Hans Martens

Hans Martens is working as an independent consultant on a number of health related policy areas with a European dimension, including value-based healthcare, health systems assessments, and more specifically on how to develop the understanding of the economic value of health and care. Hans was for several years leading the European Policy Centre, one of Brussels’ main think tanks, for which he is still chairing the health programme (CHES).

 

Authors: this article was written by Hans Martens, Martha Emneus , Anders Green and Camilla Sortso . This is the first blog of the series presenting the economic value of being in good health and the broader consideration of cost of disease. Europe’s health systems are struggling to maintain sustainability. One of the major challenges is the exponential increase in the prevalence of chronic diseases and the number of patients in advanced and costly disease stages. A challenge, which is predicted to only increase in the years to come. Chronic diseases make high demands on health systems for continuous, quality care. For patients, chronic diseases are associated with shorter lifetime, reduced quality of life and economic as well as socio-economic burdens on the patients, their caregivers - formal or informal. For society, the burden is excess healthcare, pharmaceuticals, nursing, reduced labour market participation and ability to be socially and economically active and premature mortality. Altogether these costs underpin the major challenge of chronic diseases for our societies – not least in Europe where health is a collective rather than an individualised responsibility. This challenge must be dealt with by the health systems and perhaps by reconsidering where investments should be made in the future as with many of the chronical diseases onset and progression can be prevented if diagnosed early and precisely and if the process is well managed. Among chronic diseases, diabetes mellitus is one of the most burdensome with app. 371 million people diagnosed globally and evidence of rapidly increasing prevalence. In a recent study from Denmark it was estimated that costs of diabetes amounted to 14,349 Euro per person year. Of these, health care costs accounted 17% and pharmaceuticals 4%, while for example loss of productivity amounted to 42%. And this is not the whole story, because...
This blog is part 7 of a series on MEAT Value-Based Procurement, an initiative that advocates a shift from price-based procurement towards value-based procurement in healthcare. It does so by defining a Best Price Quality Ratio method within the Most Economically Advantageous Tendering (MEAT) framework put forward in the European Public Procurement directive. Read part 1 , part 2 , part 3 , part 4 and part 5 and part 6 . Our health systems need reforms to maintain universal health coverage and, given the economic and demographic pressures we face, Europe cannot afford its citizens to be in poor health. This will require new thinking about the economic value of health for individuals, families and society (health as an economic good) in addition to the economics (the cost-efficiency) of healthcare systems. Instead of focusing on the costs of healthcare, we must consider what is delivered. The full value of investing in health and quality healthcare can be realised by focussing on health outcomes complemented and enhanced by the economic value offered by being in good health and having cost-efficient health systems. This value-oriented approach can be implemented when purchasing health technologies. It is already seen in some modern procurement procedures resulting in the highest economic value in addition to best health outcomes. These most economically-advantageous tenders (MEAT) can deliver optimal value to society. To make informed decisions about what constitutes value, we need to consider the full value that health investments bring – not just the outcomes for patients or for hospitals, but the full impact these interventions can bring to society by keeping people in good health. Defining value The real economic consequences of being in a state of ill-health are not solely related to the direct costs of health and care, but include wider socio-economic consequences and...