Participants at DIA’s 9th Annual India meet analyse the current scenario and brainstorm on possible future models of healthcare delivery
DIA’s recent 9th Annual India conference, in Mumbai had as its theme: ‘The Future of Indian Healthcare: Patients, Access and Innovation’. Chaired by Prof Ranjit Roy Chaudhury, Chairman, Task Force for Research Apollo Hospitals Group and Alexandra Pearce, Senior Vice President and Head Global Regulatory Affairs, Glenmark Pharmaceuticals, the three-day conference saw animated participation from a wide spectrum of the industry.
The first day focused on patients and included sessions on topics like patient health safety and compliance for prescription medicine, patient participation in clinical trials, universal health coverage and health insurance, medicine pricing and reimbursement, compulsory licensing, innovations in healthcare solutions etc.
Eminent speakers including MK Bhan, Former Secretary Department of Biotechnology (DBT), Govt of India; GN Singh, Drug Controller General of India; Kiran Mazumdar Shaw, Chairperson and Managing Director, Biocon; Urmila Thatte, Professor and Head, Seth GS Medical College and KEM Hospital; YK Gupta, Professor and Head Department of Pharmacology AIIMS; Swati Piramal, Vice Chairman Piramal Enterprise; and Sudharshan Jain, Managing Director, Healthcare Solutions Abbott India were speakers at various sessions.
Nata Menabde, Representative to India, WHO, India chaired a plenary session on the second day. The session got the panelists to analyse the current scenario from their perspective and suggested healthcare models based on their place in the healthcare value chain. The common element to these perspectives was the attempt to leverage the principles of accessibility, affordability and accountability by adopting a patient-centric approach towards delivery of quality healthcare to the masses. The panel members and participants also touched on the possible impact and adoption of healthcare economic outcomes research (pharmacoeconomics), health insurance, PPPs, diagnostics and pharma industry, thus spanning the entire healthcare value chain.
In her introductory remarks, Menabde said, “The world is re-visiting models of healthcare. Holistic, integrated solutions are required.”
Representing the pharma industry’s perspective on the current drug pricing policies, Piramal opined, “When you reduce the cost of the drug to the cost of the chemical but exclude the cost of safety, then price control does not help access.”
Sharing her experience of the Piramal Enterprise’s Sarvajal project, where water purifiers were installed in remote villages, she pointed out that it was not about supplying the product, but building a system and infrastructure to manage and maintain the machine. Extrapolating this to the access to medicines issue, she said that ensuring access was not about pricing but about management and policy, she concluded.
Suggesting that home-based care could be adopted as a future model of healthcare delivery, Ferzaan Engineer, Co-Founder and Chairman, Cytespace made his point by saying, “Home-based care could become the Flipkart of healthcare. Entire housing societies could subscribe to a health plan, which is based on incentives to take care of people’s health rather than curing them after they fall sick. When subscribers do fall ill, it is detected early so costs of care are less. The home health model could also take primary care home so that people fall ill less often.” Engineer is also co-founder, Medwell Ventures, a recent entrant into the home healthcare market. He also made the point that this model can be used not just for chronically ill patients, and the geriatric segment but also for the rehabilitation and physiotherapy of accident victims, which takes place over a period of time.
Participating in the discussion via telecon, Dr Devi Shetty, Chairman, Narayana Hrudayalaya Group of Hospitals, in his characteristic blunt fashion opined that the lack of skilled manpower was at the root of healthcare delivery issues in India. Analysing the genesis of the problem, he said, “Though we produce a lot of doctors, India still lacks doctors. We have a first world regulatory structure with a third world infrastructure. We need to liberate medical education from the license raj.”
On the availability of healthcare facilities, he rued the fact that all major hospitals were coming up in major cities resulting in patients from rural areas being forced to leave their homes and flock to cities for healthcare. He suggested that each district hospital should be connected to major city hospitals and converted into training centres, alluding to the model followed in the US and the UK. He also suggested that India should have a large scale insurance scheme to take care of the cost of accessing healthcare.
Rajesh Balkrishnan, Associate Professor Health Outcomes, University of Michigan, US felt that, “India’s healthcare system has to improve on three parameters: Effectiveness, Efficiencies and Equity. Comparative effectiveness is very relevant to India when resources are few. ” He also drew attention to the huge time bomb of NCDs combined with CVD which will impact healthcare delivery in India.
Summing up the discussions, Menabde said, “We cannot have pro-poor policies which are poor policies. We should have a combination of private and public insurance. Access should be independent of the ability to pay so do not ask the private sector to reduce prices. Instead, the government and private sector should work together to improve access.”
EP News Bureau – Mumbai
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