Health sector experts point to public procurement in consultation with clinicians and the market.
Value-based public procurement is a “necessary” challenge for the National Health System, although it is difficult to measure its results. This is one of the main conclusions reached by the speakers at the round table discussion entitled ‘Value-based public procurement’ at the conference ‘Lean Healthtech: the value of time in operating theatres’, organised by Redacción Médica in collaboration with the company MYSPHERA.
Mario Ledesma, legal advisor for Public Procurement at Laboratorio de la Contratación, said that in order to call it “value-based” it is necessary to “look at what is being procured and how it is being procured”. “We tend to buy on the basis of what industry tells us is in the market. However, this process needs to be reversed: we need to gather the knowledge of healthcare providers and go to the industry and ask for it in order to make a ‘tailor-made suit’,” he said.
Along the same lines, José Ramón Luis-Yagüe, director of Farmaindustria’s Department of Relations with the Autonomous Communities, added that it is the patient who must say what he or she needs in order to be able to give value. In fact, Luis-Yagüe pointed out that medication is “a special asset and is the only one subject to government intervention” and in this situation, “buying on price is a mistake”.
“We have to be solvent, that is to say, have to achieve the necessary capacity to respond to the health of citizens. In this way, we ensure that a system responds to expectations and that the right to health enshrined in the Constitution is effective,” he explained.
For his part, Francisco Dolz, managing director of the Hospital Universitario Doctor Peset in Valencia, pointed out that value contracting focuses on four points: patient intervention, innovation, cross-cutting work, and integration of all the components. “This is how health results are achieved”, he said.
The ” slow” pace of public procurement
Other aspects on the table in this debate were the pace of procurement and the need for legislative changes. “In terms of contracting, we are slow and we need a legislative change, not to be governed by the general contracting law. In addition, it is essential to count on clinicians when it comes to public procurement,” stressed Eloína Núñez, manager of the Santiago de Compostela Health Area and president of the regional grouping of the Spanish Society of Health Managers (Sedisa) in Galicia.
In this sense, she stressed the idea of establishing criteria together with healthcare professionals in order to “make progress in the slowness” of the processes. Toni Mateo, commercial director of Mysphera, is of the same opinion. He added that technology is becoming faster and faster and adapting to its speed can be difficult because time is pressing and it is necessary “to be agile in order to shorten them”. “Despite this, the health system is prepared for this and there are many ways of contracting to acquire value,” he stressed.
For his part, Luis-Yagüe has opted for market consultations to speed up the incorporation of innovation: “In this way, medicines are purchased, doctors can prescribe them, and, finally, they reach patients”.
Measuring for better results
The word “measure” was repeated in many of the interventions in this debate. Mateo pointed out that starting to measure is “a solution for operating theatres”. “If we measure data at the health level, we will have accurate information on the functioning and gears of the health system,” said the commercial director of Mysphera, who took the opportunity to support technological solutions and their implementation in the health environment, as well as public-private collaboration.
Ledesma picked up the thread and explained that, precisely, the “difficulties” in measuring results mean that the public sector cannot “launch itself”. However, he argued that a preliminary consultation of the market could save a lot of time. “Procurement and value should go hand in hand and buy solutions that go beyond mere amortization,” added the legal advisor for Public Procurement at the Procurement Lab.
How does the money invested in this sense come back? Specifically, Luis-Yagüe specified that each euro invested in innovation has a return of between seven and nine euros. “It is necessary to measure the entire care process, both in terms of costs and results. The gain is also to increase life expectancy,” he said.
Finally, Dolz emphasized the need for the government to implement legal security policies for purchases, to provide training courses for professionals, and to adapt information and communication technologies (ICT). Núñez also added the importance of social value in order to achieve solvency and the best benefit for patients. “We have to align our public and private interests to generate health,” he concluded.