“A convergence is taking place between the private and public sectors, regulators and the industry, between competitors and even between sectors, and the degree of cooperation is increasing exponentially,” says Richard Bergstrom, director-general of the European Federation of Pharmaceutical Industries & Associations (EFPIA).
Achieving dialogue between all parties is a big part of what Bergstrom does, and he says that in Europe all parties are talking to each other to reduce inequalities in health, as well as accelerating patients’ access to innovative medicines and improving patient safety.
Based on what he has seen in South Africa, Bergstrom says that dialogue here was steadily improving.
“Even the technology sector is getting involved in healthcare, with a wide variety of health apps, many of which are not complying with health and privacy regulations.
Companies in Europe are collaborating as never before, but the current healthcare model is antiquated, as typified by payment systems that focus on activities and not results.
“What stakeholders in the healthcare system are calling for is a payment model based on results. Under the US Obamacare system, in just the past few years, the percentage of payments based on results has shot up from 10% of the total to 50%. This is the way the rest of the world has to go,” says Bergstrom.
One of the challenges in implementing such a system is the quality of data available. “There has been huge investment – and huge interest – in the subject of real-world evidence.
This is something the healthcare industry is familiar with because traditional R&D starts with historical data. But this new direction of healthcare requires a focus on new and universal data generated by consumers connected to apps and sensors,” he says.
There is considerable resistance to the idea of the health of all people being tracked for diagnostic purposes, as it would violate privacy laws. “However, even regulators are suggesting that instead of doing a trial of, say, 50 000 people, we track every person’s health.
This raises a question of how to connect every patient onto the system. Governments wanting to lower the cost of health services would certainly like to give the pharmaceutical industry access to broad health records, but are not permitted to. So the question is how to take an already high level of cooperation to a new level. The collaborative space has to be expanded,” says Bergstrom.
As to why collaboration has to be increased, he explained that while a lot is happening in medical innovation, at the patient level it is far less evident. “The patient experience has to be far better planned. The technologies now starting to come through are more complex than a simple oral tablet; they are entire systems which offer the potential to reduce costs. With this, payers want different payment models and the challenge to the industry is to come up with innovations in this space.”
Intercepting diseases before onset
Cancer and Alzheimer’s are the next medical tsunamis coming. These treatments involve intercepting the diseases even before its onset, based on family history and diagnostics.
“This will be a suite of services that starts with finding the patient. Patently, this requires both data on people and on tracking outcomes, and a different payment structure. Ordinary people are not ready for this, nor are traditional ways of doing business,” he explains.
Results need to be demonstrated
The underlying theme in many new medical innovations is the ageing population, and Bergstrom says that this was likely to have more of an impact in middle income countries. Their populations were ageing, but without having the income to afford treatment.
“We need quality data because the people who were once sceptical about the results achieved by the pharmaceutical industry are today expressing equal scepticism about how good we claim the results. They have to be demonstrated.”
