Why pharma needs to understand people’s health
Often misunderstood, the new focus on prevention and population health within the NHS can help the pharmaceutical industry become a critical part of a more holistic and results-oriented strategy for local systems, says Oli Hudson.
One of the most enigmatic elements of NHS reform is the shift from disease management to population health. As a concept, this is something that has been talked about a lot in the past: Seasoned policy watchers will remember both the forward five-year vision and the NHS long-term plan both outlining a constructed future. around increased investment in preventive health.
Now, however, the agenda looks and feels more grounded, with clear statutory structure, direction, and intention around it. The idea that a more informed and joint approach to service planning can help reduce health inequalities and prevent health problems through earlier ‘upstream’ intervention is embedded in the foundations of health care systems. integrated (ICS).
The role of local partnerships within the ICS governance structure is particularly relevant. Comprised of the NHS and leaders of local authorities, they will be tasked – according to the latest guidelines – to “facilitate joint action to improve health and care outcomes and experiences among their populations”. They will do this by generating “an integrated care strategy to improve health and care outcomes and experiences for their populations.”
In support of this, there will be a big change in the way health services are incentivized: moving away from payment for (acute) activity episodes through the national tariff in a way that encourages competition between providers, towards a “mixed” contract that draws on a shared prize pool at the system level to encourage all organizations to take collective responsibility for improving the health of local populations.
So far, so good. However, around these changes, there is a persistent suspicion that this presents a strategic risk for pharma; that an increased emphasis on preventive services and a long-term abandonment of hospital-based activities ultimately means funds diverted from drugs and treatments.
These concerns are largely unfounded, although that does not mean that the health of the population does not pose significant challenges for the pharmaceutical industry, as we will see. The truth is that this will require business organizations to forge a different relationship with the NHS, but it also gives pharmaceutical companies the opportunity to fit in as part of a more holistic and focused approach to healthcare. the results.
However, to be successful in this new environment, the industry will need to be aware of the changing environment and ready to fit confidently into these discussions of population health. In this article, I’ll take a look at three essential steps you can take to develop your organization’s capacity to engage in this rapidly evolving agenda.
This channeling and interpretation of data to improve population-level outcomes will inform how integrated systems of care work and their priorities. The data will be used to model current trends and predict future needs and their likely impact. The analysis should also help identify local or national ‘at risk’ cohorts requiring more proactive support.
At three levels – system (via ICS), location (via collaborations of providers) and neighborhood (via primary care networks) – this means that there will be a strong thirst for data, analysis and information. that help predict, model and shape how health services and other interventions should be developed to meet the needs of the population.
Pharmaceutical companies can offer a range of things that NHS policymakers will find useful in this context, from expertise in understanding patient conditions and needs, to modeling and segmenting data to help systems understand. and to identify the patient cohorts that could benefit the most from a particular intervention.
Crucially, commercial vendors will need to be able to use the data to build a strong case for their proposal within a larger framework. They will need to be able to demonstrate its value compared to other types of intervention, in terms of sustainable and long-term contribution to patient or population outcomes.
At least the majority of regions will have a population health “champion” who will lead this program – often identifiable from the reports of the population health management councils. Usually this is a Transformation Manager or Partnerships Director, or Medical or Clinical Director.
Yet, although ICS has the sole budget, remember that most of the business and delivery takes place at the Local Supplier (PBP) level. This is where you will need to lead most of your conversations, as well as with clinical pharmacists, pharmacy technicians, associate nurses, social prescribers, and others in primary or community care.
There are a few essential questions to ask yourself when making an approach. Where does your value proposition or your proposition fit into the ambitions of a service? How to integrate your position as an appropriate level of intervention within the service? How could you align and tailor your response to an integrated vendor environment? And finally, how do you relate your proposal to local, regional or national targets or objectives?
The embryonic nature of population health as a defining concept within the NHS may also present an opportunity. You might consider positioning yourself as a ‘starter’ project for an NHS client – as part of a shared learning journey to understand the potential benefits that population health techniques can bring to a pathway or a given disease domain.
Much will depend on what you deduced from Steps 1 and 2 in terms of priority cohorts and their needs, but typical ‘value-added’ interventions may include: funding and delivery of training programs to build knowledge and skills. staff skills; co-develop public education programs to help patients more effectively manage their own lifestyle and behavioral condition; or supportive measures to improve adherence to a treatment protocol, or reduce unplanned episodes of care, so that resources are used more efficiently.
Likewise, managing population health does not mean the end of discussions about your product line, but it requires that the product’s benefits be framed in a larger context. Pharmaceutical companies will need to demonstrate how their offerings can help patients, clinicians, services and all systems achieve better results for the investment they make.
Expect a challenge, too: A one-time budget means systems will be under pressure to eliminate inefficiencies, ensuring interventions are done earlier and in the cheapest way. You will therefore have to be able to demonstrate that your proposal is not only an effective intervention but also the most appropriate in the course. This is potentially a very different conversation than what has happened before and it will mean that there will be an advocacy for investing economically.
The pharmacy therefore has a critical window to adapt to the new environment. It must bring together its data and its evidence base to build the economic case for its products; refine and update its value propositions so that they align with the strategic objectives of a system or a locality; and, more importantly, developing organizational skills, from product development to sales and marketing, to meet the new challenges of managing population health.