Patients Are Waiting

Is Canada finally ready to shift to an outcomes-based health system?        

Why Value-Based Healthcare Must Matter to Canadians

To now, there has been limited evidence that our health systems consider the true value of innovation when determining ongoing investment. Government procurement agencies purchase medical innovation primarily based on price, rather than the value or evidence an innovation brings to patients’ improved health and faster recovery. Value-based procurement expands the basis for purchasing decisions beyond the up-front cost to consideration of other factors such as patient outcomes and total costs of care, beyond a specific procedure. Value-based procurement criteria should differentiate offers that give the system the best value for patients’ care, in addition to consideration of the purchase price for a therapy or device. This approach has been advanced by policy initiatives like the Most Economically Advantageous Tender Directive in the European Union, and a recent Procurement Guidance issued by the World Bank.

When patient outcomes improve, manifested by less invasive surgery or fewer post-surgical complications, that alleviates pressures on our health systems in multiple ways. Hospital stays may become shorter, Emergency Room visits are fewer, and surgical backlogs are reduced, avoiding secondary medical issues that may result as patients wait for surgery. But generating data and evidence of the value of medical innovation takes time, money, and a commitment to collaboration between medical leaders, procurement agencies and the medtech industry. In Canada, despite a widespread consensus on the need and relevance of a shift to outcomes-based procurement, our provincial health systems with siloed budgets and mandates have made investing in research and data an obstacle for this model to take hold.

Value-Based Healthcare Models Are Becoming Normalized Around the World

In Denmark, a recent announcement marked a new collaboration between a teaching-based care facility and medical technology companies – including Johnson & Johnson. The announcement recognized that innovation, based on credible research, can and should be an essential pillar of positive change in healthcare delivery. The partnership leverages the expertise of each organization, with a goal to demonstrate that by working together, industry and care providers can deliver better health for Danish patients. For many years, we have joined with other health care providers such as clinical centers to carry out practice-based projects on VBHC in atrial fibrillation, bariatric surgery and joint replacement. Experience gained thus far is encouraging. For example, costs for patients undergoing hip and knee operations at a Neuchatel clinic were cut by 40 percent thanks to faster recovery and mobilization. For bariatric surgeries such as a gastric bypass operation at a defined phase of severe overweight, there was a drastic reduction in the costs incurred due to diabetes and high blood pressure in connection with severe overweight.

With a wealth of exceptionally innovative medical technology companies in this country, and a similar need for change, there’s no reason why Canada can’t embark on a parallel journey of evidence-based collaborative research. The status quo is not serving our patients in the most impactful way.

NOW is the time we must be bold in our partnership to give patients in Canada the best possible care. At J&J, our teams are working with a host of visionary and dedicated medical professionals to leverage innovations in digital care delivery, to advance R&D related to early detection of specific cancers and to provide irrefutable research results connected to best practices in areas of maternal health care. While these examples are both current and cutting edge, Johnson & Johnson’s century-long history has proven that ‘technological innovations’ have always been at the heart of better care solutions. Now is the time to realize the benefits such technologies and solutions have from a system viewpoint, rather than just the cost to procure.

New Innovation Often Becomes the Standard of Care

When J&J’s Ethicon brought the first mass produced sterile surgical dressings and sutures to market in 1887, they were met with skepticism by the medical profession, and it took almost two years of education before the new materials were widely adopted. Our current DePuy Synthes division began as the world’s first orthopaedic company and innovated fitted splints to stabilize broken limbs. These purpose-manufactured implements slowly replaced make-shift alternatives – often made from pieces of wooden barrels – which had been the accepted practice. And Biosense Webster partnered with clinicians to develop innovative technologies that have resulted in three-dimensional, real-time, colour-coded views into the electrical activity of the human heart, allowing more precise diagnosis and treatment for Canadians with irregular heartbeats – now the standard of care for Atrial Fibrillation and other irregular heart rhythm disorders.

Value-Based Healthcare Elevates Patient Centred Care

Just as we did over a 100 years ago, we must think outside the box of current delivery models to alleviate the strain our system is under. We must think about bringing innovative cross-sectoral partnerships to the forefront of the healthcare discussion. The effective adoption of new innovations and technology advancements, based on data and evidence, has consistently been a proven pathway to better patient outcomes and, if we act now, a new model of VBHC could become Canada’s north star, guiding our system back into a leadership position. I, for one, look forward to this ongoing conversation and as an industry leader, taking action to make the fundamental shift that is needed to transform our system today, while building a healthcare system for tomorrow that we can all be proud of. Patients have been waiting for – and deserve – better solutions.