Difference between revisions of "Healthcare system reform"

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'''Work under construction. In case you have any questions, additions or comments, please do not edit these pages, but you are more than welcome to [mailto:ruthdonners@hotmail.com contact us].'''  
'''Work under construction. In case you have any questions, additions or comments, please do not edit these pages, but you are more than welcome to [mailto:ruthdonners@hotmail.com contact us].'''  
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Scenario wherein the healthcare system is more integrated, shorter lines between pharma, medicine, insurance companies  
Scenario wherein the healthcare system is more integrated, shorter lines between pharma, medicine, insurance companies, which gives pharma incentive to focus more on market pull than technology push<br>
 
==Developments in time==
==Developments in time==
===2010-2015===
===2010-2015===
At the end of first decade of new millennium, innovation in the healthcare system is primarily dominated by multinational companies. Regulators had generally seen their role as being limited to that of framing regulations to deal with potential safety and efficacy issues, and ensuring compliance with these regulations. Around 2010 after the 2008 financial crisis, instead of seeing themselves as passive responders to events, regulators began to see their role in a much more proactive way. In line with “new governance” agendas and linked to globalisation
 
initiatives, discussions began to take place within regulatory bodies about their role in stimulating
At the beginning of 2009, the global economic environment was still in a major state of flux. The ever increasing cost of healthcare became one of the major issues in developed countries as well as developing world. In the United States, the actions of the Obama administration and Congress were committed to addressing healthcare issues as part of economic reform. The global economic slowdown sparked acceleration of reform in other countries as well, whether in the form of increasing government demands for price cuts, as in Germany and the U.K., or encouraged use of generics, as in Japan. Next to the governments, insurance companies started to take more significant role as the primary payer of the healthcare expenditure. <br><br>
changes in the processes and outcomes of health care innovation.
On the regulatory side, a major milestone opened the way to integration in the healthcare system. Sentinel system, initiated by the FDA’s at early 2005, was opened to pharmaceutical companies in 2011 to provide access to existing electronic health information, including claims data, emerging electronic health records, and diagnostic databases. The primary aim of the FDA was using these databases to monitor the safety of drugs and devices, and the Sentinel database was also likely to support Phase IV post-marketing studies and surveillance. In Europe a similar initiative was taken in a number of countries, like the Netherlands passed legislation in 2008 for a system called Aorta (Electronic Patient File, EPD) see [[http://nl.wikipedia.org/wiki/Elektronisch_pati%C3%ABntendossier]] (in Dutch), Sweden and Belgium [[http://www.ictzorg.com/nieuws/nieuw/2736/nederland-epd-koploper-in-europa]]. After those individual country initiatives, European Union passed Europe-wide legislation and allowed controlled sharing of electronic health care information by 2013.
The challenge addressed was to ensure the continued safety, quality and efficacy of new drugs but to
do this within a system that was responsive to the new challenges being presented by life science
innovation. There was a profound shift in the perceived nature of the problem of the failure rate of
new drugs in Phase 2 and particularly Phase 3 clinical trials. This had been seen as a failure of industry
innovation models but began to be seen more as a mismatch between:
- the nature of new biotechnology innovations;
- the nature of the companies that could best exploit these innovations;
- public and patient expectations of new drugs and treatments; and
- regulatory systems that were designed around 20th century models of drug development.
The new regulatory approach that began to emerge required creative and constructive thinking from
senior managers, regulators and analysts in life science and ICT industries, along with an enthusiasm
for collaboration across non-traditional boundaries.


===2015-2020===
===2015-2020===
As one of the most innovative industry, ICT industry saw those developments as an opportunity and moved quickly to capitalize this new market opportunity. Two of the biggest ICT giants Microsoft and Google has both launched their respective services where health and fitness information of the individuals can be stored online. While those services were targeting private individuals to manage and control their personal health, they also formed potential secondary information source for pharmaceutical industry next to the Sentinel (US) and Aorta (NL) government databases. While government systems were providing information related to health incidents, hospitalization, treatments, claims etc, those public ICT services focused beyond hospital and insurance records and collected broader data about daily life of the people in which Pharmaceutical companies later found vast valuable information for potential new drug development. Due to the sensitivity of the information, ICT and Pharmaceutical industry had to wait till end of 2018 where new legislation allowed controlled sharing of the information collected by those private services.
===2020-2025===
===2020-2025===
By 2020, development in the past decade created the suitable environment for the pharmaceuticals companies to overcome major challenges of their industry, namely, financial pressure both from insurance companies for the cost reduction and drying R&D pipelines. In 2021, Pfizer, Microsoft, UnitedHealth , WellPoint (two of the top health insurance providers in US) came together to form a joint venture firm in order to gain “first mover” advantage in what they by then perceived was “the way forward” for the health bio-economy. The new business model enabled integration of the commercial and development sides of the pharma business to ensure the commercial relevance of scientific and clinical innovation. In the first joint venture, UnitedHealth and Wellpoint reviewed R&D pipeline of Pfizer and prioritized the projects based on their potential value to the total healthcare system. In return, Pfizer enjoyed support of insurance companies in the marketing of the products to the market. The data from Sentinel system combined with Microsoft Vault system gave Pfizer the opportunity to increase success ratio of clinical trials and to decrease drug development lifecycle from 10-15 years to as low as 5 years. <br><br>
This commercial initiative set the success model for the new coordinated mode of operation which became known as Networked Health Care (NHC). By 2025, 6 of 10 biggest pharmaceutical companies in US formed similar joint operations. The pharmaceutical industry mainly moved from the heavy “push model” to market pull model where their primary customer definition is extended from only physicians to include also non-physician customers such as insurance companies, pharmacies, and patients..

Latest revision as of 22:03, 24 October 2009

Work under construction. In case you have any questions, additions or comments, please do not edit these pages, but you are more than welcome to contact us.

Scenario wherein the healthcare system is more integrated, shorter lines between pharma, medicine, insurance companies, which gives pharma incentive to focus more on market pull than technology push

Developments in time

2010-2015

At the beginning of 2009, the global economic environment was still in a major state of flux. The ever increasing cost of healthcare became one of the major issues in developed countries as well as developing world. In the United States, the actions of the Obama administration and Congress were committed to addressing healthcare issues as part of economic reform. The global economic slowdown sparked acceleration of reform in other countries as well, whether in the form of increasing government demands for price cuts, as in Germany and the U.K., or encouraged use of generics, as in Japan. Next to the governments, insurance companies started to take more significant role as the primary payer of the healthcare expenditure.

On the regulatory side, a major milestone opened the way to integration in the healthcare system. Sentinel system, initiated by the FDA’s at early 2005, was opened to pharmaceutical companies in 2011 to provide access to existing electronic health information, including claims data, emerging electronic health records, and diagnostic databases. The primary aim of the FDA was using these databases to monitor the safety of drugs and devices, and the Sentinel database was also likely to support Phase IV post-marketing studies and surveillance. In Europe a similar initiative was taken in a number of countries, like the Netherlands passed legislation in 2008 for a system called Aorta (Electronic Patient File, EPD) see [[1]] (in Dutch), Sweden and Belgium [[2]]. After those individual country initiatives, European Union passed Europe-wide legislation and allowed controlled sharing of electronic health care information by 2013.

2015-2020

As one of the most innovative industry, ICT industry saw those developments as an opportunity and moved quickly to capitalize this new market opportunity. Two of the biggest ICT giants Microsoft and Google has both launched their respective services where health and fitness information of the individuals can be stored online. While those services were targeting private individuals to manage and control their personal health, they also formed potential secondary information source for pharmaceutical industry next to the Sentinel (US) and Aorta (NL) government databases. While government systems were providing information related to health incidents, hospitalization, treatments, claims etc, those public ICT services focused beyond hospital and insurance records and collected broader data about daily life of the people in which Pharmaceutical companies later found vast valuable information for potential new drug development. Due to the sensitivity of the information, ICT and Pharmaceutical industry had to wait till end of 2018 where new legislation allowed controlled sharing of the information collected by those private services.

2020-2025

By 2020, development in the past decade created the suitable environment for the pharmaceuticals companies to overcome major challenges of their industry, namely, financial pressure both from insurance companies for the cost reduction and drying R&D pipelines. In 2021, Pfizer, Microsoft, UnitedHealth , WellPoint (two of the top health insurance providers in US) came together to form a joint venture firm in order to gain “first mover” advantage in what they by then perceived was “the way forward” for the health bio-economy. The new business model enabled integration of the commercial and development sides of the pharma business to ensure the commercial relevance of scientific and clinical innovation. In the first joint venture, UnitedHealth and Wellpoint reviewed R&D pipeline of Pfizer and prioritized the projects based on their potential value to the total healthcare system. In return, Pfizer enjoyed support of insurance companies in the marketing of the products to the market. The data from Sentinel system combined with Microsoft Vault system gave Pfizer the opportunity to increase success ratio of clinical trials and to decrease drug development lifecycle from 10-15 years to as low as 5 years.

This commercial initiative set the success model for the new coordinated mode of operation which became known as Networked Health Care (NHC). By 2025, 6 of 10 biggest pharmaceutical companies in US formed similar joint operations. The pharmaceutical industry mainly moved from the heavy “push model” to market pull model where their primary customer definition is extended from only physicians to include also non-physician customers such as insurance companies, pharmacies, and patients..