Value-Based Health Care and chronic disease

  • Posted on 12.04.2018

Value-Based Health Care and chronic disease


Tanja Valentin

Director External Affairs, MedTech Europe


I would like you to think about the evolution of healthcare in Europe and how it is organised. What are healthcare systems generally good at? Imagine a road accident. Frantic emergency phone calls. Flashing blue lights. Within 8 minutes emergency vehicles arrive. You hit the hospital accident and emergency ward. A crash team is ready. Doors are rushed through. Staff is scrambled, and lifesaving interventions happen. It’s an efficient and wondrous system we should all be proud of.

Acute and chronic

A road accident is an example of acute care. An intensive but (relatively) time-limited intervention. Over time, healthcare systems have got extremely good at delivering acute care, in many forms. But there is an emerging issue. Care for chronic conditions is far behind.

Diabetes is one of the most pressing examples of a chronic condition. In a perfect world, a person living with diabetes would have complete and timely information about their condition. They would be able to effectively self-treat easily and, if needed, have support from doctors, nurses and nutritionists at any time, day or night. In a perfect world, the condition could be managed minute-by-minute, and the person would never need to see those blue flashing lights or the inside of a hospital.

Perfection and reality

We are far from that perfect world. Two challenges arise from our acute-care focused traditional model. Firstly, purchasing and resource allocation mainly happen in short-term cycles. Acute care tends to be resource-intensive but time-limited. Secondly, acute care tends to happen in highly siloed structures. Car crashes go to A&E. Heart problems go to cardiovascular. But what if healthcare systems faced a pressing condition that was long-term and could not be neatly siloed?

This is exactly the issue with diabetes, a condition that often lasts decades and can cause complications in the feet, eyes, and many internal organs. Diabetes is set to become the single most costly disease on planet earth. Today it affects 1 in 11 people worldwide1. That figure is going to more than double by 20501 if we don’t change how healthcare systems think and act. There is a pressing need to move away from the old way of thinking. A need to shift away from short-term allocation, away from silos and toward long-term integrated disease management.

A value-based future

A change is coming. There are new ways to think about resource allocation. Value-Based Health Care is a framework that enables resource allocation to be decided by how much value is created for patients and society. What is different about this model is that, when applied, it enables healthcare systems to think more long-term and in a less siloed way.

This new thinking and framework are creating a wave of excitement across the world. In the US this is being led by Harvard professor Michael Porter. In Europe, we are seeing major clinics like Diabeter in the Netherlands and Steno in Denmark take up the challenge of proving how effective this mentality shift can be. We were excited to see so many mentions of this concept this year at the major diabetes’ ATTD conference. So, we, Medtech Europe’s Diabetes Sector Group are publicly committing to lead on Value-Based Healthcare in Europe to ensure a sustainable future for all.


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