Policies for life sciences and healthcare in the global health framework.

BACKGROUND: At a time when welfare contracts are in crisis, it is timely to discuss different forms of disruptive innovation and responses of medical finance and economic systems, especially adjusting with new instruments for recovery and innovative solutions for health reforms. OBJECTIVE: The objective of this paper is to propose some ways to develop a framework for policy changes affecting life science sectors and healthcare. It aims to analyze the types of relationships between health or medical systems and the economic systems. METHOD: Medical systems used to be generally closed systems, but the new forms of delivery, especially with increase of telehealth and Mobile health (Mhealth) solutions (boosted by the COVID-19 pandemic, such as online consultations), have open traditional boundaries and generate more interactions with economic systems. It also led to new institutional arrangements at federal, national, or local levels, with different power games according to the history of institutions and cultural differences between countries. RESULTS: Which system dynamics prevail will also depend on the political systems in place, for instance very innovative open innovation systems dominated by private players such as the USA empower individuals and favor intuitive and entrepreneurial states. On the other hand, systems historically dominated by socialized insurance or former communist countries, have investigated "attunements" or adaptation mechanisms in system intelligence. However, systemic changes are not only implemented by traditional rulers (government agencies, federal reserve banks) but also face the emergence of systemic platforms dominated by Big Tech players. The new agendas expressed for instance in the United Nation (UN) framework and the set of Sustainable Development Goals (SDGs) for climate change and sustainable growth, also require global adjustment of supply and demand, in a context where the traditional drug/vaccine split is challenged by the new technologies (e.g., mRNA technologies). Investment for drug research led to the development of COVID-19 vaccines, but also potential cancer vaccines. Finally, welfare economics is increasingly criticized among economist circles; it requires new design for global value assessment framework, facing growing inequalities and inter-generational challenges in aging populations. CONCLUSION: This paper contributes to new models of developments and different frameworks for multiple stakeholders with major technological changes.

Biotech value chain and technologies for COVID-19 research areas for collaboration on cost quality tradeoff with tool companies.

BACKGROUND: Technologies for COVID-19 are in high demand, and supply chains from biotech and pharma industries face critical supply issues. OBJECTIVE: This paper discusses the case on mRNA technologies and quality assurance issues. METHODS: Interviews with managers of biotech companies were performed. These helped to prepare biotech panels at a roundtable on quality of medicine, organized by the Polish Academy of Sciences in Paris (PAN) in 2021. RESULTS: This paper analyzes the new mRNA technology and shows the importance of emerging new biotech firms, especially tool companies providing services in quality assurance. It highlights research areas and types of survey instruments with academic collaborators, to better understand the economics of mRNA technology platforms. CONCLUSIONS: A future research agenda for collaboration with academic communities is proposed on cost-quality tradeoffs and clinical quality attributes for such genomic technologies.

Global value chains and international pharmaceutical policy.

OBJECTIVES: This paper analyzes ICT diffusion in the biopharmaceutical industry. Since new paradigms emerge in the industry towards precision medicine and fasten the digitalization of health care, it is necessary to measure the changing value system, especially between life science and the IT industry. METHODS: The global value chain (GVC) concept is used and data are extracted from the Trade in Value Added (TiVa) dataset (June 2015) from the GVC-OECD project on interconnectivity of economics and industry. A number of indicators were selected: Foreign value added share of gross exports, % of ICT imported in chemicals as a final product, either exported or in use in domestic demand. Trade data are analyzed for two industries: chemical industry, including pharmaceuticals, and the ICT industry for a group of countries: USA, Switzerland, France, Germany, UK and Japan. RESULTS: Only 0.5 to 1% of value added embodied in final chemicals and chemical products can be attributed to the ICT industry. An additional analysis shows higher prices of connectivity for services in the USA versus Japan and Germany, on a price index for a basket of broadband services (fixed and wireless, OECD 2013); this may also reflect the open model of US innovation with more transactions. CONCLUSIONS: Fast digitalization of life science requires new measures. TiVa dataset is useful for some IT equipment, but not sufficient for all forms of digital economy. The value chain concept is useful for pricing mobile computing in pharmaceuticals, but needs specific data on connectivity. Complementary datasets (e.g. EU KLEMS) can also track ICT investment in chemicals.

The use of Patient Reported Outcomes and quality in primary care.

This contribution discusses the role of Patient Reported Outcomes (PRO) in improving quality of care. The development of PROs in primary care using scoring methods on various domains such as trust, information, communication, clinical quality and access is important as a quality improvement tool, especially in the context of market disruption and disinvestment due to reforms of the welfare contracts.

Clinical judgment research on economic topics: Role of congruence of tasks in clinical practice.

This paper discusses what can ensure the performance of judgment studies with an information design that integrates economics of medical systems, in the context of digitalization of healthcare. It is part of a series of 5 methodological papers on statistical procedures and problems to implement judgment research designs and decision models, especially to address cost of care, and ways to measure conversation on cost of care between physicians and patients, with unstructured data such as economic narratives to complement billing and financial information (e.g. cost cognitive cues in conjoint or reversed conjoint designs). The paper discusses how congruence of tasks can increase the reliability of data. It uses some results of two Meta reviews of judgment studies in different fields of applications: psychology, business, medical sciences and education. It compares tests for congruence in judgment studies and efficiency tests in econometric studies.

Perspectives of biologists, epidemiologists and geneticists' controversies in sciences and health system reforms.

The global burden of diseases is predicted to increase considerably in the coming decades (GBD project, WHO, 2010 [1]) - WHO-World Bank study, 1991 [2]); for example, the World Alzheimer Report and the UN Declaration on Non-Communicable Diseases estimate that the burden associated with dementia will increase 2-fold by 2030 and 3-4-fold by 2050. Therefore, urgent needs must be met in order to help policy-makers deal with the increasing societal costs of diseases. Recent technologies can facilitate the detection and prevention of mild cases of cognitive impairments, or integrative genomic medicine can target more individualized genetic traits and pedigrees; however, scientists do not necessarily agree: results from a recent population-based study using population imaging [3] differed from results obtained using integrative genomics approaches [4], and controversy exists between molecular biologists [5,6] and geneticists [7,8] with respect to asthma genetics. These differences have led to different predictive disease models and can influence the assessment of aging and environmental modifiers. This paper highlights implications for the governance of health systems using current debates on the evolution of these major fields of science. In addition, this paper discusses the potential translation of these models for use in clinical practice, particularly with telemedicine and telecare dominated by new IT technologies and challenges of science in transition.

The economics of biobanking and pharmacogenetics databasing: the case of an adaptive platform on breast cancer.

This paper aims to discuss the economics of biobanking. Among the critical issues in evaluating potential ROI for creation of a bio-bank are: scale (e.g. local, national, international), centralized versus virtual/distributed, degree of sample annotation/QC procedures, targeted end-users and uses, types of samples, potential characterization, both of samples and annotations. The paper presents a review on cost models for an economic analysis of biobanking for different steps: data collection (e.g. biospecimens in different types of sites, storage, transport and distribution, information management for the different types of information (e.g. biological information such as cell, gene, and protein)). It also provides additional concepts to process biospecimens from laboratory to clinical practice and will help to identify how changing paradigms in translational medicine affect the economic modeling.

Mobile economics and pricing of health care services.

This paper presents tools and concepts to analyze the business environment of the biopharmaceutical industry. It was presented at MEDETEL 2010. Emerging paradigms appear in that industry and new ways to value life science technologies are developed especially using mobile economics analysis. At a time, mobile computing technologies revolutionize the field of health care, this paper contributes to show how the value chain concept can be useful to analyze the value system in a mobile computing environment. It is also a milestone for the designs of future technology platforms and of health care infrastructure, in order to retain enough value between innovators, new and traditionnal players from life science, IT and other new comers, in a fragmented global competitive environment.

New type of price measurement for medical services: interest of a cost sensitivity index for a research agenda on pharmaceutical models.

This paper aims to propose a new methodological agenda for new price measurement for medical services; it is based on a cost sensitivity index coming from series of pilot studies on physicians, in order to provide adjustment methods to household surveys for health care expenditure budgets. The use of stated-revealed preference models with inclusion of stated preference studies is proposed with an example on a physician cost sensitivity study in Europe; it could also help the ISPOR task for force best practices in conjoint study designs.