How the pharma industry can contribute to sustainable healthcare systems

Three challenges an ambitious healthcare system faces:

• The health care system is disproportionately built around intervention, not prevention:
  “People typically enter the health care system when they are not feeling well. The incentives for physicians are to treat patients or to do surgeries. …It is important to start thinking more about prevention. That would not only take waste out of the system, but also create more sustainability and more productivity”, explains Tschudin.
• Health inequity is still prevalent even in developed countries:
  “In the city of Philadelphia, for example, within a couple of miles, the difference in life expectancy is ten years. This clearly shows the importance of addressing the underserved population in the developed and, obviously, in the underdeveloped world”, describes Tschudin.
• The lack of partnerships between private and public health institutions:
  “The way to solve this is by focusing on a common objective, regardless of the type of institution. COVID-19 proved that this way of working together is effective and delivers output much quicker”, Tschudin proposes.

Who is responsible for the shift to more sustainable health care system?

Tschudin shared: “Everybody is responsible for his or her own health. That said, all of us contribute to shaping the health care agenda and can influence its focus on the right priorities, its investments and patients’ access to the right medicine.”

Key stakeholders and decision makers in the health care industry should align better on assigning the same focus to improving healthcare sustainability goals as they do to environmental sustainability goals. “Why don’t we have objectives that talk about how we are going to reduce cardiovascular risk or deaths in our country by 50 percent by 2030? It's totally doable, but we just don't talk about it.”

How can the pharma industry achieve impactful change?

There are three things that the pharma industry can leverage to improve sustainability in the industry and the outcome for patients:

• Keep up the scientific research
• Put a more balanced focus on products and customers
  
• Better understand the needs of the patients, physicians, and the health care system
  

Essentially, each stakeholder within the health care system being more accountable for outcomes. “In the case of drugs, the pharma industry is already very far: it provides drugs knowing what they can deliver. But the same accountability is also required for the overall health condition of our societies. Our industry needs to have skin in the game and work together with other organisations to determine what the health care pathways are, how patients can be treated and make sure that we are delivering what we promised”, describes Tschudin.

How can collaboration and competition co-exist?

Collaboration and competition are not mutually exclusive. The important thing is building trust in the system and the stakeholders that work together. Tschudin has a clear approach for working towards that trust and collaboration: “The relevant players in the ecosystem must understand that the health sector has so many challenges to overcome that the supposed competitors are not the real competition. Rather, it is the barriers in the system, such as access, affordability, or adherence, that should be acknowledged as competition when working towards better health care. Once the ecosystem jointly works on removing some of these barriers, it also eliminates some of its common competitors.”

What are the challenges to achieving an outcome-based model?

Tschudin describes that an outcome-based model takes very different skills and capabilities to what the industry has traditionally required. It takes population health specialists, data scientists, and a new take on public affairs. In addition to that, the industry interacts with systems that are often complex and driven by incentives that are misaligned. This highlights the importance of finding the right people who can help to have the right conversations to drive change in standard of care. It would also allow pharma companies to be more focused on how they help patients address their health issues through sustainable, long term measures that go beyond the drug.

What are the skills needed to improve health care long-term?

For health care systems to really understand its patients, they need an in-depth understanding of data. What is required are experts for data management, data analytics and digital enablement of certain processes. “Compared to the past, much more agility is needed, because people want things right in the moment it matters to them. Another huge focus lies on implementation science. That means making sure that a product or a treatment and its guidelines get implemented through the system in a way that enables quality improvements in the outcome. Those are the types of new skills and capabilities that also Novartis should contribute to building”, Tschudin describes.

How will the health care system change in the next ten to 15 years’ time?

For Marie-France Tschudin, it’s clear where the future of the health care system is headed: “In the future, the system will be much more proactive and focused on prevention wherever possible. Many diseases are preventable, such as cardiovascular diseases, diabetes and, looking forward in time, maybe even Alzheimer. Inequities will be reduced, or at least the health care industry will have tried to become more holistic and broader about the way it goes about human health. Also, public private partnerships will not be questioned anymore. It will just be a given that they work together on what needs to be done.”