“Realigning our health care together – an alliance for value-based healthcare,” suggests the pharmaceutical company Janssen in its current white paper VBHC, which was created during the last Janssen Open House online workshops (JOH). In their editorial, Dr. Dorothee Brakmann and Christian Hilmer, both members of the management team at Janssen Germany, said that Value Based Healthcare (VBHC) was “not an invention of ours, but has been a topic close to our hearts for a long time”. The goal is “an efficient, affordable healthcare system in which every person has the chance to receive the right therapy at the right time.”

>> In another editorial, JOH participant Inga Bergen, podcaster and expert in health and digital innovation, writes: "We need a new definition of the term 'quality' in healthcare." Our healthcare system needs a fundamental transformation away from a repair shop to one System that focuses on added value for patients – also in the reimbursement systems. This value-based healthcare is already being used successfully in other countries as a method and framework to implement such a change. Bergen continues: “VBHC is a concept of business: results are evaluated in the first step and remunerated accordingly - this is a big change to our current system, which remunerates services provided and not their results.”
The concept of Value Based Healthcare was introduced to a broad public in 2006 by the US economist and management researcher Michael Porter and the health economist and engineer Elizabeth Teisberg (1). The diagnosis of the two: health systems worldwide are suffering from rising costs. However, these are not offset by a proportionally increasing quality of health care. According to Porter/Teisberg, the error lies in the system: the focus is on medical services and their reimbursement, embedded in a highly fragmented system in which each actor offers their own care services in isolation (2). What is needed is a new approach that consistently focuses on patient benefits when planning care services and looks at the care process as a whole.
In the paradigm of quality and results-based healthcare, “value” is the central category. There are now a number of value concepts in the debate about VBHC. One of the best known certainly goes back to Porter and Teisberg, but there are now many additions and clarifications, for example that of a panel of experts commissioned by the EU Commission. It divides value-based care into four categories (3):
1. personal value, i.e. H. achieving the patient's individual goals through treatment
2. the technical value, i.e. H. achieving the best possible results with the available resources
3. the allocative value, i.e. H. the fair distribution of resources, and
4. the social value, i.e. H. the contribution of the healthcare system to social participation.

According to the white paper, the Dutch professor of health technology Maarten J. IJzerman presented another approach in 2017. He came up with the following equation (4): Value = a set of outcomes that are significant for the patient's condition/quality of life, divided by the sum of all resources used over the entire treatment cycle.
Another, quite inspiring impulse also comes from the neighboring country of the Netherlands. There Prof. Dr. Fred van Eenennaam and his team have already scientifically accompanied and supported the implementation of around 1,250 VBHC projects in the Netherlands and Europe. The spectrum extends across all possible disciplines: from orthopedics, oncology, cardiology, internal medicine and geriatric care to rare diseases and palliative medicine and prevention.
Van Eenennaam, President of the VBHC Center Europe, an international network committed to the implementation of VBHC in Europe, introduced his keynote speech on VBHC at the JOH with the succinct statement: “Value Based Healthcare: Does it work? Yes! Is it easy? No!"
The VBHC expert described, among other things, the example of “diabetes” as best practice. This is an association of currently five centers in the Netherlands that specialize in the treatment of type 1 diabetes. The name “diabeter” does not only allude to the disease: the Dutch word “beter” means both “healthier” and “better”. Diabeter has set itself the goal of enabling its around 3,000, mostly young, patients to live a life without diabetes complications (5). The focus is not only on improving the medical parameters (HbA1c and TIR), but also on the overall quality of life. This is achieved through a holistic care approach that uses the most modern technologies and therapies. In addition, the experts are available to those affected 24/7. According to van Eenennaam, the core elements of VBHC and Diabeter include the systematic integration of patient feedback and the ongoing evaluation of the program. Diabeter was awarded the 2017 international Value-Based Health Care Prize and received the Pharmaceutical Market Excellence Award in 2018 for its patient centricity. <<
from:
MVF editor-in-chief Peter Stegmaier