6th strategic Value of Innovation ConferenceSustainable and goal oriented healthcare system
Ljubljana, 12. october 2017 - Innovations in healthcare save lives, but the system continues to lack relevant evaluation of health technologies and the necessary registers that would allow for effective treatment of patients and access to healthcare innovations. The system also needs to institute incentives for healthcare employees and, above all, develop a vision of long term sustainability so that the system can adapt to the challenges of the future.
Only a sustainable healthcare system and evidence supported decision-making can enable rapid access to innovative medicines, vaccinations, therapies and technologies that change the treatment of many diseases and extend or even save the lives of patients. Since they also reduce the costs of specialist and hospital treatments and increase productivity, investments in research and development are not only cost efficient, they are absolutely necessary. But we are faced with an aging society and increasingly common chronic diseases, propulsive innovations, important developmental shifts in medicine and limited financial resources. All of the above factors are already severely threatening the sustainability of the Slovenian healthcare system. Medicinal product prices have already contributed to slowing the growth of current healthcare expenditures as prices are now nearly a third lower than in the years before the global economic crisis while the prices of consumer goods have increased. Costs of prescription medicinal products represent only 14 percent of public health expenditures.
At the strategic conference Minister of Health Milojka Kolar Celarc emphasised that amendments to the Health Protection and Health Insurance Act and the Long Term Care Act will provide permanent and stable sources for long-term healthcare financing and assure a high quality and accessible system that will be open to innovations. She also noted upon the importance of innovations in healthcare, including the introduction of e-prescriptions, e-referral notes and the Intravizor project that monitors the consumption and pricing of medicinal products in Slovenian hospitals, as well as the importance of pharmacological innovations and the introduction of new medicines that extend life, improve the quality of life and ability to work and added: “We are seeing especially good treatment outcomes with biological medicines that received marketing authorisation in the past 15 years and have greatly improved the health outcomes of patients with multiple sclerosis and slowed down its advance. New methods of treating rheumatoid arthritis are also slowing down the advance of the illness and even improving the condition. Over the past 20 years new therapies have led to a 20 percent decrease in cancer mortality. We have also seen great advances in the treatment of HIV patients where mortality has decreased by 80 percent, ... Besides the economic aspect, procurements also consider the ethical aspect and although our market is diminutive we have succeeded in assuring a wide range of new innovative medicines that the patients can receive comparatively quickly in comparison to other European states even though Slovenia is spending much less on the healthcare budget per capita then certain other countries.”
National Council Member mag. Peter Požun, President of the Commission for Social Security, Labour, Healthcare and the Disabled of the National Council of the Republic of Slovenia initially explained: “We are all aware that the economic crisis has left great consequences in the healthcare system. As we noted on several occasions in our discussions in the National Assembly, the crisis period caused a marked lack of funds for even established healthcare practices, let alone investments in innovations and development. Shapers of public healthcare policies are therefore faced with difficult challenges. They are expected to develop policies that focus on patients and assure a high degree of safety for their treatments while maintaining efficiency and sustainability from an economic standpoint. Unfortunately the mention of system sustainability still primarily conjures up the thought of costs - either the progressively increasing costs of treatment or, particularly in the initial phases, the rather sizeable investments into progress. We should know there is a substantial difference between the two - prudent and deliberate investments can directly or indirectly cause reductions of costs.”
Prior to the 6th strategic Value of Innovation Conference: Sustainable and goal oriented healthcare systems, that will be taking place in the National Council of the Republic of Slovenia today, representatives of healthcare policy implementors, academic research institutions, pharmaceutical industry and patients exchanged views and positions on the value of innovations in healthcare and the future of the Slovenian healthcare system which will need to adapt to new circumstances and challenges. So what should a healthcare system be like in order to enable key investments into research and development for the progress of Slovenian society, provide patients with fast and uninterrupted access to future innovations and also maintain long term sustainability?
Progress in treatment is usually linked to medicine while high costs are linked to medicines, emphasised Dr. Vasilisa Sazonov, Vice-President of the Management Board of the Forum of International Research and Development Pharmaceutical Companies which organised the 6th strategic conference in collaboration with the National Institute of Chemistry: “Medicines are expensive, we have the most expensive medicines in Europe, medicinal product expenditures are rising rapidly ... these are the most often repeated assumptions that make up one of the greatest myths in Slovenian healthcare. They have absolutely nothing to do with reality. A recent comparative analysis of official prices in Europe showed that Slovenian official prices are among the lowest in the EU. Medicinal product expenditures in Slovenia are similar to those recorded before the global economic crisis in 2009. Results of analyses have clearly shown that prices of prescription medicines have contributed to slowing the growth of current healthcare expenditures in spite of an aging population whose demand for medicines has increased. Expenditures reduced by as much as 31 percent between 2010 and 2016. Meanwhile prices of consumer goods increased by 5.9%. The public will certainly be delighted by the fact that a Slovenian patient receives nearly the same range of medicines for 200 Euros per year as a Belgian patient for almost 450 Euros. All this data shows that Slovenia has the lowest medicinal product expenditures when compared with European countries with a similar access to medicines. It also shows that there is simply no more space in the field of medicinal product pricing for any further administrative measures.”
With currently recorded multi-million losses of public healthcare institutions and emergency measures for financial consolidation of public healthcare, reduction of waiting periods and upcoming package of amendments to healthcare legislation that is currently being reviewed by the Parliament, a thorough examination of the required conditions for a long term sustainable healthcare system is certainly necessary. Mag. Marjan Sušelj, General Director of the Health Insurance Institute of Slovenia emphasises: “The financing of existing rights under mandatory health insurance and ever new innovations in healthcare requires that a certain percentage of funds should be allocated each year for investments into development, however such investments must be accompanied by practical measures towards a more effective and successful operation of the healthcare system (effective organisation of public healthcare, integrated patient care, favorable balance between costs and benefits of new medicines, ...). Investments will only return if we are able to manage our systems towards achieving set systemic objectives such as healthier and higher quality life and effective management of chronic illnesses.”
Ass. Prof. Dr. Petra Došenović Bonča of Ljubljana’s Faculty of Economics presented the challenges and new roles that public healthcare systems will face in the future, as well as some templates for financial consolidation of the existing state. She reported: “Existing measures, such as for example the renovation of hospitals, are not a sufficient response to the challenges of the future when the implementation of the fundamental principles of the healthcare system - solidarity, quality, accessibility and effectiveness - due to massive social changes and new approaches in medicine requires changes in financing with the service providers and support environment for the dispersion of information because there is a danger of modern medicine becoming accessible to only part of the population due to lack of financial resources. That is why we need to establish clear decision-making on the content of the basket that is solidarily financed, reform the health insurance scheme and increase the role of life-long financing, institute real prices of health services, modernise the payment models of service providers, provide incentives to employees in healthcare, evaluate health technologies, institute evidence based decision-making, increase transparency and efficiency of the healthcare system. The latter is absolutely necessary in order to assure healthcare similar to that in other developed countries with available resources, lest we continue to lag behind the needs.”
Slovenian scientific groups have gained international renown and respect and place into the very top in innovative research due to numerous internationally recognised scientific achievements and prestigious awards. Researcher Dr. Iva Hafner Bratkovič from the National Institute of Chemistry explained the role of academic institutions in the development of new medicines, diagnostics and innovative methods of treatment and emphasised: “Investments in basic research is a key factor in the research of the mechanisms of incurable diseases that results in the development of new medicines and advanced treatment methods. It would be my pleasure to see Slovenian science flourish if it were not malnourished in just about every respect and heavily encumbered by bureaucracy.”
The true value of innovations in healthcare is perhaps best known by patients and their families in fields where we have yet to reach a decisive breakthrough treatment, as well as those who have had their lives changed by innovations in healthcare. One such person is Aladar Belec, a patient with juvenile rheumatoid artritis from the Slovenian Association of Rheumatic Patients, whose message on today’s world arthritis day is: “Innovative medicines mean life for me - they enable me to move, take care of myself, be a father, partner, friend and as good and beneficial a citizen as I can be.Arthritis does not kill, but without timely healthcare, appropriate therapy and professional help, the life of an arthritis patient with all the pains and troubles the disease brings is not a dignified and full life.”
Participants agreed that innovations in healthcare save lives, but the system continues to lack relevant evaluation of health technologies and the necessary registers that would allow for effective treatment of patients and access to healthcare innovations. The system also needs to institute incentives for healthcare employees and, above all, develop a vision of long term sustainability so that the system can adapt to the challenges of the future.