Christopher Delporte, Group Editor03.04.09
Change, change, change. We heard a lot about it during the last presidential election. Good, bad or indifferent, change certainly has made its way to Washington. And that change is going to have a significant impact on healthcare and the medical device industry, including outsourcing.
In a broad sense, the government’s response to the current economic crisis effects most industries and individuals in some way. No surprise there. The individual impact of government programs on the economy and their effect on various business sectors is more of a mystery. In a recent speech to a joint session of Congress, President Obama outlined a broad policy and a fiscal agenda for his administration.
Regarding healthcare reform, the president said: “I suffer no illusions that this will be an easy process. It will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our healthcare has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: Healthcare reform cannot wait. It must not wait, and it will not wait another year.”
This “historic commitment” to comprehensive healthcare reform, as the president called it, would be paid for by leveraging “efficiencies in our system that are long overdue.And it’s a step we must take if we hope to bring down our deficit in the years to come.”
Efficiency and fiscal prudence haven’t always gone hand in hand when discussing healthcare in the United States. We’ll see how far the effort gets this time around. As the president noted, we have been trying for 100 years.
Be that as it may, it seems that medical technology executives—usually a pretty conservative group—are ready to do their part. During a recent conference call with the press organized by the Advanced Medical Technology Association in Washington, D.C., a group of medtech CEOs said they backed a comparative effectiveness program that received $1.1 billion in the recently passed economic stimulus bill (see Top of the News in this issue).
Provided the program doesn’t always result in the cheapest method used and innovation isn’t discouraged, they’re ready to give it a try.
Comparative effectiveness measures cost and clinical benefits of competing treatments. Historically, when companies came up with a new technology or drug to deliver care, all they had to produce was clinical data to show its efficacy. Now, technology will be examined to see how much it would cost Medicare and how much cost savings it would bring over the long term. Though, as Bill Hawkins, CEO of Medtronic, said: “We can't afford a cheapest-at-best approach to medicine.” Cost as the only driver doesn’t help anyone in the long term, but the impact of this program will be felt at most levels of the medical device supply chain. Another consideration is the speed of the project.
Tom Novelli from the Medical Device Manufacturers Association cautions in his On the Hill column this month (page 18) that time is of the essence when it comes to comparative effectiveness evaluation of medical devices.
“The study methodology can take the format of examining device-intensive procedures against similar procedures, or even a device-intensive procedure against a drug therapy regiment. Device manufacturers may find this troubling, however, due to the unique nature of the evolution of a product. On average, a comparative effectiveness study may last approximately three years,” he writes. “If studies were to proceed in this manner, many of the technologies under review could be obsolete by the conclusion of the study. In all likelihood, the device may be on the second, or even third, generation.”
Once again—as we’ve explored in MPO at length—outsourcing providers aren’t immune to these political machinations, and they’re not “too far downstream” to be affected by or—more importantly—actually affect outcomes. With cost one of the primary drivers of this process—and also one of the benefits of the outsourcing relationship (among the many others this audience knows well, including aiding in the development of innovative medical devices)—outsourcing providers in the United States have a critical stake in the discussion.Should they choose to take advantage of it, there’s an important seat waiting for them at the discussion table.
That sort of involvement really is change to believe in.