At a time when regulation of health care is increasingly complex and providing health services is increasingly expensive, how can global health be maintained or improved?
That was the overriding question at the two-day Global Health Care Regulation and Innovation Conference, held at Peking University in China in June. The first such gathering of its kind, the conference drew more than 200 people. It was jointly hosted by the Leonard D. Schaeffer Center for Health Policy and Economics at USC and the Guanghua School of Management at Peking University, with the support of Quintiles, a global biopharmaceutical services company.
Conference participants included members of academia, representatives of the pharmaceuticals and insurance industries, and government officials from both the United States and China.
Several USC faculty members took part as featured speakers, presenters or panelists. Among them were Dana Goldman, Schaeffer Center director and holder of the Norman Topping Chair in Medicine and Public Policy; Leonard D. Schaeffer, Judge Widney Professor, who established the Schaeffer Center; Julie Zissimopoulos, associate director of the Schaeffer Center and associate professor at the USC School of Pharmacy; Darius Lakdawalla, director of research at the Schaeffer Center and associate professor at the USC Price School of Public Policy; Michael Nichol, professor at USC Price and the School of Pharmacy; and Frances Richmond, School of Pharmacy professor and director of the Regulatory Science Program.
“There was a good deal of discussion about the ways that innovation occurs in the U.S., and the constraints, particularly on drug development, which are relevant to China because it is in the process of accelerating its drug-development efforts,” Nichol said. “We found that both countries operate within geographic and political constraints that affect policymaking in health care, such as budgetary restrictions in some Chinese provinces and some U.S. states, which limit their ability to offer comprehensive services.”
During the gathering, six major themes emerged from the focus on regulation and innovation:
• a model of cooperation on food and drug safety: Cooperation between the U.S. Food and Drug Administration and the Chinese State Food and Drug Administration has significantly improved the safety of food and drugs manufactured in China. Does this make it likely that future advances in health care innovation and regulation will catalyze global cooperation on drug approval processes and regulatory structures?
• improving government investment: With rapidly expanding use of health services in China, the country has a large and growing financial stake in health care. Like in the United States, China’s public investment in insurance and care can spur innovation, but how can that be done without draining the country of resources? And is the return on investment satisfactory? Lakdawalla suggested that rewards for innovation must be set at the right price and innovation must be appropriately utilized.
• a balanced approach to creating targeted therapies: The growth of personalized medicine can pose regulatory challenges, Goldman explained. For example, separating diagnostics from treatments can be wasteful, as when diagnostics are priced too high. He argued that efforts to improve the development process for targeted therapies must continue.
• importance of reforming the payment system: To maximize patient benefits from the wealth of medical knowledge and innovation available, both the costs and revenues associated with health care must be transparent, particularly in public hospitals.
• the role of data collection in improving health care: China is emerging as a global leader in the collection of many different measures of patient outcomes and satisfaction. One potential use of such information gathering is harnessing consumer behavior to improve the delivery and consumption of health care.
• resolving policy uncertainty: Doubt about policy suppresses innovation, which is exacerbated by the size of China’s population and the mobility of its citizens. On the other hand, policy certainty creates a context for the future success of health care innovation and regulation, critical for both China and the United States.
“China and the U.S., both large countries with diverse populations, have similar problems but operate within different types of systems,” Nichol noted. “By sharing the perspectives of each country, we can expand the alternatives we consider. The conference was a great opportunity to explore those perspectives and the possibilities for future collaborations.”
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