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Home » Cardiac Health, EU Health, Health, Uncategorized

“We need more partnerships between regulators and providers”

Submitted by on 12 Apr 2018 – 16:45

Dr Robert C Kowal, VP Medical Affairs and Chief Medical Officer, Medtronic Cardiac Rhythm and Heart Failure, calls for more partnerships between providers and regulators to better manage cardiac health in Europe

The issues impacting improvement of cardiovascular care in the European Union are best categorised in the realms of health policy and healthcare delivery. Both are of critical importance but bring to bear different resources and approaches at a time when ongoing financial pressures imperil healthcare funding. Strategies going forward must focus on access to health prevention and care as well as ongoing innovation in therapy delivery.

In the realm of health policy, we must continue to focus ongoing efforts to target modifiable risk factors for the development of cardiovascular disease. These risk factors include obesity, sedentary lifestyle, tobacco and alcohol abuse. However, while the patient–physician interaction remains critical to patient health, the complex interaction between social pressures and medical disease, as well as the difficulties of their management, makes targeting these risk factors transcend the medical office to a more comprehensive strategy for population health.

However, the critical role of healthcare providers in cardiovascular health and the primary prevention of cardiovascular disease should not be minimised. The importance of managing hypertension and hyperlipidemia as well as the recognition of early stages of acute and chronic cardiovascular conditions requires a well-trained and broadly distributed network of primary care providers and cardiovascular specialists. Optimal cardiovascular care requires the combination of both education and policies that support patient access to treatment and care.

While coronary artery disease is still a primary driver of cardiovascular illness, advances in prevention and treatment have continued to mitigate its impact over time. However, with the improvement of care for coronary disease, as well as the ageing of the population, we have witnessed an ever-increasing burden of chronic heart disease, specifically heart failure, valvular disease and atrial fibrillation.

Management of these chronic heart syndromes involves not only risk factor modification but also a combination of pharmacologic, invasive and device-based therapies. Further, the rapid innovation in the interventional capabilities to manage and treat these entities has increased the need for highly trained physicians and nurses to deliver the most appropriate treatment modality, often involving a redesign of clinical pathways and mechanisms for patient–provider interaction.

In order to facilitate the necessary advances to manage the growing patient and financial burden associated with chronic cardiovascular disease, we believe that several principles should guide innovation in this space.

1. Technological innovation should be supported by a reasonable regulatory environment for approval that maximises patient safety but stimulates research in the European Union.

2. Reimbursement for therapy should be harmonised across the European Union; value-based and risk-sharing models should be considered to promote patient outcomes and cost-effectiveness.

3. Strategies that promote patient engagement and remote monitoring should be encouraged to broaden access to effective care strategies while minimising burden to current healthcare infrastructure.

In summary, societal trends regarding obesity and modifiable habits along with the growing chronic cardiovascular health considerations that come with an ageing population mandate innovative approaches to both population health policy and disease-specific care strategies. Partnerships between providers, government regulatory agencies and industry are needed more than ever to innovate technology, pharmacology and care pathways.

In parallel, regulatory and reimbursement approaches must emphasise patient outcomes. We look forward to ongoing collaboration with the International Centre for Parliamentary Studies and the European Union.