For many people, medicines are an indispensable part of their daily lives. By using medicines effectively, people live longer, healthier and with a better quality of life.
Innovative medicines in the field of cancer have led to an increased chance of survival in many types of cancer over the past decades. Not only for adults, but for children as well. Cancer, like HIV and diabetes, is increasingly becoming a chronic rather than a deadly disease. Quality of life is also improved considerably by medication. For example, there are better treatments for hepatitis C and psoriasis.
Unfortunately, there are still diseases for which there are no effective medicines, despite all efforts. This is applicable for certain rare diseases but also for very common disorders such as Alzheimer’s disease. Because there is still no proper drug for dementia patients, it is good to know that much can be achieved with prevention. Only 3% of the people with dementia have a hereditary version.
The German Martini Klinik focuses on results that the patient finds important. This produces good results in prostate cancer. For example, in prostate cancer, that is continence or the retention of sexual potency.
The five-year survival rate of patients in this clinic is higher than the average in the Netherlands. It is also striking that the sexual potency of patients treated in this clinic is relatively high.
Furthermore, the continence of patients treated in the Martini Clinic is somewhat better than the Dutch average. In the Netherlands, several pilots are already running with result-oriented care.
Current care practice often considers whether a treatment has been successful in a technical sense. And billing usually occurs on the basis of quantity, rather than quality. But in value-based healthcare, the patient is asked in advance which results he/she finds the most important. Ultimately, a different manner of reimbursement is also required there. Therefore, it is important that healthcare insurers be involved in these pilots.
International outcome sets have already been created for a number of diseases. That means that for those diseases, it is clear which outcomes from a treatment are most important for the patient. The one patient, for example, finds it very important to be able to continue to exercise and to work, while the other mainly wants to be rid of the pain. These outcome sets were created by ICHOM (International Consortium for Health Outcomes Measurement).
Outcome sets are an important building block for value-based healthcare. Healthcare professionals, insurers, patient organisations and drug companies look together how they can optimise the treatment for the patient. The government wants half of all healthcare outcomes to be transparent in 2021. Many members of the Dutch Association Innovative Medicines already have a project for value-based healthcare, or will soon start one.
The five-year survival rate for many types of cancer continues to rise. Thanks to innovative medicines, skin, prostate, breast and thyroid cancers have in many cases become chronic diseases in recent years. Indeed, the five-year survival rate for skin cancer is 93%. That is good news for patients. Meanwhile, many innovative medicines are being developed for cancers that are less easy to treat.
Only about 3% of all variants of dementia are hereditary. In all other forms of this disease, lifestyle can have great influence. When a young adult has already adopted a healthy lifestyle, the risk of dementia can be reduced by about 30%. The most important lifestyle rules to this end are: sufficient exercise, not smoking, and maintaining a healthy body weight. Mental challenge, diabetes, high blood pressure and depression also influence the risk of dementia.
Nerve pain, or neuropathic pain, is an ailment that can very negatively affect the quality of life. This pain often occurs as a result of other diseases, such as cancer and diabetes. Nerve pain can be treated or suppressed in approximately half of the patients. Medicines play an important role here.
More than 1.2 million Dutch inhabitants have a variant of diabetes (type 1 or 2). The number of people who die on an annual basis with diabetes as the main cause of death is steadily decreasing. That is for a significant part due to good medicines. In addition, sufficient exercise and healthy nutrition are also important.
Vaccines have drastically decreased the number of deaths due to whooping cough, tetanus and polio. In 1950, a total of 184 Dutch inhabitants died from these three diseases. That number dropped to three in 2017.
The government is concerned about the immunisation rate for measles, among other diseases. A vaccination rate of at least 95% is required in order to be able to keep virus outbreaks under control. For years, the Netherlands was above that rate, but in recent years that rate has fluctuated around 94%.
Drug companies aim to make their medicines more widely available for people from third world countries, as is apparent from the latest Access to Medicine Index, which appeared in 2018. Medicines and/or vaccines are in development for two-thirds of the diseases that primarily affect third world countries, according to the World Health Organisation (WHO). The pharmaceutical sector is particularly committed to combatting malaria, HIV and tuberculosis.
The Access to Medicine Index considers seven factors: management, compliance to laws and regulations, research & development, pricing, patents, building capacity and donations. In the 2018 Index, GSK, Novartis, Johnson & Johnson, Merck and Takeda scored the best, in that order.
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