NHS financing and innovation, discussed at the GSK Chair of the UPF Barcelona School of Management

• Experts in health economy and NHS funding attend a meeting organised by the GSK Chair and UPF Barcelona School of Management
• Experts agree on the need for independent analysis for evaluation and funding of the National Health System

The GSK Chair and UPF Barcelona School of Management (UPF-BSM) in Health Economy has celebrated the I Meeting of Experts on the territorial financing model, and financing and evaluation of innovations in the National Health System (NHS).

Experts have agreed that independent mechanisms and tools are needed for the evaluation and funding of the NHS, and stress the need for transparency in the whole system.

The scientific director of the Chair and Master in the Health Economics and Medicine, Jaume Puig-Junoy, values the relevance of the meeting as: "The pandemic has exacerbated some weaknesses of the NHS and highlighted some major shortcomings. The sooner we become aware of where these gaps are, the better, the sooner we can begin to remedy them, and these days with experts must serve for this."

Puig-Junoy: "The sooner we become aware where the NHS' shortcomings are, the sooner we can begin to remedy it, and these days with experts must serve for this."

The Executive Director of the Chair, Natalia Pascual Argenté, applauds the forum's celebration: “More than a meeting is a reunion. It is the first face-to-face forum after covid-19 with experts from different health sector disciplines in which to discuss some important changes that have been implemented in the process of buying and financing NHS medicines".

The GSK Director of Access to Market in Spain, Sergio Ostalé, puts in value how such collaborations can help bring improvements to our NHS and therefore to everyone's health: "The GSK mission is to help people do more, feel better and live longer and to launch collaborations like this with the UPF-BSM is key to being able to continue to advance and, together, to continue searching for ways to improve our NHS so that the most innovative medicines can reach the patients who need them most as soon as possible".

Health Policies, Pharmaceuticals and Funding

The inaugural conference was held by Francisco Pérez-García, professor emeritus of the University of València and director of the Valencian Institute of Economic Research (IVIE), and has focused on public finance and welfare during and after the pandemic. Pérez-García has spoken about possible solutions to the risks posed to the welfare state, “for example, the sustainability of welfare between generations, pandemics, climate crisis. etc. as well as the emergence of new internal - territorial, gender-, and international inequalities - development aid, migrations...

Ostalé: "Collaborations like this with the UPF-BSM are key to being able to continue to make progress, together, to continue looking for ways to improve our NHS so that the most innovative medicines can reach the patients who need them most as soon as possible'

The first round table moderated by Professor Puig-Junoy has dealt with the economic Challenges in health: inequalities and model of territorial financing and service provisionde In this debate have spoken David Cantarero Prieto, from the University of Cantabria; José María Abellán Perpiñán from the University of Murcia; Rosa Urbanos Garrido from the Complutense University of Madrid and Enrique Bernal Delgado from the Aragonese Institute of Health Sciences.

Canterano has addressed inequalities in spending and funding between autonomous communities, emphasising that “the uniformity in per capita expenditure must not be set as an objective. Perpiñán has proposed “the incorporation of the foral communities into the financing of interterritorial solidarity, in order to deepen horizontal equity”. Urbanos has focused on access inequalities, remarking that "the increase in waiting time is displacing even middle classes towards private insurance with the risk of creating a dual health system". Finally, Bernal has addressed unjustified variations in clinical practice, remarking that "there are significant differences in provision, both between CCAAs and between health centres. The ictus protocol is an example of improved variability that should serve as a reference model".

The second day has started with the table Review of the current model of financing and price fixing of medicines and innovative benefits moderated by Abellán and with the participation of Fernando Antoñanzas Villar of the University of La Rioja; Sandra García Armesto, Executive Director of the Aragonese Institute of Health Sciences; Atanasio García Pineda 0, Director-General Prestations and Pharmacy of the Balearic Islands and Juan Oliva Moreno, from the University of Castilla-La Mancha.

Abellán has shown concern about the opacity of the price-fixing system for medicines. Antoñanzas has compared the laws and practices of financing and price fixing in several European countries by underlining the importance of "flexibility in the application of thresholds". García Armesto has spoken of the importance of designing organizational innovation strategies, as genuine innovations, to transform the ways of working and orienting them to the patient. Then, Pineda has described the plan for the consolidation of IPT medicines in the NHS; and finally Oliva has advocated the need for an independent health intervention and health policy assessment authority.

The last table of the forum has reflected on Assessment and Decentralized purchase of innovative medicines and health technologies, with the moderation of Oliva and contributions of Antonio Picón Macías, technical coordinator of the Assessment of Hospital Expenditure of the AireF; Caridad Pontes, manager of Medicament at CatSalut; Maria Queralt Gorgas of the Hospital Universitario Vall d'Hebron and Josep Lluís Segú Tolsa, professor of the Master in Health Economy and the Median of the UPF-BSM.

Picón has unleashed proposals to improve the management of hospital pharmaceutical expenditure from the AIReF's point of view, suggesting primarily the creation of a similar collaboration network to RedETS. Pontes has spoken about the pharmaco-rapeutic assessment in Catalonia, namely the experience of the therapeutic harmonisation programme. Gorgas has worked out various proposals to improve the management of the health budget at hospital level, such as certain strategies for limiting expenditure. Finally, Segú has stressed the importance of defining the purchasing needs to be met with the shared risk (ARC) agreements and sharing information about the conditions with other administrations.

The closing conference was pronounced by former Minister of Industry and President of the Ernest Lluch Foundation, Joan Majó Cruzate. Majó has stated that the danger of the health system's insustainable nature is a consequence of the inability to prevent and that health spending will increase in the future. It also stressed that both climatic and social unsustainability are relevant aspects in today's society. By way of conclusion, Majó considers that recovery and progress cannot be measured solely by GDP, as additional indicators need to be added that consider the well-being of the population.