COVID-19, the crisis that turned VBHC, HTA or HEOR into critical capabilities

Why VBHC, HTA, Outcomes Research, Pharmacoeconomics and related practices are even more important after COVID-19, for healthcare value chain?

 Reason number one: the perspective changed, and healthcare is now credited for being at the center of everything.

We have been bombarded by news and expert opinions on the virus spread, on the economic crisis that was looming, on the role of non-related industries to supply the “war effort”, or the impacts that the virus and the lockdowns have had in, e.g., tourism, in social security or in the entertainment industry. This crisis has shown how everything is connected.

So, we can no longer have decisions in healthcare to be made without looking at the far-reaching consequences in society. This is to acknowledge the advantages of new medications, new health facilities or political decisions. But it is also a great load of responsibility and accountability for healthcare professionals, pharma industry and payers – they have conquered a central role in societies, having also become under greater scrutiny. It is a good thing that society will be more prone to acknowledge and reward their role in developing their countries – and it is also an added level of responsibility for all in the value chain: to deliver better outcomes for all. A proper set of tools is in order to meet these expectations: the holistic perspective of VBHC; the sound methodologies of HTA; the experience in systemic analysis of Health Economics, and the grounded decisions supported by Observational Research, are the answer.

 Reason number two: the search for efficiency will escalate.

A severe economic crisis has just unfolded, due to the global lockdowns on economic and on social activities. As a result, there will be a strong pressure to save on spending, to focus on clever investments, to search for efficiency and to address all disease areas that were out shadowed by the emergency of COVID-19 patients.

The “value-based” approach (VBHC) focuses on delivering the best results (defined from the patient's perspective) at the lowest possible cost. We will be providing state of the art care, and at the same time saving on variability, waste, contracts and improving overall efficiency.

 Reason number three: patients will demand it.

Patients will demand greater participation in attending their needs. VBHC stands for a transformation of the entire value chain, that “places the patient in the center” in a consistent way. VBHC will be the competence that will support the re-organization of the care delivery chain, industrial facilities and financing based on this primacy.

 Reason number four: because they work in practice, for all stakeholders.

Delivering better care at lower prices requires a structured approach and tools that have proven to deliver such results over time, like VBHC, HTA and HEOR, as it can be seen by the growing body of literature and industrial applications. The vitality of professional organizations, such as ISPOR, ICHOM or HTAi is also a testimony of their growing interest.

The main reason why they are so effective is that they operate though an integrative approach. They allow for balancing and aligning the different interests of the interested parties – which is key, being the healthcare value chain the most complex in the world.

They work all over the world, because they sustain the capacity of the various actors to create more value than they require to finance themselves – this is true for providers, for pharma companies, for universities, and even for patients. In fact, healthcare is an exciting service to work on because of its unique capability to produce externalities: giving back to the national productive system by relieving the burden of disease, by boosting external trade, or by attracting investment in qualified R&D, or even by the externalities that health unequivocally generates.

 Reason number five: the digital transformation will accelerate it.

The COVID-19 crisis will structurally change the world economy and the healthcare value chain, by means of 2 fundamental mechanisms: by accelerating some trends; and by highlighting some bottlenecks in the value chain, that need to be addressed.

Digital transformation is a huge arena, from virtual medical appointments, to digital tools to facilitate logistics anywhere, that has several advantages (new services; more quality; efficiency; faster growth of activities; better decisions, etc). Living in confinement, has raises awareness on many of these technologies, has led to several experimentation and innovations in this area in a record time. In the end, the solutions that prove to work – to sustain services, to overcome bottlenecks in the value chains, to reduce costs, to explore data and support diagnosis and other decisions, etc – will have passed beyond the proof of concept stage and will be incorporated in future practice.

VBHC has always welcomed digital transformation as one of its pillars because there is no other option to deal with the massive volumes of data that healthcare includes without AI tools. Likewise, managing the flow of operations in a hospital or an healthcare system requires reliability and high throughput in logistic and administrative activities: witch would be impossible without the electronic automatic means. Finally, new services can be provided with better outcomes, more convenience and less cost with the help of these tools: like monitoring patients, speeding R&D processes, or supporting the reorganization of care delivery in hospitals with speed and confidence in the outcomes.

In conclusion, all health stakeholders are concerned with treating patients the right way. However, they may have their own perspectives on what this implies, and on how each can benefit. So future healthcare will emphasize cooperative behaviors around outcomes that matter to patients, to secure alignment, such as:

?           providers will measure clinical outcomes and patient-reported outcomes (PROMs) to learn how treatments influence patients' quality of life.

?           patients and families are involved in making shared decisions to choose the most appropriate treatments or providers.

?           payers will be able to contract with health care providers who offer the best results versus the respective cost. Among these, governments can develop policies that support value-based healthcare.

?           Life sciences or digital R&D can experiment with performance models and more assertive diagnostic tools.

Let’s hope for the best and keep working.