Innovation in European healthcare – what can Sweden learn? - LIF

Conclusions – what can Sweden learn from…
Germany has a healthcare system
with a multitude of providers
The country introduced an all
embracing DRG system a few years
ago.
When the system was designed, it
was understood that emphasis on
productivity would reduce the room
for innovation. Therefore, special
reimbursement structures were
created – inpatient as well as
outpatient sector.
There are ”good” and ”bad” costs in
healthcare – which can be
incorporated into the
reimbursement system.
Sweden should consider establishing
a national reimbursement method
for innovative solutions – preferably
incorporated into the DRG system
The German integrated care
contracts are useful for innovative
healthcare services or technologies
that are integrated with services, to
establish new pathways, treatment
of chronic patients etc, in situations
where innovation needs to cross
barriers in the healthcare system.
France has a healthcare system with
diversity and a multitude of
providers – both private and public
There is a national reimbursement
system, which has been harmonised
to cover all providers, private as well
as public
National recommendations on
innovative products are incorporated
into the reimbursement system
However, the average time to get
approval for reimbursement is long,
compared with Germany or Sweden.
France has also introduced a “fast
track” for innovations that are
difficult to evaluate in terms of
expected medical outcome.
In conclusion: like Germany, France
shows that specific and predictable
reimbursement for innovative
products is important, but in terms
of implementation we have more to
learn from Germany.
The stakeholders in France
emphasise the importance of local
headquarters of global companies.
The lack of global French medtech
companies is seen as a main reason
for the sector’s decline.
The healthcare system in the UK is
going through massive reform – the
result of which remains to be seen
The UK is struggling with the same
issues as Sweden in innovation:
there are excellent structures for the
assessment of new technologies, but
the national recommendations are
non-binding, leading to large
variations in the technology uptake.
There are no structured reimbursement
systems for innovative products
or services in the UK. The NHS
has identified innovation as a key
objective and has built up an
infrastructure to support innovation.
“Innovation” has central place in
policy-making. There is an innovation
directorate on the national level, at
the Department of Health
Actions are taken to ensure that
NICE recommendations on
innovative products are
implemented across the country.
The UK and Sweden apply similar
measures, why the lesson we can
learn is not what to do, but how to
do it. Will the efforts to enforce NICE
guidelines at the local level across
the country be successful?
Denmark has a healthcare system
and an approach to innovation that
is similar to Sweden’s. Despite this,
Denmark has been more successful
than Sweden in the biotech and life
science sector.
In terms of the national innovation
strategy, two clear differences
between Sweden and Denmark can
be identified:
The political focus on the medical
industry is greater in Denmark;
The Danish Innovation strategy,
published in December 2012 , has
the overall objective to ensure that
public investments in research,
education and innovation, to a larger
degree than today, is converted to
growth and job creation.
The lesson for Sweden:
Swedish policymakers should put
more emphasis on translational
research and commercialisation of
innovation in healthcare
The healthcare system should
consider clinical research and
collaboration with the medical
industry part of their responsibility
The Netherlands went through a
major healthcare reform, based on a
well thought through plan for the
creation of three healthcare markets,
but the overall objectives were not
reached
Neighbouring countries, like
Germany, initially considered the
Netherlands as an example that
should be followed, but the Germans
now consider the Dutch experience a
failure.
One of the factors contributing to
this failure was that the system was
built on political control, rather than
the dynamics among a multitude of
stakeholders that is found in four
example Germany, or France.
In terms of innovation in healthcare,
Sweden has little to learn from the
Netherlands
However, the Implementation
fellows at the University hospitals
are worth mentioning.
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