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With incredible innovation coming down the pike, pharma must do more to help health systems cope, says EFPIA’s Nathalie Moll
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Is pharma a victim of its own success? The incredible wave of innovation that is only just starting to crash on the shores of European healthcare systems, and which will deliver truly remarkable new medicines for years to come, also runs the risk of washing away pharma’s return on investment.
With more than 7,000 new products in development – many game-changing therapies or even potential cures – the challenge of how Europe’s health systems will pay for this innovation is one payers and governments cannot tackle alone.
Pharma must do more, says Nathalie Moll, Director-General of European industry association, EFPIA – not just to articulate the value that it brings to patients and health systems, but to work alongside health stakeholders to find solutions that are just as innovative as the new medicines themselves.
“As a scientist, it’s very exciting to be at the forefront of discussions when it is innovation that is driving the change, but these very disruptive innovations are somewhat like a Mexican wave, where the impact is felt right across the healthcare system.
“We are seeing incredible innovations coming and many are turning everything on its head because they are so different compared to classical treatments. We need to understand how these incredible new products will disrupt the health systems. Collectively, we need to understand how to manage their entry, how to evaluate their value throughout the chain and then how do you compensate for the investment made in that innovation.”
The key word is ‘collectively’, she says. “Pharma innovation is just one part of the disruption taking place in healthcare. Not only are we seeing a revolution in terms of our products but also a revolution in the digital space, so there are breakthroughs and changes in nearly every stage of the health system. If we are to capture the full value of these disruptions – and make the most of them – we have to work together.”
The good news is that we all have the same objective – to optimize healthcare expenditure and ensure products reach patients faster – yet fresh thinking is needed, says Moll. “We need to optimize healthcare expenditure not just pharmaceutical expenditure. It is time to move away from looking just at the 15-20% cost of healthcare represented by pharmaceutical products and focus instead on 100% of the expenditure.”
Smashing the silos is one part, but the other is breaking the annual budgeting cycle. “Some of these new medicines are true cures, like we’ve seen in hepatitis C. Here, patients are cured in just a few weeks but in addition to the huge increase in the quality of the patients’ lives, they won’t need to be hospitalized because of the virus, they won’t need a liver transplant, they won’t get liver cancer, all of which they might have needed or had without this drug.”
She compares it to buying an electric car. “We might decide to buy an expensive electric car because of savings in petrol over a 10-year period. We won’t necessarily use the savings we make to buy another car, rather we will use the money in other ways, and health systems need to do the same.
They need to choose to make the upfront investment in a key treatment to then achieve savings elsewhere, which they may not use to invest in more drugs but in other parts of the system. We need to learn from past experience and taking a siloed, short-term approach hasn’t got us very far. It’s time to look at the entire continuum.”
Only by working together – with health systems and patients – can we achieve the best health outcomes. “We must collect data – you can’t do anything unless you measure – if we want to decrease wastage. We also need to be clear about what outcomes we want to achieve, adapting every bit of the journey to ensure we reach them. Maybe we’ve been measuring the wrong outcomes? The involvement of patients will be key here as only they can tell you what outcomes are really valuable to them, and, at the end of the day, they are the people we all work for.”
Moll is encouraged by the “evolution of thinking” that she sees among leading pharma companies. “I can also see some movement within health systems too, with many countries running pilots or integrating their systems to collect data and measure. This really feels like a grass roots activity now, driving itself, but we must be clear that it’s not going to be super quick even if we are heading in the right direction.”
While working more closely with payers, policy-makers and patients will build strong and long-lasting relationships, Moll believes pharma needs to do more to bring the “story of what we do” to the outside world. A key example is EFPIA’s #wewontrest campaign, which encourages those who work in pharma to tell their stories of why they won’t rest to combat disease.
“The advances we have made in the last 50 years are extraordinary, yet I’m not sure we’ve done a good enough job communicating about them, engaging in debate and sharing information. The danger is that, in our very connected world where everyone is a journalist and everyone can blog or tweet, if we don’t talk about our achievements and engage, then the void will be filled by someone who may not know the story as intimately as we do. If we don’t communicate the value of our products and share why we do this, how can we expect anyone else to understand?”