Value-Based Healthcare: More Than a Structural ChangeBy Andrea Villar | Wed, 01/27/2021 - 16:00
Value-Based Healthcare aims to make the system more efficient without sacrificing the quality of patient care, improving the health of the population and consequently reducing costs. However, there are still many challenges ahead to introduce this system in Mexico, stressed panelists on Wednesday, Jan. 27, during the first virtual edition of Mexico Health Summit.
This system is not new, said Diego Guarin, Regional Market Access Lead for Latin America at Merck MSD. However, the fragmented health system in the country has not allowed this model to be deployed. “The different health plans that exist in the country, which depend on people's labour affiliation, have generated a fragmentation that does not allow Value-Based Care to be developed,” he pointed out.
One of the first steps toward a migration to this system in both the public and private sectors, Gaurin explained, is the development of tools or technology platforms for coordinated patient follow-up. In addition, there is a need for outcome measurement and an integrated system. "You need a patients’ registry, including healthy people and those in treatment or rehabilitation. If we are integrated, we can see how the patient evolves; we can prevent illnesses and manage crises," he added.
In agreement, Sandra Sánchez-Oldenhage, President of PharmAdvice Consulting, said that change requires the participation of the entire healthcare ecosystem. It is not an easy thing to do as it is an issue that has generated a lot of resistance and people find it counter-intuitive. Sánchez-Oldenhage's recommendations include the definition of metrics and outcomes to drive continuous quality improvement, increased efficiency and reduced costs. “We also have to work together with the sector, providers and patients. Reducing costs while improving quality will only be possible when we all share the benefits and risks.”
“In OECD countries, healthcare costs are growing on average 1.5 times faster than GDP. If we take into account the objectives of Value-Based Care, the health system in Mexico today has to be substantially reformed. We have to change the model from fee-for-services to fee-for-performance,” Oldenhage pointed out.
Ironically, countries that have the infrastructure in place to establish better health models are the ones that need it the least, said Augusto Muench, CEO of Boehringer Ingelheim Mexico, Central America and the Caribbean. "Mexico, on the other hand, with more than 130 million inhabitants and without infrastructure for individual patient follow-up, is one of the countries most in need of such models," he said.
In the future, such a system could bring great benefits to the country by being able to predict public spending around a condition, Muench noted. In addition, wasteful procurement in the health system would be reduced. "It is inconceivable that the public budget is focused on a purchase that is then not used. The value of the product has to be assessed to ensure that it is used for what is needed,” he said.
According to Javier Picó, Partner at LifeSciences Consultants, this system has not been accepted largely because of perception. "If the public sector talks about this model, it is believed to be intended to reduce spending. But if the private sector talks about it, it is believed to be because they want to improve access to complex or expensive treatments,” he said.
“The COVID-19 pandemic is a historic opportunity. For the first time, society, politicians, businesses and citizens have realized the value of health. Regulatory changes are now needed," Picó stated. “The pandemic has also made investors fight for the vaccine. This increases the GDP in health through private funds.”
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