Value-based procurement initiative for heart failure diagnostics
Cwm Taf Morgannwg University Health Board (CTMUHB) of NHS Wales, Roche Diagnostics UK Ltd, Life Sciences Hub Wales and Digipharm have launched a cutting-edge collaborative initiative to explore an innovative value-based contracting approach to pioneer sustainable value-based procurement models in Wales.
All partners have been working together to pioneer the development of an outcome-based agreement model for a diagnostic test (Roche’s NT-proBNP) in Heart Failure using Digipharm’s blockchain platform. This is the first of its kind and will push the boundaries of existing value-based reimbursement agreements into the diagnostics sphere.
This project will focus on the value of the diagnostic test within the heart failure pathway, initially in primary care, and explore the development of a fair reimbursement structure based on the value observed across the care continuum for these patients and the healthcare system.
The collaboration will explore and identify key outcomes that matter to patients and healthcare systems
alike with the aim to identify impacts on efficiency, time to diagnosis, resource impact/staffing and impact on health outcomes.
The project will enable procurement, clinical, operational and informatics teams at NHS Wales to develop
and pioneer VBHC-led purchasing strategies for diagnostic technologies in the future, in addition to
outcome-based contracts for therapeutics and devices used widely across the healthcare ecosystem.
In order to optimise the use of the diagnostic test and improve patient outcomes, all partners are initially
working together to understand how the diagnostic test is being requested and used currently
within primary care heart failure pathways and establishing a baseline for relevant KPIs/outcomes from
which future value-based reimbursement models can be modeled.
The final stages of the project will see a proposed collaborative purchasing approach for NT-proBNP’s longterm implementation, which will be underpinned by evidence from CTMUHB data and captured by an overarching outcome-based agreement. This information will act as best practice for other departments and Health Boards wishing to incorporate sustainable value-based procurement into their workflows. Whilst the VBHC ecosystem in Wales is relatively advanced, the successful completion of this project will lay the foundation for an all-encompassing VBHC reimbursement environment (by identifying what is available, what is missing and what is needed) where capability to implement flexible reimbursement models for medicines, diagnostics, medical services, and digital therapeutics will be invaluable in developing a sustainable health economy that rewards value.