High-value innovations in care delivery play an essential role in solving the challenges facing Europe’s health system. However, ensuring adoption and uptake of new technology solutions is far from simple.
Current reimbursement and access models have served Europe well but are now reaching their limit in ensuring timely patient access to truly cutting-edge technologies and services.
Therefore, it is time for innovative approaches to better integrate innovation into existing health systems. To that end, a new Value of Innovation and Partnership access model (or VIP for short) is proposed.
Innovative models
Let’s look at how access works today. The current approach has three main elements: regulatory approval, reimbursement and procurement. The problem is that some really innovative technological advances do not always fit neatly into existing reimbursement pathways. They may have high potential value but require additional investment or structural changes in how care is delivered.
My new opinion paper, ‘Access to Medical Technology Innovations: A Proposal for a Value of Innovation and Partnership Model’, sets out in more detail the shortcomings of the current access model.
Any new model needs to find ways to reward high-value medical technology innovations; provide timely access to these innovations; and ensure that health systems are sustainable. The proposed VIP model aims to do this in a spirit of partnership between healthcare providers and innovators. It has two phases:
1) The research & innovation phase: testing and assessing safety, clinical performance and claimed benefit
2a) The health system accessibility phase: special innovation access programmes to address unanswered questions
2b) The routine usage phase: adoption of a new technology, along with reimbursement or a new finance scheme
Accelerated Coverage Pathways for Innovation
For most technologies, phase 1 and 2b are sufficient as they will fit into existing reimbursement systems. However, phase 2a applies to (potentially) truly innovative solutions where high levels of value are anticipated but not certain. These are the potential game-changers that may require additional investments in healthcare and for which additional evidence is needed to determine their true value.
One potential feature of phase 2a is what can be called Accelerated Coverage Pathways for Innovations (ACPIs) which progressively introduce the innovation into the health system under certain well-defined conditions (agreed by manufacturers and payers).
This agreement would spell out the conditions under which remaining uncertainties are addressed before investments are made to integrate the technology into the health system.
ACPIs can be seen as an impactful instrument for addressing the uncertainties that payers and manufacturers face during the initial access period while evidence is being collected.
In this phase 2a, public procurement of innovative solutions (PPI) can also play a role. Similar to ACPIs, this approach has been used to answer questions about value while facilitating timely access to innovation.
Making VIP work
Adopting this new model is a shared enterprise. Hence, there are three key ingredients for success: partnership/dialogue, evidence, and valuing innovation.
This VIP model has the potential to unclog a bottleneck that is slowing the impact of the disruptive and transformative innovations needed to steer health systems onto a sustainable path.
Indeed, with a shared commitment to evidence and rewarding innovation, Europe’s healthcare systems can chart a course to a better future.
