Product manufacturers adjust to European health care industry's passage from freedom to control

London 04 August 2003Needs assessment, planning and delivery in Europe's health care sector are undergoing a paradigm shift. The traditional latitude given to physicians is giving way to stricter controls. Higher quality and cost-effectiveness in terms of treatment outcomes is now the primary focus area with disease management emerging as the planning technique of choice, according to a report issued by Frost & Sullivan.


Popular methods of quality management that have emerged in recent years include Healthcare Technology Assessment (HTA) and evidence-based medicine. Both have influenced treatment choices, achieving greater control through published guidelines and protocols that lay down care "pathways". While HTA's main application is in the area of product testing, evidence-based movement offers quality management at the treatment level.

Disease management, an integrated approach to the diagnosis, maintenance and treatment of chronic diseases or disorders, has folded neatly into these trends. This planning concept has resurfaced since falling into disfavour in the early 1990's due to overexploitation by the pharmaceutical industry. Today, disease management has transformed from being a product concept favoured by the vendor, as was the case when it was initially promoted by pharmaceutical companies, to a format popular with the purchaser.

As health care providers increasingly turn to evidence-based medicine, companies will have to demonstrate that their products provide the benefits that health care providers are seeking in terms of quantifiable outcomes and cost-effectiveness. One way is through offering "packages of care".

"Industry needs to promote the use of its products in terms of the benefits which can be derived from packages of care, rather than isolated procedures", elaborated Gordon Blackwell, Research Analyst at Frost & Sullivan. "At the single product level they can only use the results of basic health care technology assessments to define their effectiveness, whereas health care providers are really looking for evidence-based medicine."

IT is set to play a central role in helping companies offer such evidence-based treatment solutions. The introduction of IT "enablers" is likely to open new opportunities for erstwhile sub-contractors in the disease management service sector. Expanding IT applications have already elevated quality of care by providing access to data that has assisted in care management and control, helped quantify performance and facilitated the identification and regular use of more effective treatment.

The immediate need is for greater integration of IT systems operating within the health care environment. For instance, the creation of an electronic patient record (EPR), which collates data from various sources and incorporates it into a single record. A more long-term goal would be an electronic health record (EHR) that would provide a cradle-to-grave compendium of an individual's health records. Improved decision-making is the expected outcome of such integration trends.

From organisational to regional and national levels, planning in health care is now seen as central to controlling costs. Planning efforts range from management at disease level to needs assessment, target setting and the regular publication of action plans, often with specific built-in quality initiatives. The ensuing health care structure has helped deliver better, more organised care to patients.

The United Kingdom has been the pioneer in devising a national planning system, with the National Institute for Clinical Excellence (NICE) spearheading the successful application of HTA. Even Germany, bastion of a free health care market, has ushered in the era of planning with the introduction of disease management programmes for numerous chronic conditions.

At the same time, these new controlled, health care regimes have ensured that there are clear roadmaps for future product development endeavours. "For the industry selling products and services into these health care systems, planning means that administrators and planners may make decisions that cannot subsequently be changed by professionals in the care environment", explained Mr. Blackwell.

"Without an effective relationship with planners to enable companies to have visibility of the planning process, it is possible for products to be excluded from use within a plan without the company being aware", he warned. "Thus it is necessary to aim marketing efforts as far up the planning chain as possible, and to fashion messages in an appropriate language for the audience." For more information you can contact Mrs. Katja Feick of Frost & Sullivan.

Leslie Versweyveld

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