Diabetes Care in The Netherlands: - Novo Nordisk

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Significant Significant evidence evidence gaps gaps in in basic basic statistics statistics and and in in treatment treatmentevidence suggest insufficient supporting incentivesEXAMPLESDescriptivestatistics• How many patients are there?• How many Type 1 patients are there?• In what stages of the disease are they?• In which regions and which groups is therapy adherence high?• How often do complications really occur?• What is the impact of labour productivity of the different complications?• What is the average cost of treatment Type 1 and 2 per stage of diabetes?• What is the relationship between cost of complications and the progression of the disease?• What are cost of treatment differences per region?Effect oftreatment• How often do which diabetic complications lead to working disability?• What is the impact of therapy adherence?• What is the life expectancy of Type 1 and Type 2 patients?• What is the impact of prescribing insulin when currently SU-pills are prescribed?• How would GLP -1 contribute to therapy adherence?Booz & Company 14 November 2011 Prepared for Novo Nordisk3340
Recommendation 1: Insurer should integrate contracting of ofprimary care and specialist care in networksprimary care and specialist care in networksIntegration contracting ofprimary care and specialistcare• Gain sharing for primary care• Expected impact of substitutionin volume agreements withhospital• Specialist can charge standardhour tariff for support toprimary care• Support IT infrastructurePOHGPPrimary careObjectives Resource Constraints Resultingbehaviour• Providecomplete andcomprehensivecare• Realize income• Protocol• Income relatedto quality gains• Access tospecialist adviceResource fromintegrated care• Lack of time fordedicateddiabetes serviceInteraction and collaboration• High qualityprimary care incollaborationswith thespecialistImpactIntegrated careInsurer• Provide the bestcare• Realizerevenues for thehospital andhimself/herself• Periodic reviewswith GP onpatients in theGP practice• Enabling ITsupport• (Largely) fixedincome fordiabetespatients• Supports GPsin providingbetter care• Serves patientswho really needspecialist careDiabetic nurseSpecialist careResource fromintegrated careConstraint fromintegrated careImpactIntegrated careBooz & Company 14 November 2011 Prepared for Novo Nordisk3441
Page 6 and 7: SummaryDiabetes is a serious and de
Page 8: diabetes care. Extra compensation w
Page 11 and 12: ContentsSummarized findings and rec
Page 13 and 14: 11Diabetes is a major and underesti
Page 15 and 16: 33Further improving health of of di
Page 17 and 18: 22Recommendation 2: Engage employer
Page 19 and 20: 44Recommendation 4: Introduce condi
Page 21 and 22: Already more than 1M diabetes patie
Page 23 and 24: Costs of of complications and treat
Page 25 and 26: Number of patients reaches ~1.4M in
Page 27 and 28: Increase in lost productivity is dr
Page 29 and 30: Diabetes care clearly improved in t
Page 31 and 32: Better compliance can be stimulated
Page 37 and 38: Delaying complications saves medica
Page 39 and 40: LimitedLimitedcollaborationcollabor
Page 41: Individual quality incentives are l
Page 47 and 48: Labour shortage from late nineties
Page 49 and 50: However, curative and participative
Page 53 and 54: Non-compliance leads to severe comp
Page 55: Facilitated patient networks are su
Page 58 and 59: Recommendation 3:Facilitate network
Page 62 and 63: But new medication could add a lot
Page 66: Booz & Company is a global manageme

Diabetes Care in The Netherlands: - Novo Nordisk

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