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This blog is part 9 of a series on the MEAT value-based procurement project, an initiative that advocates towards a shift from price-based procurement towards value-based procurement. It does so by defining a Most Economically Advantageous Tendering (MEAT) framework that includes the value of medical technologies, services and solutions in procurement processes across Europe. Read part 1 , part 2 , part 3 , part 4 , part 5 , part 6 , part 7 and part 8 . Health systems across the globe are faced with unprecedented challenges. Demand and patient expectations are rising while financial resources are diminishing. To respond to these trends, we need a new approach to how we manage healthcare. At NHS North West Procurement Development, we have been looking at how rethinking procurement can deliver better outcomes for patients, increased savings opportunities, and wider operational efficiencies. We began exploring the principles and practices of ‘Value Based Procurement’ (VBP) in 2014. By working with the University of Liverpool and engaging with a wide range of stakeholders – including ICHOM, legal experts, suppliers and MedTech Europe – we have studied how VBP can work in practice and the changes needed to make it commonplace. New framework for change To move this process to the next stage, we have published a 30-page guide setting out the rational for embracing VBP, providing a framework for delivering change, and setting our vision for the future. We want this to inform the work of procurement officials and suppliers alike, to inspire health professionals, patients, policymakers and others to change how they think about preparing our health system for the future. Hospitals are busy places and there is rarely time to take a breath and consider reforming the system. That’s why we have aimed to make the new guide clear, concise...
Nadim Yared is President and Chief Executive Officer of CVRx and Chairman of the AdvaMed’s Board of Directors, our sister organisation in the United States. He is a speaker at the MedTech Forum 2018 and his sessions include: CEO #NOFILTER and The MedTech Europe Code as a Business Enabler, both on Thursday 25th of January. For more information go to the MTF website and follow #MTF2018 on Twitter. *************************************** The toss of a dice. An incoming tornado. The decline of investment in medtech. Each of these events could be considered a butterfly effect – the notion that small causes can have broad effects. The medical device industry is undergoing tremendous tectonic shifts, where advances in technology are crossing new boundaries in the medical device space and widening horizons for patients. Internally, our industry has been evolving in response to these advancements. R&D teams have become more digital, more connected, more in-tune with the trends of Silicon Valley. Internet companies are empowering patients with information that enables them to control their destiny more than ever before. Patient advocacy groups are getting stronger and more influential. With this in mind, you might assume that our industry is growing healthy and that our innovation ecosystem is vibrant. Well, maybe. The number of U.S. patents in our field is at an all-time high. However, the translation of that innovation into products that are actually accessible to patients is bottlenecked. And the canaries in the mine here are the small medtech companies. I have seen the number of new medical device companies being formed fall over the past decade. In fact, ten years ago there were four times as many new companies as there were last year. While the total funds allocated by venture firms have been reduced by half, the average investment required by...
This blog is part 7 of a series on MEAT Value-Based Procurement, an initiative that advocates a shift from price-based procurement towards value-based procurement in healthcare. It does so by defining a Best Price Quality Ratio method within the Most Economically Advantageous Tendering (MEAT) framework put forward in the European Public Procurement directive. Read part 1 , part 2 , part 3 , part 4 and part 5 and part 6 . Our health systems need reforms to maintain universal health coverage and, given the economic and demographic pressures we face, Europe cannot afford its citizens to be in poor health. This will require new thinking about the economic value of health for individuals, families and society (health as an economic good) in addition to the economics (the cost-efficiency) of healthcare systems. Instead of focusing on the costs of healthcare, we must consider what is delivered. The full value of investing in health and quality healthcare can be realised by focussing on health outcomes complemented and enhanced by the economic value offered by being in good health and having cost-efficient health systems. This value-oriented approach can be implemented when purchasing health technologies. It is already seen in some modern procurement procedures resulting in the highest economic value in addition to best health outcomes. These most economically-advantageous tenders (MEAT) can deliver optimal value to society. To make informed decisions about what constitutes value, we need to consider the full value that health investments bring – not just the outcomes for patients or for hospitals, but the full impact these interventions can bring to society by keeping people in good health. Defining value The real economic consequences of being in a state of ill-health are not solely related to the direct costs of health and care, but include wider socio-economic consequences and...
This blog is part 6 of a series on the MEAT value-based procurement project, an initiative that advocates towards a shift from price-based procurement towards value-based procurement. It does so by defining a Most Economically Advantageous Tendering (MEAT) framework that includes the value of medical technologies, services and solutions in procurement processes across Europe. Read part 1 , part 2 , part 3 , part 4 and part 5 . When the new EU Directive on public procurement was finalised in 2014, replacing the previous framework, it was hailed by the European Parliament as a tool for ensuring better quality of supplies and services and value for money. The European Parliament was also keen to emphasise how the Directive was designed to encourage innovation, improve SMEs’ access to public sector markets and to integrate environmental and social considerations into procurement policy. One of the tools within the Directive to achieve these aims was the requirement for contracting authorities to base the award of contracts on the most economically advantageous tender (MEAT). Contracting authorities were also permitted to use lifecycle costing in their award criteria in order to assess total costs. Previously, tenders could be awarded either on the basis of lowest price, or on MEAT criteria which typically included a balance of price and quality criteria. All of this seemed to be good news for those of us with an interest in value-based healthcare. Defining what MEAT really means However, whilst the terminology was promising, it was misleading. Indeed the Directive provided that MEAT could be based either on price only, cost only, or best price quality ratio. Although Member States have been given a choice when implementing the Directive into national law whether they wanted to exclude or restrict the use of price or cost only as the sole...
I was delighted to speak at the 2015 European MedTech Forum. This event is always a great opportunity to connect with old friends and colleagues and to be part of lively and innovative debates. This year, I had the opportunity to discuss the need for a new healthcare system in order to build a healthier world. Improving existing healthcare systems and developing new ones is a vital part of Aetnas’s vision. The aim? To make populations and individuals healthier for longer, more economically viable and also happier. So, in broad terms, where is healthcare today? It’s a 60 years old rats’ maze that, according to the Institute of Medicine, wastes $800 billion every year in the US alone, and isn’t actually focused on getting people healthy. In fact, I would argue that the system results in frustrated doctors and patients and a focus on episodic care. We need to start a holistic approach focusing on health and not just treatment . The challenge is a big one: the cost of care worldwide continues to increase chronic disease is becoming more prevalent as nations develop and there is a growing shortage of healthcare professionals to keep up with demand. The solution, however, is clear: a simpler healthcare system built around the customer. We need to change the whole healthcare ecosystem and move from a medical system to an integrated health system. We also must move from paying for treatment to paying for good health and build a system designed to keep populations healthy and address the continuum of care needs. Our blueprint for a future healthcare system comprises five interrelated components: - Proper system design – analyse the needs ofpopulations using big data to provide the care that’s needed; - Health IT – the future healthcare model incorporates sophisticated IT as...
Cochlear implants are just one example of how life-changing innovation can change people’s lives. Their impact is profound. Deaf children who receive one of these devices at a young age can develop normal language skills, allowing them to hit the same development milestones as their peers. But imagine your child’s hearing was saved by a cochlear implant only for the device to fail, perhaps at the age of six or seven years. They are at risk of abruptly losing their hearing, falling behind in school and suffering socially. What would you do? Perhaps you would expect your health insurance (public or private) to replace or fix the failed device. If that did not work, you might consider paying out of pocket. If it cost thousands of euro you may have to cancel a holiday or buy a cheaper car. You’d do whatever it takes. Now, think how you would solve this problem if you lived in Bulgaria, a European Union Member State where a typical salary is €400 per month. This was the reality faced by some parents in my country. Several years ago, after a long but successful campaign by patient advocates and parents of deaf children, the national health insurance fund agreed to reimburse cochlear implants. But there was a catch: while the surgery to implant the device is covered, maintenance was not. Devices need their batteries changed and sometimes they need to be fixed or replaced. Families went to all kinds of extraordinary lengths to save their children’s hearing in cases where the device needed to be maintained. Many got a second job, others sold family property, some launched fundraising campaigns and a few left the country in search of work in countries where cochlear implants were fully covered – countries where their children would be able...