How Will the Pandemic Shape Health Care Policy of the Future?

Two presenters at the first plenary of ISPOR 2020 on Monday urged that the world not lose sight of the difficult lessons and realities uncovered during the coronavirus disease 2019 (COVID-19) pandemic.

As the United States tries to figure out how to reopen, health policy experts convened on Zoom to discuss what the future might look like during the “Health Policy—Designing for the Future” session of this year's virtual ISPOR conference.

It’s going to be difficult to look at the future of health care redesign without taking into account everything that has happened with COVID-19, noted Sir Andrew Dillon, founder of the United Kingdom’s National Institute for Health and Care Excellence. After the story of COVID is written and the public returns to the “new normal, I suspect the challenges will look reassuringly familiar,” he said.

Dillon brought up the World Health Organization (WHO), which President Trump has attacked repeatedly. Last month, the president said he would cut funding to the global health organization, although House Democrats say he does not have the authority for a unilateral funding decision.

Global collaborative efforts need to be conducted through a stronger WHO, not a weaker one, Dillon noted. “This is not the moment to disinvest in working with each other,” he said.

He also praised the life sciences industry and other stakeholders for working together in an unprecedented way to develop a vaccine. On the morning Dillon spoke, biotech company Moderna reported that interim phase 1 results show a COVID-19 vaccine was safe in 8 volunteers and provoked an antibody response.

In Dillon’s view, health is an “essential component of a properly functioning society.”

“If we are prepared to accept unequal access then we are diminished both as individuals and as society,” he said.

Society needs to have conversations with funders of health systems about priorities in order to balance the investment between prevention and treatment, and to increase the resiliency of health systems, Dillon added.

“We need to make a commitment to delivering universal health care as a basic service for all citizens,” he said, noting that although his country's National Health Service is not perfect, it is "cherished."

But for universal health care to happen elsewhere, he said, the public has to want it and policy makers need to show leadership, he said. In addition, he said there needs to be a new level of transparency when discussing new diagnostics and therapies when considering possible incremental benefits.

Looking Ahead to 2040

Before the pandemic, Deloitte Consulting LLP was already engaged in a project called “the future of health,” looking ahead to what health care could be in 20 years, said Margaret Anderson, a managing director.

Based on conversations with various stakeholders, the analysis looked at areas such as value-based care, vertical consolidation, customer engagement, and pharmaceutical research and development, among others.

Now there is ‘”intense collaboration,” whether it is across states or companies, and developments and improvements that were once expected to take years are now happening very quickly because of the pandemic, she said.

“It’s going to be very difficult to put the genie back in the bottle,” she said.

Drawing on her past experience in patient advocacy, Anderson said she was concerned that the COVID-19 response does not allow the public to forget about other concerns, such as rare diseases, 90% of which have no treatment, she pointed out.

“If anything, those folks are not getting the same care they were getting, or the attention,” she said. And research labs may now be busy with COVID work, Anderson said.

“Could we take a bit of the expediency and the speed and apply that to looking at those disease and really understand how do we speed that system up and not go back to business as usual?” she asked.

The plenary was moderated by Dana Goldman, PhD, the Leonard D. Schaeffer Chair and a distinguished professor of public policy, pharmacy, and economics at the University of Southern California and director of the USC Schaeffer Center for Health Policy and Economics. Goldman is also a member of the editorial board of The American Journal of Managed Care^®.