Every time I read the news, I’m confronted by stories about the human cost of the COVID-19 pandemic and the unprecedented strain it is putting on European health care systems. With what we know now, the underlying weaknesses in the way some services are funded, designed and delivered seem so obvious. It’s easy to feel overwhelmed by the scale of the challenges we face. But I have also been struck by how the pandemic has cast a spotlight on some of the best characteristics of our health care systems: the selflessness and dedication of their health care professionals, their inventiveness and openness to innovation and, above all, their willingness to collaborate in the interests of the societies they serve. I am convinced that this spirit of collaboration, across borders and across sectors, is the key to building health systems that are resilient to emerging health threats and are sustainable in the long-term.
Rethinking health care in the context of COVID-19
For the first time this century, people in Europe are living through a dual-pronged health care and economic challenge. The approach some policymakers adopted in the wake of the 2008 financial crisis — of restricting health care budgets in a short-term attempt to restore public finances — is not an option today.
Today’s situation calls for a new approach. It feels like the world is at a turning point in our response to the virus. Now is the time to come together and co-create solutions to some of European health care’s most enduring challenges. As we continue to work through the pandemic, European citizens expect health care stakeholders from different sectors, and across the region, to come together under a new EU Health Innovation Pact.
“This spirit of collaboration, across borders and across sectors, is the key to building health systems that are resilient to emerging health threats”
It has been encouraging to hear the president of the European Commission announce her intention to “reinforce and empower” the European Medicines Agency and the European Centre for Disease Prevention and Control; and to create an EU version of the U.S. Biomedical Advanced Research and Development Authority (BARDA), which would support the EU’s response to cross-border threats and emergencies. These institutions have performed well during the pandemic and remind us that we are stronger when we work together, rather than trying to tackle COVID-19 country by country.
At the same time, we also need to collaborate to determine a long-term future for our health care systems. The World Health Organization’s Pan-European Commission on Health and Sustainable Development could play a vital role in supporting investments and reforms, and we look forward to submitting evidence to the Commission and hearing its conclusions next year.
Adopting innovative approaches to funding, service design and delivery through a new EU Health Innovation Pact
As politicians re-consider spending priorities in light of the pandemic, I hope they choose to significantly increase investment in health care to reflect the renewed value we place on it as a society. But investing in health care systems will only be sustainable if it funds worthwhile interventions. According to the OECD1, up to one-fifth of health care expenditure is wasted, partly due to spending on interventions that do not deliver the best outcomes for patients.
To help decision-makers target their investment effectively and make health care more sustainable, health care systems need to embrace the use of real-world data. This may include data that is already routinely collected by health care systems (for example, in electronic health records or disease registries), but could also include patient-reported data from apps or other digital platforms. Embracing the use of real-world data has the potential to transform every aspect of health care: from technology appraisal processes for innovative new medicines, to day-to-day clinical practice in primary care.
“The aim of value-based investment is not to cut budgets, but to reinvest potential savings in innovation and higher-value care.”
Some of the major challenges to reaping the benefits of health care data in Europe lie in: the lack of interoperability of the systems where data is held; the lack of standards to ensure that data is of sufficient quality to be shared and to generate insights; and the lack of suitable governance frameworks for data sharing.
Janssen is already collaborating on several projects to increase the access to, and quality and usability of, real-world data for health care decision-making, including through the Innovative Medicines Initiative. Projects such as HARMONY2 and PIONEER3 define outcome measures and utilize big and deep data sources to improve patient care. We have set up a federated network called Haematology Outcomes Network in Europe (HONEUR)4 to partner with universities, hospitals and institutions, and analyze real-world data, quickly and at scale, from as many sources as possible. Moreover, Janssen is a member of the European Health Data and Evidence Network (EHDEN)5 project, which seeks to harmonize around 100 million electronic health records for real-world data research.
Making better use of real-world data will enable health care systems to adopt new, outcomes-based models of funding where spending can be targeted on the interventions that deliver the greatest value. This strategic focus on value should not be confused with short-term cost containment measures. The aim of value-based investment is not to cut budgets, but to reinvest potential savings in innovation and higher-value care.
Some trends that have been slowly underway for a while, such as relying on different kinds of evidence generation and different clinical trial designs, are being accelerated in this environment, as companies and regulators alike realize we are going to need to do things in new ways for an extended period of time, and maybe in perpetuity, as a result of COVID-19. For example, the rapid adoption of telemedicine during Europe’s lockdowns has the potential to show whether, in some cases, delivering health care remotely can result in good health outcomes, a positive patient experience and lower costs.
Health care systems now have an opportunity to learn from this experience and accelerate health care digitization. This may include the rollout of remote consultations in appropriate contexts, as well as the use of digital apps and devices to help patients and health care professionals to better manage conditions. In many cases, these approaches have the potential to not just improve outcomes, but also to ensure patients are empowered and their preferences are taken into account throughout their treatment pathway.
Building a spirit of collaboration and trust
Janssen is ready to partner with governments and stakeholders across the health care sector, sharing our expertise in science and medicine to rebuild our economies and bolster our health care systems. But we also want to collaborate to seize the opportunities of health care reform and design a pro-innovation environment in which health care systems and regulations can keep pace with scientific progress.
We believe we can only realize this ambition by working together under the auspices of an EU Health Innovation Pact, co-creating a new and wide-ranging blueprint for Europe’s health care systems with all health care stakeholders. By working together, we can develop innovative approaches that help Europe’s health care systems become resilient to short-term shocks, sustainable in the long run, and ready to make the most of advances in medicine, technology and data science. The EU’s forthcoming pharmaceutical strategy6 provides an immediate opportunity for Europe to send a clear signal that collaboration between sectors is critical to innovation in health care.
I hope that in some years from now we will be able to say that the COVID-19 pandemic was a turning point — and that its legacy will be collaboration, transparency and greater trust between health care stakeholders for the benefit of patients across Europe.
This article originally appeared on Politico on October 28 2020.
