How to combat chronic disease in an ageing population

What will the future of health and healthcare look like? In a joint series of blog posts by the World Economic Forum’s Strategic Foresight and Health teams, a number of leading voices will present their own visions for the future. Contributions are linked to the Scenarios for Sustainable Health Systems project, the Workplace Wellness Alliance and the Healthy Living Initiative. In the following post, Joseph Jimenez, Chief Executive Officer of Novartis, will share his perspective on the future of health.

We are experiencing a sea change in healthcare. The world’s population is ageing, with the number of people over the age of 60 expected to increase 75% over the next decade. There has been a tremendous rise in chronic diseases, which cause more than 36 million deaths globally each year. In China, chronic diseases, like diabetes and heart disease, account for 85% of the total deaths per year. These factors are leading to staggering healthcare costs. In Russia, about 400,000 people die each year due to smoking, costing the country US$ 48.1 billion annually in health costs and lost productivity.

To meet today’s demands and lower costs, we must shift away from the traditional “transactional” healthcare approach. I see a future of healthcare systems that is focused on delivering positive patient outcomes. Instead of rewarding stakeholders for simply providing care, value would be placed on products, services or business models that incrementally benefit patients or reduce costs. However, I see three key barriers we must overcome to achieve this.

First, we must focus on better prevention and education to lower incidence of chronic diseases and reduce costly hospital visits. We’ve already seen how this can have an impact in Russia, where we’re collaborating with the local government in the Yaroslavl region to reduce the high prevalence of hypertension. We established a regional hypertension centre and launched a public education campaign. In addition, we have established three pilot sites in the region to trial hypertension intervention tools. As a result of these measures, blood pressure control rates nearly doubled at our pilot sites over the past 18 months.

Second, we need to reduce the cost and time needed to bring innovations that improve outcomes to patients. Right now, it takes on average 10 years and costs close to US$ 1 billion to develop a new therapy. Additionally, clinical trials are becoming more complex, with a recent 65% increase in the average number of total procedures per trial protocol. This is unacceptable. Pharmaceutical companies need to work together with regulators to bring medicines to patients more quickly. This can be done by using genetic data to identify patients most likely to respond to a therapy, reducing trial size. Using biomarkers, some of our oncology trials have already been reduced in size ten- to twentyfold, shortening timelines by many months.

Third, we can benefit from better use in healthcare of technologies we all use in our daily lives. Things that we take for granted, such as smartphones, could help engage patients in their own health and make a real difference. Consider the power of something as simple as creating an app to remind patients to take their medication or help track vital signs. These tools could improve compliance rates and enable healthcare professionals to monitor patient progress remotely. At Novartis, we have several “mHealth” projects under development, and are working to find more ways new technologies can help patients take healthcare into their own hands.

Ageing population and the rise of chronic diseases, as well as the tsunami of costs, are forcing changes in healthcare. They also offer an opportunity to rethink our model for treating patients. As a first step towards a system that puts patient outcomes at the centre, we need to institute strong mechanisms to better measure outcomes and costs for key disease areas. This will help drive continuous improvement by more quickly identifying and adopting best practices. Instead of sitting on opposite sides of a transaction, all healthcare system stakeholders need to collaborate and align on the common goal of improving outcomes. Although this kind of complete mindset shift is a daunting task, it’s the only way we can have a real impact on the health of the world.

Author: Joseph Jimenez is Chief Executive Officer of Novartis, Switzerland. Previously, Jimenez served as the head of the Pharmaceuticals division and as head of the Consumer Health division.

Image: An elderly woman reads the newspapers in her farmhouse in a small village near Hanover REUTERS/Christian Charisius