizing itself in the current scenario.

Q: How will HS Estudios Farmacoeconómicos continue supporting the local healthcare system?

A: Our team always prioritizes knowledge, ethics and social responsibility. This year, we were awarded the Socially Responsible Company recognition and are undergoing the ISO9001 certification process. We generate insights with valuable, valid information so our clients can make the best decisions for patients and the healthcare system. Many technologies will arrive in the country during 2021 but it is necessary to evaluate which ones the system will be able to afford. It is worth mentioning that we want to support the certification of the key competences of the area and of course, maintain the standards of quality and innovation in the area through academic alliances and research to continue with scientific production.

HS Estudios Farmacoeconómicos is a Mexican company with six years of experience providing pharmacoeconomic studies, systematic revisions, metanalysis and other solutions.