By 2030, approximately three quarters of a billion people will live in the MENA region; people are also living longer. While this is a testament to the many advances made in medical science, we are seeing an increasing incidence of non-communicable and chronic diseases, including rare diseases.
Rare diseases are not really rare collectively in the Middle East. There are up to 2.8 million people suffering from this disease, out of a total regional population of around 400 million. Among those affected, 75% are children, for whom there is a high risk of early mortality.
Adding to this burden, the negative impact of COVID-19 stretched healthcare systems to their limits, even rolling back several successes. This also means that healthcare costs will skyrocket.
In this context, healthcare systems need to be reimagined to address these economic challenges and the many health inequities highlighted and amplified by COVID-19 in order to improve patient outcomes. A new value-based model is gaining traction, which many stakeholders argue has the potential to revolutionize healthcare by providing greater value to patients.
Under this value-based health model; the valuation of medical services, such as the cost of a drug or medical procedure, would no longer be defined per unit. Instead, it would be based on patient outcomes achieved, as opposed to consumption. In other words, health care providers would be financially compensated based on their positive impact on patients and society at large, such as improvements in patient health and less dependence on caregivers.
All about the results
A value-based healthcare model would ultimately incentivize stakeholders to deliver better patient outcomes. Furthermore, it has the critical potential to benefit underserved communities. By evaluating treatments based on outcomes, biopharmaceutical companies will be more likely to invest in R&D of treatments for low-prevalence diseases, such as rare diseases, thereby providing innovation to underserved populations.
Recognizing the potential of value in health, the Dubai Health Authority launched the first value-based healthcare model. Known as Ejadah, the model is based on value-based procurement rather than volume and is expected to improve patient outcomes and performance with a focus on improving preventive care, helping to improve overall health of the population and reduce healthcare spending.
A number of obstacles in the epidemiology of rare and complex diseases have been identified in the application of value-based public health strategies to these conditions. These include creating a revised culture of health and well-being, reviewing how prevention and health care service delivery is organised, as well as improving the inclusion of marginalized groups.
This Ejadah model could offer much respite and support to patients with rare diseases. As a performance-based payment model, Ejadah will measure patient outcomes and is symbolic of the pace of transformation in healthcare reimbursement we’re seeing, leading by example in an industry that has otherwise experienced a certain level of stagnation. With their system of diagnosis-related groups using a case-mix system, based on a uniform amount for each case per hospitalization, we will see clear evidence of reduced costs and reduced average length of hospital visits .
Extended care for everyone
Ejadah can be a template for supporting diverse patients who may be excluded and undeserving in a traditional system. Within this system, many services that were costly can also be considered and will require a special focus, to ensure that patient outcomes are better delivered. This is also true of payments, which are performance and case-based and will continue to drive innovation and access.
We subscribe to the same idea that care should be based on patient outcomes through a model that helps deliver greater value for everyone. Among the many factors that could support this model are health data, absolutely integral to determining patient outcomes, reducing variations in care quality and experience, managing inequities in health care delivery, and reducing the waste of resources and equipment.
To ensure a long-term commitment to value-based care, learnings from data must continually optimize systems and, critically, patient outcomes themselves. We also recognize that there is no one-size-fits-all model; Value should be determined and measured based on the specific needs of affected communities on an ongoing basis and reported across the sector.
Beyond collaborating on data, industry partners must cooperate to develop the framework and set the standards for patient outcomes. While the transition to this system will not be straightforward, the challenge and opportunity remains to responsibly allocate more resources to high-value care that provides the most benefit to patients.
