Session by Mark Pearson, Deputy Director, Directorate for Employment, Labour and Social Affairs, OECD For too long, health system reforms have been built around the needs of hospitals and clinicians, rather than patients. How can we turn this around? Guided by the mandate of over thirty Ministers of Health meeting at the OECD last month, the OECD is spear-heading an international collaboration to benchmark health system performance, based on whether patients themselves say that health care has benefitted them, and to what extent. Better measuring value, however, won’t take us very far unless we also control spending and tackle waste. Drug prices are escalating and high prices do not always come with high benefits. At the same time, up to a fifth of health system spending and activities does not contribute to improving outcomes. This session will discuss how governments could re-shape the pharma industry to better respond to citizens’ needs, and tackle waste in the delivery of health care.

1. Patient-centred care:
The next generation of health reforms
Mark Pearson,
Directorate for Employment, Labour and Social Affairs
5th OECD Parliamentary Days
Paris, 9 February 2017

3. On traditional measures, the difference between best
and worst performers can be minimal…
Variation in clinics’ care for prostate cancer in Germany

4. … patient-reported outcomes, however, reveal huge
differences in the quality of care.
Variation in clinics’ care for prostate cancer in Germany

5. The next generation of health reforms

6. At last one fifth of health spending in OECD
countries is at best ineffective and at worst,
wasteful
• Adverse events in 1/10 hospitalisation, add between 13 and 17% to
hospital costs and up to 70% could be avoided
• Geographic variations in rates of cardiac procedures (x3) and knee
replacements (x5) are largely unwarranted
• 12% to 56% of emergency department visits inappropriate
• Share of generics varies between 10% and 80%
• Administrative expenditure varies more than seven-fold
• Loss to fraud and error averages 6% of payments

7. 7
Inappropriate use of antibiotics by type of health care
service is high, especially in general practice
0
10
20
30
40
50
60
70
80
90
100
Dialysis [3] Pediatric [9] Critical care [5] Ambulatory [4] Hospital/Tertiary
[27]
Long-term care [13] General practice [4]
%Inappropriateuse
Estimates of the proportion of inappropriate use based on literature by service (range)
Numbers in squared parentheses indicate the number of studies available

8. New Health Technologies:
Managing access, value and sustainability

9. 9
Right innovations:
Number of new antimicrobials approved by the Food and Drug Administration since
1983
1983- 1988- 1993- 1992- 2003- 2008-
1987 1992 1997 2002 2007 2012
20
15
10
5
0
Year
Source: Adapted from Infectious Diseases Society of America, 2011 in Cecchini et al., 2015

10. 10
Right prices:
Cancer drug price per life year gained at approval in the United States (in 2013 USD)
Source: Howard et al., 2015

11. 11
Right rewards:

12. http://www.oecd.org/health/biotech/
http://www.oecd.org/health/paris.htm
oe.cd/tackling-wasteful-spending-on-health
Contacts:
Mark.Pearson@oecd.org
Website: www.oecd.org/health
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