The health ecosystem has changed considerably since Atlee’s Government sent a leaflet to every house in the country promising that the NHS “will relieve your money worries in time of illness.” While the principle of healthcare being free at the point of delivery and based on need, not wealth, is still firmly embedded in society, the NHS faces an ever-increasing challenge to continue to deliver on its promise.
Driving factors include:
• An ageing, growing population
• Evolving healthcare needs, such as the increase in cases of obesity and diabetes
• Medical advancements.
It’s estimated that the total NHS spending on medicines in England has grown from £13 billion in 2010/11 to £17.4 billion in 2016/17 – an average growth of around 5 per cent a year. These figures are uncertain due to gaps in data, but the rate of increase is substantially faster than for the total NHS budget over the same period. 1
While it’s difficult to pinpoint exactly what’s driving this increase, it’s evident that hospital spending accounts for a large proportion of these costs. Contributory factors include an increase in the number of patients being treated and the development of costly new products such as cancer drugs which help extend and save lives – but also have a significant impact on overall expenditure.
The NHS has responded by reforming the Cancer Drugs Fund and introducing a budget impact test, which in some cases, could negatively impact the availability of new medicines.
These cost challenges aren’t unique to the NHS. The private sector also faces the conundrum of balancing the ability to offer our customers value, through prompt access to effective treatments while ensuring that expenditure on healthcare is at such a level that it’s affordable – for all parties. However, the solutions proposed by the NHS, may not always work for the private sector.
The private sector has its own unique challenge – increased customer expectations. Research conducted by Aviva2 highlighted that consumers believe that both the quality of care and clinical outcomes they’d receive in the private sector are better than they’d receive through the NHS.
And, some of the most important factors they considered when taking out their policy were access to a more efficient service, a better quality of care and more treatment options.
We weren’t surprised to learn that it’s highly important for people to know that they have cancer cover included in their private healthcare. Very few were comfortable taking out a policy without the benefit. 2
Medical developments are moving at a pace. As drug companies continue to innovate, we’re seeing reports of the successful management of some of the most difficult-to-treat diseases. However, these new drugs could come at a high price, with possible costs running into the hundreds of thousands of pounds.
And so, insurers face the challenge of meeting customers’ expectations while keeping products affordable.
While it’s easy to be seduced by the claims of ‘blockbuster’ drugs, we shouldn’t forget that they might not always be right for every customer. At Aviva, we’re focusing on delivering value-based healthcare. It’s about operating with integrity and funding diagnostics such as molecular profiling tests to help the consultant’s clinical decision-making process. We’re increasingly funding genetic based medicines such as CAR T therapy that use the patient’s own immune system to fight certain types of cancer. And, using data science to identify variance in practice and outcomes to build our knowledge so that we’re confident we’re funding the ‘right’, most effective treatment for our customers – not just ‘any’ treatment.
However, value isn’t just about choosing the right drug for the right biomarker; end-to- end personalisation is key. We’re all made up of multiple layers of information from molecular level of genomics to our anatomy, social preferences and the environment that we live in.
By understanding every aspect of our customers’ needs we can help support them from a life changing diagnosis, through every step of their clinical journey – appreciating that their needs and preferences may change along the way.
Above all, we’re taking it as our social purpose to clinically curate and commission care from those providers who augment the ‘C word’ with other ‘C words’ such as compassion and collaboration.
