If anything, the pandemic has manifested itself in the shortcomings of the sanitary system. The lack of technology, protection equipment, production capacity, disabling problems; the collapse of primary attention to the deficit of resources and professionals, of the UCI; the vulnerability of restraint and vigilance structures to control the epidemic; the coordination between autonomous communities, which has led to a slow and heterogeneous response, and the lack of prevention and planning strategies in many places are some of them. But what to do and how to improve management at a critical moment?
In December, more than 300 clinicians, academics, economists and lawyers will publish a manifesto proposing the creation of an Independent Sanitary Performance Evaluation Institution. It is said that a public agency with an organic statute that values and recommends the entry into the system of new medicines, medical devices, tests and diagnostic tests, technologies and surgical interventions, through an analysis of cost-effective economist, biostad economist, patient organizations, epidemiologists, pharmacologists–, explained Ruth Puig Peiró and Pilar Pinilla Domínguez, respectively, vice president and member of the Association of Health Economics (AES), united poster that, in February. Series like an Airef, pero sanitary, ilustran.
The idea is to evaluate the cost-effectiveness of all sanitary services, from pharmacies to medical devices
“In Spain, healthcare management and financing is much more politicized. Decision making takes place within the ministry [de Sanidad]”We do not have protection, guarantees, to minimize these irregularities, nor a homogeneous system, and we can create inequalities in access and a lack of important coordination”, advises Puig, who works in the Catalan Service of Health (CatSalut).
The country is owned by the Spanish Redoubt Agency for the Evaluation of Sanitary and Performance Technologies (Redets), except for examining the cost of pharmacies, Pinilla Signal, which has been reviewed by RevalMed. “These agencies exist at the autonomous level, are managed as they can and depend a lot on the political management of the moment”, agrees Puig. Por eso plantean la creación de un HispaNice, emulando el modelo británico, the National Institute for Excellence in Health and Care (Nice), in the opera since 1999 and the recommendation of the boy legally vinculantes. In Germany, France, EE UU, Canada or Australia the suggestions of these agencies are not theirs.
The economist promoting the document, Guillem López Casasnovas, chairwoman of the Pompeu Fabra University (UPF) as well as a member of AES, urges op ‘n trabajar en dos ambitos: rationalize the actual guest and prioritize the future. “What he committed in the last few years to a double digit is the hospital guest hospital due to the poor tension between the hospital pharmacy and the clinicians. It is not rational that it is the best option and that it is possible to follow the rest of the centers, ”he said.
And respect for the future guest, added: “Someone who mires if the incremental benefit that supports the technology, the medicine or the new indication of the existing one corresponds with the additional costs”. López is the party copy of the ICER (Institute for Clinical and Economic Review) study center, centered on the effectiveness analysis. “Require less people, they can use the existing agency network and only have a license to approve these actions”, defiende. The inversion (not calculated) takes place with European funds and is self-financing with the tasks that cover the industry through its services.
For the patron of Farmaindustria, “the economic evaluation is necessary in the process of pricing and financing new medicines and corresponding to the State decides which one to carry out. The important thing is that agreement is made with an objective, transparent, participatory and agile procedure ”.
Digitization, other languages
The digitization of the sanitary system is key to the incorporation of personalized precision medicine and to establish a preventive, diagnostic and therapeutic focus on the patient. Here is a recent information published by the Roche Foundation, which includes 50 recommendations in five areas for advancement in implantation, increase management and reduce costs.
The document, ‘n vrag of a group of specialists and experts in different areas, proposes the need to stimulate technological innovation, to have an interconnected infrastructure and to establish actions that ensure governance and regulation of values.
In addition to guaranteeing the organization, standardization and interoperability of data, security, and enhancing the training of healthcare professionals, managers and system operators. It will favor, according to the information, a preventive assistance model, public health, biomedical research, management and patient participation in the decision-making process.