On 7 June 2018, policymakers and health representatives met within the framework of the European Parliament Interest Group on Innovation in Health and Social Care, to highlight the critical role of secondary prevention to improve patients’ outcomes while contributing to the financially sustainability of healthcare system.
As pointed out in the first remarks of MEP Marian Harkin (ALDE, Ireland), regular exams and screening tests can detect a disease in its earliest stages, increasing the chance of curing it, improving better quality of life for all patients and reducing costs for the system. Screening tests are available for some of the most important noncommunicable diseases (NCDs). Despite significant disease-related strategies and approaches (e.g. Recommendation on cancer screening) set up by the European Commission to exchange good practices across member states, EU action on secondary prevention is still limited. Access to early diagnosis, which is a central component of secondary prevention, also varies across countries, challenging EU goal to give people equal access to high-quality healthcare.
During the debate, WHO Senior Advisor Ms Luminita Silvia Hayes illustrated new strategic priorities aimed at ensuring 1 billion more people benefit from universal health coverage; 1 billion more people are better protected from health emergencies; and 1 billion more people enjoy better health and well-being. Achieving this “triple billion” target could save 29 million lives by 2023, while bringing innovation and transformation in healthcare systems, and achieving the Sustainable Development Goals (SDGs), with a particular focus on SDG3.Innovative solutions are showing good results, such as in Slovenia relating to cardiovascular programmes, and solutions are being designed to more advanced approaches that require intersectoral actions. On 13-14 June 2018, WHO high-level regional meeting is being held in conjunction with the 10th anniversary of the signing of the Tallinn Charter. As emphasised by Ms Luminita Silvia Hayes, there is a ¨need to show our health systems are strong, resilient and adaptable to a changing environment¨.
Personalised medicines – defined as new medical model built around an individual – are new frontiers in health care designing tailored screening, early diagnosis and therapeutic strategy for the right person at the right time, determining the predisposition to disease and/or delivering timely and targeted prevention. In this frame, coordination between resources is essential to deliver better health outcomes, as pointed out by Ms Irene Norstedt, Head of Unit for Innovative and Personalised Medicine at DG Research and Innovation in the European Commission. Current projects, such as EuroGentest, aim to make a real difference in the field of rare diseases, standardising genetic testing, supporting professional services providing information to the public and promoting novel technologies into current practice.
Mr Davide Integlia, Director for Innovation at the I-Com – Institute for Competitiveness, highlighted how secondary prevention can reduce healthcare costs while innovating healthcare systems. To do so, resource planning model need to be revised, especially at the national level. Very modest resources are allocated to prevention policies, from 1.2 to 3.4% only. National governments mainly focus their attention on savings without a pluriannual strategy that allow healthcare systems to change the pattern of cost generation. National provisions should be less oriented to cost minimization and consider more principle like cost-effectiveness and provide measures based on the evidence-based medicine, emphasised Mr Integlia. Moreover, the potential of Artificial Intelligence (AI) within mass screening programs for the prevention of diseases, such as diabetes or cardiovascular diseases, is considerable and would lead to a 10% cost saving for the National Health System.
The debate was also enriched by the contribution of Ms Peggy Maguire, Director General of the European Institute of Women’s Health, and Mr Johan Prevot, Executive Director of the International Patient Organisation for Primary Immunodeficiencies, on the value of screening in women health and newborns.
Statistics show the incidence and prevalence of certain diseases are higher among women, who yet remain the heaviest medicine users underrepresented in clinical trials, research and data. Healthcare systems should be highly more responsive to their health needs. Maternal health is a vital point for public health intervention to reduce the burden of illness and promote wellbeing. Also, cancer screening programmes are of utmost importance since cancer represents the second leading cause of death in EU women.
Furthermore, SCID newborn screening is becoming a reality in the world, but there is still slow uptake in the EU. Urgent actions need to be developed to tackle disparities between countries in line with other EU developments, such as the European Reference Networks (ERNs). Without early diagnosis and proper treatment babies will die before their first birthday.
MEP José Inácio Faria (EPP, Portugal) concluded the meeting calling for a real behavioural change. Patients play a vital role in implementing effective secondary prevention policy. Health literacy and awareness raising are key enablers to overcome stigma around diseases and to shift mindset towards health promotion prevention and early intervention tools.
As enshrined in the 5 Health First Europe Factsheets showcasing early diagnosis and screening examples already incorporated into the patient pathway, secondary prevention not only gives more chances to a better life to EU citizens but also paves the way for a more reliable and efficient health system. Although healthcare is a national competence, this should not turn EU policymakers away from working toward better coordination and mutual learning that will lead to more targeted, effective opportunities for prevention, treatment and care.