The debate on the future of healthcare is very rich and active in Finland, where the reduction of inequalities, the effectiveness of the system and new investments in health are among the main priorities that should be pursued according to the local Pharma Industry Association, Lääketeollisuus ry. “Adequate funding for health care and medical care must be secured and new, flexible financing models need to be developed, so all Finns will have equal opportunities for timely and optimal care regardless of their financial position or place of residence”, said the president of the Association, Sanna Lauslahti, commenting the objectives for the next government term. The next Parliament elections in Finland are due on 14 April 2019.
Improve the access of patients
In the commentary published on the Lääketeollisuus ry’ website, Sanna Lauslahti criticised the delays often observed by Finnish cancer patients and their neighbours to access new therapies, if compared to other European countries. Treatment options are also internally fragmented across different Finnish regions. Something that – according to president Lauslahti – is in contrast with the very good reputation of the welfare system of the Nordic country. The request for the new government is thus to provide adequate funding for health and medical care, together with new, flexible financing models. “Funding channels must not control access to care”, added Mrs Lauslahti.
According to Pharma Industry Finland, innovative and well-targeted treatments are not only important to improve patients’ health and quality of life; they may offer also many opportunities to better manage healthcare and social costs, as well as indirect costs related to labor or disabilities.
But the current Finnish model of evaluation of new medicinal products needs improvements to avoid the observed fragmentation: the suggestion for the new government advanced by Lääketeollisuus ry is to establish a single Health Technology Assessment body for hospitals, outpatients and vaccines.The medication reimbursement system should also discontinue the mutual valuation of diseases among different categories of compensation. “Resource allocation should increasingly be based on knowledge management, and treatments should be evaluated from the point of view of their effectiveness and value, not just through the costs generated. This requires that health data be utilised more and more effectively. We also need nationwide charters and impact indicators”, said Päivi Kerkola, the chairman of the Board of Directors of Lääketeollisuus ry.
The many opportunities for pharmaceutical R&D
Another main target for the new government suggested by Pharma Industry Finland is a major attention towards pharmaceutical R&D, in order to create an effective research ecosystem. The Health Sector Growth Strategy already adopted by the current Finnish government defined the pharmaceutical industry as the engine for health and economic growth in the country.
The Strategy sees the cooperation of the Ministries of Employment, of Economy, Social Affairs and Health and of Education and Culture and it extends more broadly to the entire life sciences sector. The establishment of a national cancer centre and genome centre are among current main investments, made by the funding parties (the Academy of Finland and the Finnish Funding Agency for Technology and Innovation-Tekes).
The Strategy is striving to reinforce the role in pharmaceutical R&D of the Finnish highly educated healthcare professionals and the activities for the recruitment of patients, in order to establish the country as a main location within Europe to run clinical studies. Many patient registries are already available in Finland, as well as a wide portfolio of blood and tissue samples collected by biobanks. This last sector is based on a legislation considered to be one of the most advanced worldwide, and which is due to be further revised and improved to ameliorate it. New steps in this direction that might be pursued by the new government might include amendments to make possible the information already contained in registries can be used for patient recruitment and registry-based research. Finland is also setting up a one-stop application and filing process which will considerably accelerate the current handling of applications. There is also a need for close cooperation between the research community, hospitals and healthcare companies, according to Pharma Industry Finland.
The importance to invest in real world data
Real world data (RWD) are the future of pharmaceutical research, as they allow to assess the effective behaviour of a medicinal product on the general population, outside clinical trials. A research report published on Lääketeollisuus ry’ website describes the finding of a survey run by MedEngine on behalf of the Pharma Industry Research Foundation and aimed to assess the current status of RWD research in Finland.
According to results, some more steps are needed in order to place Finland in a good position in the highly competitive scenario, starting with the need to approve the new law for the secondary use of health and social data. The culture of real world evidence has also to be improved among healthcare professionals and organisations, as well as the knowledge and understanding of the global operations and strategies typical of the pharmaceutical industry. A sufficient number of data scientists with expertise in health data analytics should be available, and expertise in artificial intelligence’s applications (i.e. machine and deep learning) would be also valuable. The attraction of international investments may help to expand the sector and create commercial value, and to establish Finland as a new first-class destination for effective drug development processes, new pricing models and improved and more effective approach to health management and treatment.
The FinnGen study
An example of the opportunities offered by the Finnish pharmaceutical R&D is given by the FinnGen study, that plans to analyse up to 500,000 unique blood samples collected by a nation-wide network of Finnish biobanks. The project is funded over six years by a current budget of € 59 million and aims to better characterise the unique genetic heritage of the 5,5 million Finnish population. Two thirds of the budget are expected to come from seven pharmaceutical companies participating to the project (Abbvie, AstraZeneca, Biogen, Celgene, Genentech, Merck and Pfizer) and one-third from Tekes.
The project is coordinated by the University of Helsinki and the Helsinki University Central Hospital, and sees the collaboration of many other biobanks and research organisations. The Finnish genetic heritage is much less heterogenous than those of other European populations, thus it “makes Finland a great testbed for genomic research”, according to Kimmo Pitkänen, director of the Helsinki Biobank, and can make the analysis of genomic data much more faster and effective. The ultimate goal of the project is to identify new therapeutic targets and diagnostics for treating numerous diseases. ”Tekes wanted to support the project, because of its potential to promote healthcare innovation and to support the growth andinterna- tionalisation of local businesses,” said Minna Hendolin, responsible for Health and Wellbeing at Tekes.