Monthly Archives: September 2012

Everyone is talking about Patient Adherence

OK. Maybe not everyone.

But certainly all of pharma! And then much of healthcare – payers, insurance companies, private medicine, even some doctors, although not all.

Notice what’s missing?

Patients! Patients aren’t talking about adherence!

So what is going on here? We all know big pharma is facing a very uncertain future. Lots of big – read profitable – products going off patent, and, of course, the rise in the use of generics, so where to go to continue to grow profits. Of course, everyone is looking to emerging markets, but even there it is becoming clear that the future is not as promising as it once appeared to be, with strong price pressures from governments, massive competition from within big pharma and a market that does not want to be dominated by big international players. So patient adherence is growing in importance.

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Is this simply all about the money?

 

English: Total U.S. healthcare spending. 1960 ...

English: Total U.S. healthcare spending. 1960 to 2007. Percent of GDP (gross domestic product). Data is from OECD Health Data 2009 – Frequently Requested Data. (Photo credit: Wikipedia)

Healthcare can form a significant part of a country’s economy. In 2008, the healthcare industry consumed an average of 9.0 percent of the GDP across the most developed OECD countries. The United States (16%),  France (11.2%) and Switzerland (10.7%) were the top three spenders (Wikipedia).

In the US, that accounts for more than 2.2 trillion dollars per annum.

This is not one of those issues where clearly the more money you throw at the problem the better the outcomes will be.

Yet what does this huge amount of money the US spends each year on healthcare do for the health of the population. Because it does not deliver the best health outcomes the world has to offer (at least according to many) so what does it deliver?

One answer can be: it delivers huge profits to some of the players. With so much money at stake, in the US, companies are competing to expand their share of the pie. Many corporations return considerable profits to shareholders and Wall Street – yet those profits never seem to be enough! So when it comes time to reform, restructure, realign, reinvent healthcare, then those with vested interests can prove difficult partners. It is this profit driven approach that really contributes to making healthcare reform in the US such a difficult process.

Not that this only applies to the US. In Europe, where a single payer is the norm (government funded model), money, or today, the lack of it, drives much of the healthcare agenda. Governments are desperate to cut the cost of healthcare delivery. Almost it seems at any cost. yet the barriers to change seem to be as mountainous as those in the US.

So, we have more than 50 million people without health coverage in the US, a plethora of corporations making billions of dollars of profit year on year, the rising cost of healthcare, the rise of medications and treatments that can cost up to $400,000 pa per patient and a general debate that the system is not sustainable. In Europe, countries are restricting the type of interventions delivered, delaying new innovations, cutting salaries of healthcare professionals and outsourcing as much as possible…..

And so it goes on.

There is a real perception, both in Europe and the US, that in order to continue to provide good quality healthcare, costs must continue their trajectory skyward. That better healthcare simply is going to cost more.

I disagree!

Foto de David MacKenzie Ogilvy

Foto de David MacKenzie Ogilvy (Photo credit: Wikipedia)

The well known advertising guru from years gone by – David Ogilvy – famously said that he knew 50% of his advertising spend was wasted, but that he didn’t know which half? Seems to me, the same applies. There is so much waste, duplication of effort, competing interests etc that it is hard for some people to believe that better healthcare does not have to cost more money.

This is the challenge for us all today. What do we need to do that will enable us to continue to deliver good health outcomes, or better health outcomes, to more people, without costing more?……….and so the debate continues.