Teva, the world’s largest generic drug company, and Mount Sinai Health System, one of the largest hospital groups in the United States announced a partnership to improve patient and health system care for Multiple Chronic Conditions.
The initiative was announced to an audience of public health leaders at the World Economic Forum’s (WEF) Sustainable Development Impact Summit. The meeting, which formed a part of the Summit, was convened to advocate for action to address Multiple Chronic Conditions (MCC), an emerging and unaddressed global health threat.
MCC are defined by the presence of two or more chronic conditions in a patient, representing a growing pain point for families and society. Currently, one in three adults globally, and two in three adults over the age of 65, suffer from two or more chronic conditions.
MCCs are a global problem spanning multiple disease areas and affecting patients, communities and healthcare systems in different ways. The top conditions contributing to mortality and morbidity in high-income countries include ischemic heart disease (IHD), stroke, lung cancer, depression, diabetes and back and neck pain. In low- and middle-income countries, the top diseases include IHD, stroke, diabetes, and depression, as well as communicable diseases, such as diarrhea, HIV and tuberculosis.
Teva and Mount Sinai aim to gain new data and insights into interventions that can meet the needs of people with MCC. One pillar of this effort is a regional pilot program at Mount Sinai’s Arnhold Institute for Global Health in New York, which will design and evaluate a patient-centered, integrated approach and ultimately, adapt it for delivery to larger patient populations.
A new report introduced at the meeting, Multiple Chronic Conditions: The Global State, quantifies the health, economic and personal burden weighing on patients, families and healthcare systems. The report found that with each additional chronic condition, healthcare costs more than double, so that treating a patient with four chronic conditions could cost as much as 16 times more than a patient with only one condition. It also revealed that multiple chronic conditions also greatly reduces the patient’s ability to comply with medication, increases the likelihood of depressive symptoms and greatly increases the care burden on families and health facilities.
The report also found that focusing care around the patient’s overall health and wellbeing as opposed to treating individual diseases in isolation, and by employing better technologies, health systems can actually reduce the cost of care while improving the quality of life for patients. Proposed changes include re-introducing the concept of a family doctor, since the family doctor can coordinate care, creating patient-focused teams of specialists who work better together, improving opportunities for home care, and creating combination therapy drugs that reduce the need for patients to take a large number of different medicines and improve adherence.
“All signs in our research support the fact that as the current population ages, and more young adults are diagnosed with multiple chronic conditions, the cost and complexity for healthcare systems will rise exponentially,” said Derek Yach, MBChB MPH and co-author of Multiple Chronic Conditions: The Global State. “The global scale of this growing public health issue warrants a much more robust, well-integrated response. Now is the time for action and pragmatic solutions that will help alleviate pressure on governments, providers, patients and their families.”
“While the personal challenges may differ, the mental, social and financial strain of multiple chronic conditions on patients and their families is universal,” said Iris Beck Codner, Group Executive Vice President of Teva Pharmaceuticals. “We hope this effort will shed light on the unique pressures weighing on patients and the potential for centering treatment on the patient versus individual conditions to help them live better and longer lives.”
"In low-income and underserved communities, nearly one in every two patients suffer from multiple chronic conditions," said Prabhjot Singh, MD, PhD, Director of The Arnhold Institute for Global Health and Chair, Department of Health System Design and Global Health, Mount Sinai Health System. "Health systems must do a better job of caring for these patients in ways that incorporate the full context of their lives. Our goal at Mount Sinai is to develop better methods and care models to change the trajectory of outcomes for these patients in New York and around the world, and ultimately drive impact to keep patients healthier for longer.”
The Summit discussion and Multiple Chronic Conditions report reviewed opportunities to reduce the toll from MCC. Potential areas for exploration in public-private partnerships include:
- Cross-Condition Management: Opportunities include innovative primary care models that coordinate treatment of different conditions across providers, as well as guidelines to help providers assess and treat patients with MCC by using symptom-based algorithms.
- Medication Regimen Simplification: Adapting dosage plans so patients have fewer pills to remember – and take – each day, as a way to increase control of chronic conditions. For example, providers can improve the patient’s medication adherence by prescribing fixed-dose combination medicines, which combine multiple medications in a single pill, and with digital compliance technology, such as pills with sensors that generate data the medical team can monitor.
- Technology-based Solutions: Making care more accessible and personalized through advancements such as telemedicine and remote monitoring to provide on-demand treatment, as well as cognitive computing to derive insights into medication interactions.
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