The Roche Column





In-vitro Diagnostics – the more questions we answer, the more lives we save

 

Demand for healthcare is growing around the globe. In almost every corner of the world, the proportion of the population aged over 60 is growing faster than any other age group(1). The rising pervasiveness of chronic diseases such as cancer, diabetes and cardiovascular diseases, costs and scarce resources are at a collision.

Countries can no longer afford inefficient healthcare systems. If treatments are given incorrectly, money is squandered and outcomes are diminished. Failure in accurately diagnosing diseases early on paves the way to a plethora of pro¬blems including but not limited to: expensive, late-stage and overuse of therapies and poor disease management. From an economic perspective, these inefficacies result in superfluous spending.

What are in-vitro diagnostics?
In vitro diagnostics (IVDs) are non-invasive tests performed outside of the body on the blood, tissue, or other body fluids of a patient. IVDs play a critical role in driving clinical decision-making across medicine and their true impact includes the cost savings and increased efficiencies of the downstream activities to which the testing leads or prevents (Petry et al., 2015; Sharma et al., 2015; Vyberg et al., 2015). Despite the potential of modern IVDs to advance sustainable healthcare, they remain currently underexploited and undervalued. For example, IVDs account for 2.3% and 1.4% of total health care expenditure in the U.S. and Germany, respectively, while driving 66% of clinical decision-making (Rohr et al., 2016).

IVD testing answers many crucial questions about a patient’s health status: their risk or predisposition for developing a certain condition, the severity of their disease, chances of responding to a given procedure or therapy and disease progression once treatment has begun. IVDs have the potential to reduce costs by allowing earlier, personalised interventions that can reduce consequent health problems, ward off unfavourable consequences, reduce or even eliminate time spent in hospital and avoid the cost of late-stage or unnecessary treatment (Davis et al., 2009; Institute of Medicine, 2015).

Medical Value IVDs that provide validated, relevant and actionable data (Schäfer et al., 2015a, 2015b) empower providers and payers to reduce spending improve outcomes and deliver cost-effective care at every step of the patient’s journey.

So why are IVDs underutilised?
Firstly, it is complex to gauge the cost of not doing something, such as ordering a test. If a payer captures laboratory test bills, but not long-term savings (i.e. less use of downstream resources), diagnostic testing will always appear as a net cost. Moreover, convincing evidence of the direct health and economic effects of IVDs on patient outcomes is scarce (Hallworth, 2015a; Lewin Group, 2009b; Rohr et al., 2016).

In addition, IVDs are too often easy targets for short-term budget cuts, even if those cuts ultimately increase society’s overall healthcare bill. For instance, the World Health Organization (WHO) recently completed a longitudinal study of tuberculosis (TB) control using data from 21 EU countries. Due to shrinking public health budgets during the 2008-2011 economic downturn, IVD testing decreased, and rates of TB case detection fell by 5.22 percent across the EU (Reeves et al., 2015). The result? WHO projects that the prevalence of TB and TB-attributable mortality will increase by as much as 3 percent for more than a decade after the recession ended (Ibid.)

However, IVDs are uniquely capable of advancing sustainable healthcare in three key ways:

1. Early detection and treatment
2. Targeted delivery of medicine
3. Optimised disease management

A recent WHO report concluded that evidence-based treatment using diagnostic tools is urgently needed in developing nations to replace the less effective “syndromic management” approach, which treats patients on the basis of a constellation of symptoms, rather than on data (Peeling and McEnerney, 2011).

At Roche Diagnostics, innovations in solutions are helping to remove uncertainty from healthcare, providing fast answers to patients’ most pressing questions, and saving providers’ money without compromising environmental impact reduction goals.

References
1. Adlbrecht, C., Huelsmann, M., Berger, R., Moertl, D., Strunk, G., Oesterle, A., Ahmadi, R., Szucs, T. and Pacher, R. (2010). Cost analysis and cost-effectiveness of NT-proBNP-guided heart failure specialist care in addition to home-based nurse care. European Journal of Clinical Investigation, 41(3), pp.315-322.

 Date of upload: 13th Sep 2016

 

                                  
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