Archive for July, 2018

Gift Of Life Campaign Advocacy Guidance for National Members

EKHA has developed tailored advocacy campaign guidance here to help our network get involved with and disseminate the key messages of the Gift of Life campaign to improve access to transplantation in Europe.

Given that hospital-based dialysis can cost as much as 80K€ per patient per year, that 1 in 10 Europeans has some degree of kidney impairment and that 3 patients per day die in the EU while waiting for a transplant, EKHA believes it is urgent to call for a change to policies affecting kidney health and patient care in Europe.

EKHA is encouraging European stakeholders to take action to ensure this change will happen. How? By advocating towards public and private audiences e.g policy-makers, industry, insurance/payers, doctors, patients, families, etc. in favour of organ donation and transplantation. Advocacy is not reserved to an elite. It can be done by anyone possessing the right methodology, tools and knowledge needed to know where to start and how to progress towards a goal.

Feel free to contact sara.martin@ekha.eu if you have any questions!

Prevention is better than cure

Just a couple of months after it launched its new Best Practices Portal, the European Commission announces the creation of a Steering Group on Promotion and Prevention.

Composed of representatives of EU Member States and chaired by the EC, the Steering Committee aims to help EU Member States reach the UN Sustainable Development Goals related to health and to reduce premature mortality from non-communicable disease.

These initiatives clearly illustrate the Commission’s willingness to focus – and invite Member States to do so – on dedicating time and resources to measures for preventing chronic diseases, including chronic kidney disease, rather than on curing them.

In practice, the Steering Group will provide expert advice to the Commission on developing and implementing activities in the field of health promotion, disease prevention and the management of chronic diseases. Sharing best- practices and experiences between EU Member States will form an important part of the work of the Committee. The EC best practice portal on non-communicable diseases launched in April 2018 provides a useful tool in this framework.

Thought as a ‘one-stop shop’ for consulting good and best practices and submitting practices for assessment, the online portal currently references best practices from over the last two years and covering actions funded under the EC Health Programmes.

In addition to advising the Commission on the selection of best practices, the newly established Steering Group will work with the European Commission to replicate and implement successful projects in other EU member States and/or scaling these up at the European level – using the funds from the EU Health Programme or other EU financial instruments.

The EC Expert Group will hold its first formal meeting on 6 November 2018 in Luxembourg.

More information on the Steering Group here.

Non-communicable diseases (NCDs): Has progress been made on the SDGs?

Heads of State and Government from around the world will take stock and make recommendations on this issue as part of the third UN High-level Meeting on the prevention and control of noncommunicable diseases (NCDs) which will undertake a comprehensive review of the global and national progress achieved in putting measures in place that protect people from dying too young from NCDs.

Chronic diseases (or Non-Communicable diseases (NCDs))  of which chronic kidney disease is an important percentage, remain the major cause of deaths in Europe, resulting in the premature death of 500,000 people of working-age in the EU each year1. Mortality from these diseases account for €115 billion economic loss annually for EU economies2.

In parallel, evidence suggests that even a relatively minor increase in funding for disease prevention would result in considerable health gains and reduced future healthcare costs. Despite this, healthcare expenditure is still dedicated to treatment – (97%) and only a small portion (3%) goes to prevention. Unsurprisingly, chronic kidney disease is given relatively low priority within the public health response.

In the context of the UN High-level Meeting, it is expected that Member States will be encouraged to move from reflection to action, and to focus on prevention. This would echo the latest European Commission-OECD reports as part of the “State of Health in the EU” cycle which, albeit acknowledging that  important progress was made when it comes to addressing risk factors and treating NCDs, stressed that there is room for improvement in prevention and management.

zero draft outcome document for the UN meeting in September is now out and negotiations are taking place.

The event is likely to provide a good platform for the EU to demonstrate the European added-value of EU health policy and collaboration and it is hoped it will contribute to accelerate the very much needed paradigm shift from disease care to health care. Health promotion and disease prevention are indeed key to more effective and efficient health systems, reducing premature mortality from chronic diseases and ensuring a healthy future for European children.

More information on the UN High-Level Meeting on NCDs here.

*Sources

  1. OECD/EU (2016), Health at a Glance: Europe 2016 – State of Health in the EU Cycle, OECD Publishing, Paris. 
  2. See note 1

CKD care: a changing landscape

Given that 2% to 3% of health expenditure in most European countries is absorbed by patients on dialysis who represent just a small fraction (0.1%–0.2%) of the general population…it is admitted that a shift is needed to ensure appropriate treatment for CKD patients in the long run through cost-effective renal replacement therapies such as transplantation and home dialysis, but also by preventing renal diseases.

Focus  on prevention should increase in the coming years. Indeed, preventive medicine is historically in the remit of general practice, and the new instruments for prevention that are being developed will contribute to expanding the GPs’ remit. Like General Practitioners, the role of nutritionists, pharmacists, social workers, physicians, etc. will increase in the care pathway for CKD patients.

In addition, the evolution towards a more patient- centered approach has sparked reflections like the establishment of interdisciplinary care clinics (IDCs*). Studies suggest that IDCs “may improve patient education and preparedness prior to kidney failure, both of which have been associated with improved health outcome” . Interdisciplinary care may also “delay the progression to end-stage renal disease and reduce mortality”. Most studies suggest that interdisciplinary care services are likely cost-effective but there are still uncertainties as to the long-term cost-effectiveness of IDCs. In addition, the creation of IDCs raises challenges regarding financing and insurance.

Changes to kidney care pathways, evolution of specialists’ areas of competences, move to a more patient-centered approach, etc. all foster a significant shift as regards kidney care, and a collaborative approach from the point of view of prevention, care, treatments, etc. will be the cornerstone of this evolution.

EKHA welcomes this evolution and believes collaborative efforts drawing upon the patient’s experience based expertise as well as medical knowledge are essential to increase CKD prevention, improve early detection of CKD, and provide more efficient treatment to help reduce the predicted tide of new cases of kidney failure needing Renal Replacement Therapies (RRT).

See EKHA recommendations for Sustainable Kidney care here: http://ekha.eu/policy/

Sources:

* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603306/