Editor Cornelie Abrahams, in daily life advisor and partner of samhealth, spoke to independent advisor Jannie van den Broek and made the portrait below.
Over 4 years ago, you already told us about value-based care and managing on outcomes. You no longer work for a large pharmaceutical company, but have continued independently. What are you doing now?
“I have been self-employed for a year now. Before that, I worked at Amgen, where I was part of the Leadership Team as Director Strategic Capabilities & Solutions and was involved in everything related to patient value and how we as a pharmaceutical company could play a bigger role in that. Every day was about value-driven care, innovation, transformation and working within the ecosystem. I learned a lot about what works and especially what doesn't work. And I have saw the urgency to really do things differently in healthcare.
From that urgency I started as an independent advisor a year ago. In my own company, North Star Advice, I am still very much involved in healthcare and how it needs to change in order to remain accessible and affordable, but especially with the actual realization of that innovation. I help parties in and around healthcare to continue to make their unique contribution to healthcare. This can be done in many ways, with workshops to develop vision and strategy and a step-by-step plan to implement this, but also by paying attention to what it requires from people in an organization to bring the vision to life. In addition, last year I also did a very nice interim assignment as director of the Zorgambassade, a foundation that focuses on removing obstacles to innovation in healthcare. In addition, I am a member of the Central Expert Panel of ICHOM, an international organization that develops standard outcome sets, and of the NZa's External Sounding Board Group "Passende Zorg" to collectively discuss what is needed to make the transformation to "Passende Zorg". Finally, for several years now I have been a member of the Governance Board of an organization for elderly care in Breda (Surplus) and chairman of their quality, safety and innovation committee. This is where I even better get to know the (elderly) care, and the major challenges we are facing.
So you could say that still my every day is about value-driven care, outcomes, innovation and transformation…”
What is your vision of value-based care and managing outcomes in 2023 and how has this changed compared to a few years ago?
“For years we have been confronted with an aging population and associated dejuvenation, with more and more diseases that are becoming chronic and with more and more treatment options. The real problem underlying this however, is the way we pay for care. We pay for transactions and not for the outcome of those transactions. And when you pay for services, you receive services. With the demographics we are facing, we won't be able to afford that for much longer. I am still convinced that a different way of paying can relieve care. And by that I mean that we need to look into ways to give outcomes of care a much more prominent place in payment.
Now we are a few years further down the road, I see more and more that the change we are facing is an anourmous task, which is not limited to healthcare alone, but which entails a major social transformation.
For healthcare it means more than just making healthcare outcomes the leading factor in treatment and payment. It also means we need a shift from care to prevention and to health. And the realization that we can no longer, nor must solve everything within healthcare, but that well-being will also play a greater role. And that means that more and more attention must be paid to digitization, hybrid care and cross-domain network solutions.
Now I also see that people are confronted with bureaucracy, the slow pace, the lack of common interest and ownership. What I also see happening is that the enthusiasts from a few years ago are slowly losing heart because they all run into these barriers. So we really have to get to work and we have to do that together. That requires guts and visionary leadership.
How can pharmaceutical companies contribute to this?
Pharmaceutical companies are as suppliers part of the healthcare sector too. And are therefore jointly responsible for maintaining high-quality care that is accessible to everyone and remains affordable. I therefore think that pharmaceutical companies should jointly develop a vision of their role in healthcare of the future, a role in which you take on the challenges together with the healthcare field. And here too guts and visionary leadership are needed! But I also understand very well that this is complicated. You have always worked mainly as competitors, you have a head office that expects some things from you and you still sometimes suffer from a reputation that doesn't help when it comes to mutual trust. The collaboration will therefore have to focus mainly on the major themes that all pharmaceutical companies struggle with and less on the smaller areas in which they compete.
In addition, as a pharmaceutical company it is not easy to properly interpret trends and developments in healthcare and to convert them into strategy and a clear action plan. From my different perspectives I have already thought about many of the trends and challenges and I have developed an approach to take this from thinking to doing. If readers want to talk more about this, they can always take a look at my website.
You are still working in healthcare while you could also use your knowledge and expertise for other branches. What drives you to continue working in healthcare?
I've been getting that question more often lately. And it is very easy for me to answer. My drive is to keep healthcare accessible, affordable and of high quality. Today, as my father's caregiver, I see how unintentionally complex and inefficient many things still are, but also in the future, for my children, and possibly for my grandchildren one day. It cannot be that we live in such a beautiful and developed country, but could not get this sorted. That we will soon be able to develop all kinds of great innovations, but that we cannot get them to patients, simply because we have blown up the system. So my drive remains to have an impact on that. To help figure out how to do things smarter instead of just not doing them anymore because we can no longer afford them.
In conclusion… do you have a message for pharmaceutical marketers?
The urgency to change is greater than ever and so complex that no one can do it alone. All parties will have to work together and that is only possible if there is trust and a shared interest. This demands a lot from everyone's behavior. Above all, you must be honest and transparent about your intentions. Don't shy away from the difficult conversations, be sincere and patient.
And with such a big task, don't forget that it's not about how many times you fall, it's about how often you get up, dust yourself off and keep going!
Cornelie Abrahams is a consultant/partner at samhealth.