Value-based healthcare in Spain: Regional experimentation in a shared governance setting is an Economist Intelligence Unit (EIU) report, commissioned by Gilead Sciences. It looks at health outcomes of treatment relative to cost and at the structure of Spanish healthcare delivery, the process of making healthcare more accountable in Spain, and the growth and adoption of value-based measures.
Spain’s decentralised National Health System grants financial, planning and management powers to the regional health services of the country’s 17 autonomous communities and two autonomous cities. In addition the regions also have more responsibility for the appraisal of treatments and care pathways, and for final price negotiations with drug manufacturers.
This paper will show that the process of making healthcare more accountable in Spain is evolving in a number of ways but the growth and adoption of value-based measures remain fragmented. This is largely due to the decentralised administration of healthcare in the country.
Why read this report
- Since 2012 all regions have been members of Spain’s inter-ministerial pricing committee taking cost, efficacy, safety and need into account when determining the coverage of “curative care” for both outpatient and inpatient services. However, Spanish authorities do not consistently evaluate cost-effectiveness or budget impacts.
- Healthcare planning and policy at a regional level can greatly vary due to the dominance of a political party in the regional government or because regional health authorities take into account the leverage of the industry in the region. These considerations are becoming increasingly important in price negotiations between pharmaceutical companies and the regions.
- Spain’s regions have begun to pioneer ways of extracting greater value from their healthcare investments and are sharing best practices accordingly but the system still needs to develop better measures of value and learn how this can be best delivered.
