To Operationalize the VBHC in the Medical Device Area – An Italian Experience

OBJECTIVES: The Value-Based-HealthCare (VBHC) theory has been widely shared all over the world. Where applied, results are good in terms both of clinical outcomes and cost savings. As it is not immediate to change the system according to the VBHC rules, one of the starting points is often a change of the purchasing process, with a partnership between suppliers and providers, where the concept of “value” stated according to the VBHC theory (outcomes that matter to patients/costs to achieve these outcomes ) can be applied. The aim of this analysis is to share the experience of a single medical device company (Medtronic Italia SpA) in the Italian Healthcare setting to describe patterns to apply the VBHC concept.

METHODS: All the agreements signed in the last six years by Medtronic Italia were included in the analysis, both with private and public accounts. Specifically, the agreements and tenders with a risk-sharing clause, and/or solutions offered including monitoring outcomes, have been selected.

RESULTS: Since 2019 Medtronic Italia SpA has signed 45 agreements in 10 private and 8 public accounts under the “value offers” umbrella. The therapeutic areas involved have been mainly cardiovascular therapies (35 agreements), neurological therapies (4 agreements), and general surgery (1 agreement). The majority of agreements included a risk-sharing clause based on clinical outcomes according to the literature and validated with clinicians, different therapy by therapy, with a scheduled pay-out if the outcomes were not met. A data collection platform was generally offered to monitor outcomes, with the aim to improve patient pathways.

CONCLUSIONS: During these years several steps were done to operationalize the VBHC theory in the medical device field in Italy. The evolution of the purchasing process has been observed year by year in the private and public sectors.