In 2018, 47.6% of hospital spending was on drugs, a higher percentage than ever before and this is growing. With almost half of hospital spend being allocated to medicine, pharma represents the biggest area of expenditure for healthcare across the globe. It’s therefore vital that this spend isn’t simply justified, but that it’s also optimised for the very best outcomes to ensure patients, healthcare professionals, hospitals and healthcare systems benefit.
Focusing on outcomes
More and more, pharma has to respond to a bigger challenge around outcomes and there is, understandably, increasing pressure to provide evidence of outcomes delivered in the real-world compared to those expected on the basis of clinical trial data. Companies simply cannot charge a lot of money for their medicines without scrutiny or challenge. Simply put, medicines need to prove their worth. Not just in isolation but as part of a coherent state of the art treatment pathway adapted for real-world clinical settings, not simply a consequential pathway as a result of individual marketing authorisations.
This affects the pharmaceutical industry across the globe as healthcare systems become more value for money and outcomes focused. It’s further highlighted by a raft of recent legislative changes in the US to bring about greater transparency around drug prices and risk-sharing payment models already emerging. And, as technology becomes more sophisticated, the ability to access, analyse and act upon vast amounts of data is invaluable. It gives the pharma industry a vital validation tool to help demonstrate product value at the points of decision-making and/or approval and whether they work over the longer term, which ultimately will lead to affordable quality care.
Working together for better healthcare in the UK
In the UK, the data and analytical capabilities enabled by the digital revolution opens up new possibilities for medicine optimisation through collaboration between the NHS and pharma companies. For the NHS, it offers an opportunity to not only be more efficient with funds i.e. managed costs but also improve outcomes, for patients and for pharma. In order to do this effectively, more work needs to be done to ensure the right systems are in place and aligned. In fact, recently, outgoing chief medical officer, Professor Dame Sally Davies, stated: "We should invest in systems and solutions that contribute to making health more equitable, secure and sustainable”.
Optimising medicine to alleviate pressure
Why is it so important to make sure medicine is being optimised? We know that around 50% of patients who are prescribed medicine don’t take these medications properly and in doing this they waste time, money, medication and also risk their wellbeing. It’s no secret that the NHS is under incredible strain, so by optimising medication and ensuring patients are taking drugs which are the most effective this benefits a hospital financially, reduces some of the pressure on the staff who work there and improves patient outcomes.
Helping physicians home in on a personalised adaptive and responsive approach, within a constrained budget
There is a wealth of data available, but by collating this and fully utilising as much information as possible, the benefits go beyond just numbers. It is, for example, invaluable in the decision-making process of physicians, who control 80%-90% of all pharmaceutical spending in hospitals. AI for example, can help these physicians to understand not only the efficacy of certain medications, but also help predict when medications aren’t taken correctly and the impact that this will have on patients. This insight enables us to focus on optimising drug usage to avoid wastage and ensure cost containment. It also frees up valuable time so that physicians can focus more on delivering patient-centric care.
Data can also prove invaluable in reducing duplication and by helping healthcare professionals take a proactive approach. By using AI, it’s possible to identify trends and track patient outcomes, ensuring the most effective medicines are available in the right quantities for better health.
The future is already here
The digital revolution has brought with it incredible opportunities to deliver solutions to very complex issues including cross-platform data consolidation – from the tech-savvy online users to phone. Some industries, such as finance, have made huge leaps and embraced change – creating innovative solutions which are built for the future rather than relying on simply improving solutions for historical problems, the healthcare industry has lagged behind and is ready for disruption. The healthcare industry must learn from successes in other countries i.e. disease-specific, system specific, as well as other industries, keeping an open mind and, of course, ensuring that knowledge is shared.
While there is no perfect healthcare system and each country has its specific issues, there is much to learn from examples of best practice in other countries. After all, healthcare delivery is a global issue which, sadly is not currently efficient or sufficient. Hospitals in the Middle East, such as Sidra Medicine in Qatar and Mediclinic hospital in UAE, for example, have a unique advantage as greenfield hospitals. They can bring in experts from around the world to share knowledge and help build a new system from scratch. And, while these countries won’t have to adjust to working with historic systems, they will certainly have valuable information to impart. Other more established countries, may be able to share learnings after success with specific health issues – perhaps cancer treatment is better in some EU countries, where others may have more success with HIV or diabetes. How is data being collected? How is it being analysed? How is existing data being maximised for the future? What can others learn?
Bringing it all together
For established healthcare systems the incredible amount of data is underutilised and, of course, dated systems and processes working in a silo can hamper progress and patient care. This is where a major disruption is needed. This doesn’t mean ripping everything up and starting from scratch, that would be lunacy. Technology acquisition – something the industry is already great at – is needed to streamline and consolidate existing systems and information. That said, with this acquisition, the industry also needs to look at what systems, both technology and ways of working, it can abandon. From there, best practice can be evolved to continually improve. And, we don’t need to add lots of new platforms to make it work, but consolidate data from existing systems to reduce the number of disparate platforms and so data can be surfaced.
An additional problem faced by long established healthcare systems is improving only what already exists – a reactive approach to best practice which is constrained by existing parameters, rather than being guided by the future. With so much new technology, why rely on systems and practices which in some cases have been around for centuries? By embracing change, we can unlock a wealth of possibilities that data can deliver, ensuring medicine delivers what it’s meant to.
Sharing is caring
Data can be the difference between life and death. If a patient falls ill and their data is on a centralised platform, full medical history including any medication and underlying conditions can be used for faster and more informed treatment. Unfortunately, while some data sharing exists, in most cases, it’s blocked by systems not talking to each other both on a global level and within different countries. Ultimately, everyone, particularly the patient, suffers.
Bigger picture benefits
The patient is at the heart of the healthcare system, but by focusing on which drugs are most effective, both patients and hospitals benefit. Patient experiences of the healthcare system will be improved with more consistent insight into which medicines are right for them, allowing them to move through the system more efficiently.
In addition to creating a better environment for patients, this information will allow healthcare organisations to better manage their resources, using medicine not only as a tool to improve a patient’s condition, but also as a way to manage and predict patient flow. With so much on the line in the healthcare system, medicine optimisation will reap rewards for everyone.
Orlando Agrippa is chief executive and founder of Draper and Dash