MedTech Forum, Brussels: Norway puts pain ahead of price when picking catheters


A Norwegian hospital group factored in patient perception of pain and when deciding which intravenous catheters to buy. As a result, it bought more expensive devices, but they are easier to use, saving time, reducing pain

A pilot project in Norway has added patient and nurse feedback into its tender evaluation criteria when buying intravenous catheters. Rather than buying the cheapest device at the minimum specification, key criteria such as the level of pain patients feel when the catheter is inserted into their arm and how often the product must be replaced, were factored into procurement decisions.

“Our scoring method allowed us to see the big picture and helped avoid buying a cheap product that would cost more in the long run. And, importantly, it improved the quality of the service we provide to patients,” Kjetil Marius Istad, Director of Procurement and Logistics in Helse Sør-Øst RHF, the largest regional health authority in Norway, told the MedTech Forum in Brussels earlier this month.

Millions of patients have catheters placed in their arms in European hospitals every year and the products are sold by several companies. Norway has an agreement with the medical technology sector that allows hospitals to test products to see which one users – health professionals and patients – like best.

“When we ran a tender to purchase intravenous catheters we gave health professionals a chance to use [the agreement] and sought feedback from patients,” Istad said. “During this two-month testing period, we found that the cheapest catheter was not as sharp or flexible as the competing product, and health professionals often needed to try more than once to puncture the patient’s skin.”

For patients, this lack of flexibility and difficulty inserting the catheter were major drawbacks. In some cases, the catheter had to be removed and replaced, costing time and money. “The phrase ‘buy cheap, buy twice’ came to mind on these occasions,” said Istad.

Pricing pain

Price, dependability and other factors were still accounted for in the scoring method used by procurement officials, but the system is one of the few that includes not only patient reported outcomes but also patient experiences of healthcare procedures.

Industry experts at the MedTech Forum viewed this approach to procurement as a practical way of incorporating patient outcomes and promoting value-based healthcare.

Götz Gerecke of BCG, a consulting firm, said feedback from patients is one of several factors that will drive the future of health policy and guide procurement policy. “Value-based healthcare can be viewed as a simple equation: the outcomes that matter to patients divided by the cost of achieving those outcomes,” he told a session at the event.

Gerecke called on companies that produce devices, diagnostics and hospital equipment to invest in measuring patient outcomes even if this adds to the cost of doing business. “I recommend that healthcare companies invest now; this is the future,” he said.

Procurement pilots

BCG and the medtech industry have developed a new tool to guide procurement decision-making. The system includes 34 criteria ranging from price to reduced infection rates. The consortium, which plans to step up its activity next year, hopes it will be embraced throughout Europe to ensure that a common approach is taken to assessing the value of health technologies. 

In 2017, the initiative will roll out several pilot projects that use this approach to tendering and will encourage companies and procurement officials to join a ‘community of practice’ where experience can be shared.

“We are launching 10 pilots and plan to bring together people working in this area to generate and share expertise,” said Yves Verboven of MedTech Europe. 

The focus on patient outcomes was reflected throughout the conference from speakers in the areas of health technology assessment, regulators, payers and the industry.

John Carlson, President of Flex Medical, a company that designs and builds connected medical products, told the conference that medtech companies need to think more broadly about delivering value to the healthcare system. “We have a triple aim: satisfaction, cost and outcomes,” he said. “We are moving from a fee for service model to a fee per outcome model with the consumer at the centre.”

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