As the President of Innovative Medicines Canada, Pamela Fralick leads the industry association for Canada’s innovative pharmaceutical companies, working with its members and communities to ensure Canadians have access to the medicines they need when they need them. In her first article for PharmaBoardroom, Pamela calls for the regular assessment of the value of healthcare investment, rather than focusing only on cost.
In no other area of economic activity would this lack of performance management be tolerated. Yet in healthcare, we almost exclusively talk about dollars spent and count the number of services provided, the number of health providers, the number of prescriptions dispensed or products purchased.
There is perhaps little that Canadians value more than our health – and our health system, flaws and all. Perhaps not surprisingly then, we are among the biggest investors in health, in the world. Collectively, we are projected to invest more than $253 billion in 2019. As well, there are some 1.92 million Canadians who work in the health and social services sector, of which more than 960,000 are health workforce professionals. The financial and human resources that support Canada’s health systems are significant and Canadians should expect a great return on their investment.
For any typical investment fund, there would be detailed analyses and reports, organized by portfolios and measured over multiple time horizons that would demonstrate to investors the performance and return on their investments. These analyses and performance measures, when compared against the investor risk profile, are essential to allow for adjustments in order to achieve the investment goals of the investor. While investments in healthcare represent 11.3 percent of Canada’s gross domestic product, there is rarely a report or a system of performance measurement that attempts to measure the Wealth Dividend – or the return on investment generated by all this economic activity.
In no other area of economic activity would this lack of performance management be tolerated. Yet in healthcare, we almost exclusively talk about dollars spent and count the number of services provided, the number of health providers, the number of prescriptions dispensed, and services or products purchased. Provincial governments, as reported in their annual reports, provide some measures of health improvement; typically public health measures such as births and infection rates for Sexually Transmitted Infections, for example. However, there is no regular or standard reporting on the economic benefits derived from the healthcare investment.
In the pharmaceutical industry in Canada the levels of evidence to be met, both in terms of effectiveness and economic benefit, are robust. But are we equally assessing the value of our investment – or just the cost? How do we achieve a balance between these two important perspectives? Canadians expect and deserve the reassurance that both are weighted in any assessment of their health system.
There is a new world order emerging in the pharmaceutical industry – one which all Canadians need to know about, and which should excite them. It is an industry fiercely driven to develop the most effective innovative medicines for patients, based on the highest standards of ethics and value for the dollar. An industry driven by the newest technologies – AI, precision medicines, biologics – and a robust, ever-advancing Code of Ethics. An industry that stands ready to work with governments to contribute to the highest performing health systems. A brave new world, indeed! Yes, there will be challenges and tensions. This is not an industry focussed on ‘mundane’ products. It transforms lives. It saves lives. It understandably elicits high emotion. Over the course of my next columns, together let us explore the best and brightest of what innovative medicines have to offer – even as we seek stronger, productive relationships with governments to address affordability solutions. Let’s also make sure we focus on value, on potential, and on lives waiting to be saved. We all deserve nothing less.