A Year of Uncertainty and Opportunity

Uncertainty and opportunity are the touchstones of 2017, in which health services are shifting to value-based healthcare, a move from which there is no return. This has been a trend for a long time and has already consolidated in the US. Mexico is a little behind but is getting there.

On the side of risk, we have new geopolitical dynamics, but business and health go beyond this. PwC has identified five megatrends: rapid urbanization, climate change and resource scarcity, a shift in global economic power, technological breakthroughs and demographic and social change. These megatrends configure the reality we face in a country where the middle class is the size of Peru’s population and almost twice that of Chile. This class is changing many views of the health sector and asking for more value. The megatrends themselves overlap; for example, putting together technological advances with the lack of resources in the city are empowering ideas like Uber, Airbnb or services that provide care at home. There are also 2,500 private businesses practicing a new model of integrating a doctor inside the company, a new market that has been captured by companies like Previta. Also, there are websites such as Curely and Doctorondemand on which many Mexican doctors offer their services. This fusion with technology and collaboration between sectors is what we need to develop smart cities or, in the case of health, clusters that gather clinics, academics and researchers. There have been many initiatives for the development of clusters in Mexico: Biometropolis, the health park in Cuernavaca called Ayana and Tecnopolo. However, these projects have been subject to political changes that put them on standby.

When talking about the shift of healthcare to value, there are three ways in which a company’s strategies are oriented: strategies to adapt for value, to innovate for value and build for value. PwC has compiled an executive report on the top US health issues of 2017 and there are six that translate to Mexico.

Patients are increasingly open to sharing their information with the pharmaceutical industry on how they feel after taking certain medicines. In Mexico, we need to personalize pharmaceutical care through programs of patient engagement for treatment adhesion. There are some initiatives already operating such as Pfizer Conmigo (Pfizer With Me) or Abrace a la Vida (Hug Life) from Abbott, which must evolve to achieve their full potential. For example, PwC has developed Bodylogical, a group of algorithms that, when given information on a patient’s vital signs and habits, will predict what the patient will suffer from within a specific set of diseases.

There should be alliances between insurance companies, pharmaceuticals, medical devices companies and patient associations to create a model guaranteeing patients are taken care of. In the future, we should see changes such as COFEPRIS requesting that when registering a medicine, pharma companies register a patient engagement program too.

Another important aspect is the security of patient information. There is a company in Mexico called SOHIN that has developed a program to assist patients with cancer by giving them advice and liaising with insurance companies. This is the type of integrated model we need in Mexico.

An element to consider is the new force of innovation devoted to detecting infectious diseases like H1N1 and zika. The current test for zika takes two to three days to provide a result, whereas a new test created by In Bios International, currently undergoing registration with COFEPRIS, takes only four hours.

There is also a wave of new medicines designed to counteract antimicrobial resistance and others improving diagnosis. In addition, the Ministry of Communications is sponsoring a project called SINBA carried out by the Department of Health Information (DGIS) of the Ministry of Health. It is a platform that will help improve epidemiological surveillance of the country and will eventually link all relevant information from the day we are born. So far, SINBA has released an app that locates the closest health center.

Many programs in Mexico focus on nutrition and wellness, such as PrevenIMSS and PrevenISSSTE, and the National System Against Obesity spends MX$80 billion (US$4.4 billion) every year. We have to continue working on education because there are no short-term solutions. In our survey in the US, consumers were asked from whom they would be willing to take nutritional information and 79 percent chose their family doctor over their pharmacy, gym, employer, grocery store and big box store. More followups after yearly checkups are needed and we should try more popular models. The University of Texas launched an experiment with hospitals in which community members could subscribe to a nutrition program for free. First, they were tested for diabetes or potential diabetes and then were given a work-out plan and medicine if needed. This could be implemented here. On the strategic sourcing side, decision-makers from IMSS ask themselves if they should buy from regional or national distributors in consolidated purchases because there are four national players and around 16 regional ones. The question is: why not integrate a fifth player through national credits and in this way increase competition? Another important topic is collaboration. The best example in Mexico is the PPP model. However, the situation is sad because many projects have been suspended, such as Bahia de Banderas, Tabasco and Mazatlan. We need from our authorities what we call the 4 Cs: communication, collaboration, compassion and compromise. Politicians are lacking compassion for citizens by blocking PPP projects, while certain hospitals are overwhelmed by demand.