One major finding is that the competitive performance of the biosimilars we analysed in Europe is mixed both across countries and products. Although the European Union has a common regulatory system for approving biosimilars, differences in reimbursement practices and incentives as well as variations in medical practices have resulted in different outcomes across countries.Does anybody know what's happening here?
- Social and therapeutic value of the drug and incremental clinical benefit, taking into account its cost-effectiveness relationshipNew drugs are being accepted every month, and since June 2012 the Health Ministry hasn't updated the website. Nobody knows its cost-effectiveness. Some weeks ago a transparency law was approved. It's a joke.
Governments think only in terms of office, citizens perspective focus on long-term welfare. Fortunately for Canadians, the council cares for a long-term performance assessment of health policies.Although the resources to improve our health system and the health of Canadians were made available, the success of the health accords in stimulating health system reform was limited. Overall, the decade saw few notable improvements on measures of patient care and health outcomes, and Canada’s performance compared to other high-income countries is disappointing. Some pressing issues have been addressed including wait times, primary health care reform, drug coverage, and physicians’ use of electronic health records. But none of these changes have transformed Canada’s health system into a high-performing one, and health disparities and inequities continue to persist across the country.
On the basis of the evidence presented above, few clear-cut conclusions can be drawn with regard to the best strategies for strengthening countries' health care systems. An approach that works well in one country may work less well in another, and not all approaches are equally acceptable to all governments or their multiple constituencies. There is no one blueprint for an ideal health care system, nor are there any magic bullets that will automatically elicit improved performance. This is hardly surprising: health care systems are complex social systems,31 and the success of any one approach will depend on the system into which it is intended to fit as well as on its consistency with local values and ideologies.
A recent historical study of the contribution of the health care system to improved health in five countries identified a number of characteristics of successful health care systems Such systems were able to develop the capacity to select promising strategies and to learn from the efforts of other countries as well as from their own experimentation. The strengthening of a health care system requires a focus not only on specific strategies, such as those considered above, but also on the creation of an environment that supports innovation. Health care strengthening must thus be seen as a long-term process that involves complex systems and requires carefully orchestrated action on a number of fronts. The global community can help by supporting country-led processes of reform and by helping to create a stronger evidence base that contributes to cross-country learning.
PS. HA Blog, a comment.Prior research shows that private hospital prices vary considerably both within and across markets, even after differences in patient populations and services provided are accounted for. The wide variations in price and the high prices at some hospitals reflect an ongoing tug-of-war between increasingly consolidated buyers (health plans) and increasingly consolidated sellers (hospitals and hospital systems).Given the intense and growing pressure to rein in the growth in private health insurance premiums, the continuation of current trends appears to be unsustainable. It remains to be seen whether or not health plans will somehow regain the upper hand. If they do not, more radical approaches—such as state-based rate setting or restrictions on contracting arrangements between hospitals and health plans—may gain traction.
Thrasymachus was a citizen of Chalcedon, on the Bosphorus. His career appears to have been spent as a sophist at Athens, although the exact nature of his work and thought is unclear. He is credited with an increase in the rhythmic character of Greek oratory, especially the use of the paeonic rhythm in prose, and a greater appeal to the emotions through gesture.
338c: Ἄκουε δή, ἦ δ᾽ ὅς. φημὶ γὰρ ἐγὼ εἶναι τὸ δίκαιον οὐκ ἄλλο τι ἢ τὸ τοῦ κρείττονος συμφέρον..[1] (“Listen—I say that justice is nothing other than the advantage of the stronger.”)This forceful statement is dated from 426 BCE more or less. I'm just quoting it after 25 centuries.
Delivering accountable care for a population involves five key components:My impression is that in our health system we already have good examples of such organisations. Unfortunately, some issues fail due to wrong regulation. For example, payment and incentives, an issue that should be reformed as soon as possible.
1. A specified population for which providers are jointly accountable.
2. Target outcomes for the population - outcomes that matter to individuals.
3. Metrics and learning, to monitor performance on outcomes and to learn from variation.
4. Payments and incentives aligned with the target outcomes.
5. Co-ordinated delivery, across a range of providers, of the care necessary for
achieving the desired outcomes.