Transformative Partnerships: Value-based Healthcare in Canada

Recently, I posted about the Public Policy Forum Canadian Life Sciences Table which engages leaders across federal and provincial governments, academia, non-profits, research and industry. This group shows great promise in shaping a Canada that is significantly more prepared for the next health security issue of our generation.

I say with confidence that the conversations occurring now in life sciences are richer and more impactful because we were brought together in a united mission during the pandemic. This taught us that we can respond in the moment, that being on our back foot is not ideal during a crisis or indeed to optimize healthcare system outcomes anytime. Our current health care model feels like we are on our back foot. It still rewards cost containment and drives a myopic view of progress. It discourages a more broad-based view of value. But if we want better patient and system outcomes, we must embrace readiness and foresight. We need to fundamentally understand how various investments in our system result in short-, medium- and long-term impact. That long view is one that can only be precipitated by open and authentic conversations across stakeholders. We need to meet each other in the middle. Canadian patients can not afford to wait anymore and time is of the essence for this shift.

Why partnerships

Getting to a more resilient system requires a strengthened relationship between government, academia, industry, and society built on trust and co-creation. In the VBHC model, we are called to move beyond the current ways we determine value to a fundamentally new framework driven by better patient outcomes and overall long-term system value. It is also the most certain path to resilience for the future.

That is a clear point of alignment among payers, partners, providers and patients…

• For the payers, better patient outcomes through partnerships will reduce cost in the long run as better information sharing, solution development, and deployment of best evidence-driven technologies will reduce preventable strain on the system.
• For the partners, increased opportunities for integration and innovation in the system offer proof products/systems lead to better results.?
• For the provider, better information and treatment options lead to optimized care.
• For the patient, it’s all about better health outcomes.?

This alignment is also in lockstep with Federal and Provincial goals of enhancing our domestic health security. Creating more robust partnerships that value and adopt meaningful innovation will make Canada a more attractive partner on the global stage and thus more indispensable when the next health crisis lands - whether in the form of a pandemic, climate change or regional conflict.

Acknowledging the realities of all stakeholders

Our collective goals to provide the best health care for Canadians are inextricably linked to global business realities and we must examine our partnerships with an eye to those realities, while expecting our global partners to understand the unique model of Canadian healthcare. We really see the power of this collaboration when we find areas of mutual benefit and respect for the role that each of us plays in providing better care for Canadians.

I am encouraged of late by more and more leading institutions in the Canadian healthcare system sharing similar goals for VBHC and better outcomes. Some leading hospitals have offered to validate select J&J MedTech innovations that are designed to help reduce surgical infections, shorten surgery and enable faster recovery after procedures such as knee replacement. Most promising with these nascent partnerships is the willingness to take a broader view of where value lands in the patient journey. Rather than narrowly focus on cost in the operating room, value in terms of readmissions to hospital, revision surgeries and overall hospital efficiency are all being assessed and valued as part of the intervention.

There are increasing pockets of momentum and substantiation in this space and now is the right time to coalesce these efforts to bolster the profile of this model.

Examples of transformative partnerships across J&J MedTech in other markets

We are tackling pressing healthcare challenges and taking bold steps that lead to new standards of care while improving patient outcomes:

• An economic analysis on patients undergoing colectomy surgeries with our ECHELON CIRCULAR Powered Stapler (ECPS) vs. a standard of care manual stapler demonstrated that, in a US hospital-based budget impact model, the incremental cost of using our device was more than offset by the savings from lowered incidence and cost of management of leaks, a potential surgical complication. Our business in Germany is leveraging similar results in partnerships with health care systems, as well as Brazil, and shortly we will start implementing in the US.
• In the UK, a recent National Health Service study highlighted the potential clinical and financial benefits of using radio frequency ablation technology vs. cryoballoon ablation for atrial fibrillation (AF) patients. A reduction in the of number repeat ablation procedures was observed in this study. This reduced the cost per patient of achieving freedom from AF and allowed for capacity to be used for first-time ablation patients.A recent study in Canada demonstrates data continues to emerge highlighting the value of earlier intervention in the treatment of AF. Early intervention could lead to better outcomes with fewer patients progressing to a persistent stage. Partnerships between industry, clinical stakeholders, and procurement to reduce long waitlists could benefit the healthcare system by lowering the cost of managing more chronic AF patients. This will be a trend to watch as the benefits to the patient and the health system are felt outside the realm of the procedure itself, a key tenet being assessment of the value of innovation across the care continuum.

The path forward

We must urgently create forums to get diverse groups to the table. We also need to demonstrate the results that create an imperative for deeper conversations about value, especially in changing the paradigm from one of cost in the operating room or in the lab to value across the continuum of patient care. It starts with collecting real-world evidence to help make well-informed decisions and shape future strategies, and then with sharing data with industry and other healthcare stakeholders to foster collaboration. It also means adopting innovative procurement approaches, e.g., value-based agreements. And procurement entities need to be aligned on hospitals’ short- and long-term strategic objectives so that their decisions will not be based solely on prices but on outcomes that help achieve those objectives. Together, we can deliver more of what Canadians expect and what they truly deserve from our cherished health care system.