The way that pharma accesses the NHS is changing and traditional models of selling will no longer work. It has never been more important for pharma to be able to demonstrate the real value of their offering. Yet in an environment where decisions are no longer made by individual prescribers, communicating the value of a device or product to a cash strapped NHS can mean the difference between good and great performance.
Of course, the acquisition cost is still important, but it almost certainly does not represent the true value of a product or device. Particularly given the number of stakeholders involved, it is both harder to define what constitutes value and to ensure that the key messages reach the right audiences.
According to the Office for National Statistics, the NHS has a managerial workforce that is one-third the size of that across the UK economy as a whole. NHS managers simply don’t have time to pick through the vast amounts of data that are available, analyse it and explore the impact of efficiencies. This presents an opportunity for pharma companies to become integral to the commissioning process, developing meaningful relationships with their customers supplying the information the NHS needs to commission services.
The challenge for any supplier to the NHS is to show the true value of its product or device in a way that can be readily understood and accepted by their NHS customers. There are three key elements required to achieve this.
First - a firm grasp on the numbers
How many patients are there and how much do they cost? What are the most important issues facing your customers? Is it the volume of activity? Is it the length of stay? Is it the rate of readmissions or mortality rate? Can this information be combined with other data sets to give new insight and facilitate decision making?
Second - understand the patient pathway
The patient pathway is a record of a patient’s journey through the NHS. It establishes what resources are consumed, in terms of time, human resources and physical resources (equipment and room usage, costs, revenue, etc). A patient pathway is not a clinical guideline which is an ideal treatment protocol based on the best medical evidence, but a picture of reality. When commissioning a new service it is the fine detail of the patient pathway that leads to success. If we truly understand the patient pathway then we can identify the value points or those parts of the pathway that can be changed or improved to create value for the patient, the NHS and the pharma industry. It enables a pharma company to consider the impact of their product not just at the point of intervention but throughout the whole patient’s journey.
Third - add simulation
Simulation is the process of studying the behaviour and performance of a model when its variables are changed. Simulation allows models to be optimised by making comparisons between different scenarios which could not easily be done in a real life system. Simulation gives visibility of a process with quantitative output.
The pathway includes events such as consultation, diagnosis, treatment, medication, disease progression, assessment. Discrete event simulation takes into account all the resources and constraints involved as well as the way these interact with each other over time, allowing the pathway to be studied in much more detail.
Whereas cohort patient models estimate the outcome for a group of patients, simulation also explicitly considers the outcomes for each individual.
Finally - support implementation
Undertaking the first three steps provides a roadmap for implementation, improves understanding and builds consensus. Moreover, the approach facilitates service planning and decision making and speeds up the pace of change in your patient pathway. Each of these elements is essential in delivering the full value of a product or service for the benefit of patients, the NHS, and the organisation.
In an environment where traditional sales models are failing to deliver, it is the ability to understand, prove and facilitate value across the entire patient pathway that will be the new benchmark of success.
David Southern is managing director of market access specialist Spirit Access