“Britain and America are two countries separated by a common language.” Although the original text of this quote is often questioned, the sentiment cannot be argued. After spending over three years in the UK learning the UK health care system, Visante believes this idea can be extended to the UK and US healthcare systems.
Despite fundamental differences between payment schemes involving a single payer approach in the UK versus a conglomeration of payers in the US, both systems are struggling with the same basic issues. Each country is experiencing an aging population with the post war “baby boomer” generation on the edge of retirement. The result could be a demographic tsunami as the largest age cohort currently in the work force moves to a position of requiring increased levels of healthcare services. At the same time both countries are continuing to implement improved care management protocols resulting in increased life spans with additional demand for healthcare. Patient access to care is also a common issue, although for some common and dissimilar root causes. Both the UK and US are working to improve timely delivery of healthcare for all citizens. Finally, the two countries are seeking to contain the rapidly escalating cost of healthcare. At 17.9% of GDP in the US and 9.4% in the UK, this is simply not a sustainable model.
In response to these rising pressures, both of our governments are working on major health reform initiatives yet many of the “how to” details are still under development. As a part of these plans, both countries are also insisting that better quality outcomes be a part of the healthcare provided. Although the US spends the most on healthcare, we do not have the best results. According to the World Health Organization ranking of world healthcare systems, the US shows up in 38th place. Recent headlines in the UK regarding issues in the NHS speak to similar quality concerns and a desire to improve outcomes. In summary, both countries must improve access, quality and reduce cost if they are to be successful.
To that end, Visante sees medicines management and medicines optimisation as key elements that can contribute to both cost containment and quality improvement in the UK and the US. One of the fastest growing expense lines in healthcare is for medicines. The primary treatment modality for over 80% of hospital patients consists of pharmacotherapy and one of the highest risks for medical error is with those medications. It becomes clear that an effective medicines management system can have a major impact on both cost and quality. Yet, in both countries the prevailing position is often to treat medicines management and optimisation as a commodity with a “one size fits all” approach. This fails to recognise the unique contributions that an improved and comprehensive medicines management system can make.
At Visante, we have been excited to see some very innovative and successful elements added to medicines management in both the UK and the US. We feel that with UK and US practitioners and consultants working in concert, we can bring the best of the two systems together to help each country improve overall medicines management and ultimately contribute to improvements in cost and quality for the larger healthcare systems.