For many people, medicines and vaccines are an indispensable part of daily life. By using medicines properly, people live longer, healthier and with a better quality of life. We noted how important that is in 2020, when the corona crisis broke out.
Innovative medicines to combat 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. More types of cancer, like HIV and diabetes, are becoming a chronic, instead of a deadly, disease. People also get better due to 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 true for certain rare diseases and also certainly for a very common disorder such as Alzheimer’s disease.
Diseases can be prevented by paying more attention to prevention. That is why the national government, together with more than 70 social organisations, entered into the National Prevention Agreement. It contains more than 200 agreements to make the Netherlands healthier. In particular, the Prevention Agreement focuses on promoting a healthy lifestyle and vitality by addressing smoking, obesity and problematic drinking.
Medicines also often have a preventive effect. Medicines prevent later stages of a disease, for example, blood thinners and cholesterollowering drugs. Preventive interventions predict, and even prevent, diseases. Vaccinations are not part of the Prevention Agreement, even though, after clean drinking water, this is the most effective intervention in the global fight against infectious diseases. The importance of vaccination in preventing disease or the burden of disease in society is great and urgent.
It is apparent from various international publications that the quality of life and healthcare in the Netherlands is good. For example, life expectancy for a Dutch person is almost one year higher than for the average
European. Access to healthcare is also remarkably good in the Netherlands and not dependent on income. Improvements are possible in areas such as data collection by the government and mortality due to certain forms of cancer, such as lung cancer.
The five-year survival rate for many types of cancer continues to rise. According to the latest figures, 66% of cancer patients are still alive five years after the diagnosis. Due to new treatments such as immunotherapy, skin, prostate, breast and thyroid cancers have in many cases become chronic diseases in recent years. The five-year survival rate for skin cancer is even 94%. That is good news for patients. Innovative medicines are being developed for many types of cancer that are less easy to treat.
Breast cancer is still a disease that affects many Dutch women: one in seven. The disease is most common in women between the ages of 50 and 70, but very occasionally men can also develop breast cancer. The number of women who die from the consequences of breast cancer has decreased since 2016. The reason is partly because there are more options for treating breast cancer.
More than 1.2 million Dutch people have a form 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.
Unfortunately, there is still no cure for Alzheimer’s disease and other forms of dementia, although there are medicines that somewhat inhibit the disease or symptoms. Which medicine should you give, in what dosage, to which patient and at what time? There is increasingly more clarity regarding these issues. Combined with the advancing diagnostics, there is hope.
Compared to other countries, the Netherlands is very reserved in prescribing antibiotics. That is important because resistance to antibiotics occurs less frequently with limited use. Yet it remains important to invest more in the development of new antibiotics. In many countries, this resistance is already a major problem, which will only become larger in the coming years. Focusing on keeping existing antibiotics available and developing new antibiotics are important areas of concern for the future.
Outcome sets are ready for more and more diseases. That means that for those diseases, it is clear which results from a treatment are most important from a medical perspective and which results 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. The ICHOM (International Consortium for Health Outcomes Measurement) has now prepared these outcome measurements for 39 diseases.
Outcome sets are an important building block for outcome-oriented care. Healthcare professionals, insurers, patient organisations and drug companies look together how they can optimise the treatment for the patient. The government and the healthcare parties have expressed the ambition to provide insight into and use outcomes for 50% of the disease burden in 2022. Many members of the Association Innovative Medicines already have a project for outcomeoriented care, or will soon start one.
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