From www.eiu.com - December 21, 2015 10:40 AM
The Economist Intelligence Unit's latest white paper looks at the latest developments in value-based healthcare.

After years of tight healthcare budgets in many OECD countries, healthcare spending is now starting to accelerate again. In the UK, where doctors are about to go on strike, the government is having to promise extra money to bolster emergency or even routine care as demand from an ageing population rises. It is not alone: in the past month Ireland and Canada have both announced plans to increase spending, as has the much poorer India. But with budgets still struggling to keep pace with demand for health, these countries need to be sure any increase in spending is not wasted.

In the latest of a series of reports on value-based healthcare, the Economist Intelligence Unit looks at how countries are working to ensure that spending on health is linked directly to the resulting health improvements, rather than to the volume of operations or doctor visits. For many developed countries that means stepping up the development of health technology assessment (HTA), which attempts to work out the cost-effectiveness of medicines, medical equipment, or treatment methods. These efforts are being echoed by smaller projects in developing markets, which are keen to improve their citizens' health without building up the costly healthcare infrastructure of the US or Europe.

Key developments highlighted in the report


  • The US has been rolling out bundled payment schemes on a voluntary basis in order to reduce the costs of Medicaid expansion. In January 2016, the first mandatory bundled payment programme will be rolled out to 75 regions.
  • France introduced a new cost-effectiveness focus into its HTA system in January 2014, while Germany and the UK are adjusting their HTA methodologies to make them broader and more transparent.
  • Japan is considering the introduction of economic evaluation for pharmaceuticals, with the next drug-price review in 2016 seen as a likely date for implementation.
  • China has abolished price controls for the majority of drugs, laying the groundwork for the introduction of HTA.
  • Bodies such as the international Decision Support Initiative are trying to spread the word about evidence-based healthcare in developing markets.

Despite these efforts, the implementation of value-based healthcare remains a work-in progress. Although the idea of linking health spending to outcomes is a simple one, both the underlying principles and the implementation mechanisms may be difficult to establish. Many countries are experimenting with different mechanisms, using pilot projects or tweaking their methods as problems arise. But the report emphasises that valuable lessons are emerging from these experiments, as the idea of value-based healthcare spreads worldwide.

The full report, entitled Value-based healthcare: an update, is available for free from: http://www.eiu.com/public/thankyou_download.aspx?activity=download&campaignid=VBHNov2015