Healthcare as a business case: Which importance is placed on societal impact vs economic impact?

Healthcare as a business case: Which importance is placed on societal impact vs economic impact?

by | Apr 26, 2023 | Blog, mHealth

Over the past decade, public spending on health in Denmark has been above the EU average. Due to the COVID-19 pandemic, government spending on healthcare has grown by more than 5% in 2020 alone [1], reaching total healthcare expenditures of DKK 270.794m in 2021 [2]. But how does Denmark decide which new treatment approaches to spend money on, and does the societal impact of healthcare measures play an equally important role as their economic impact?

Though member states of the European Union are not precluded from “releasing marketing authorisations valid at national level” for new medicines/treatments, EU-wide marketing authorisations require new treatments to go through a centralised authorisation procedure managed by the European Medicines Agency (EMA), which evaluates the pharmaceutical quality, safety, and efficacy of new treatments [3]. However, whereas obtaining marketing authorisation on an EU level allows providers to offer their new medicines/treatments, it is mainly the national health authorities’ decisions on reimbursement and pricing measures that affect if patients will have access to them [3]. 

In Denmark, the Danish Medicines Council (Medicinrådet) is an important body that assesses new treatment approaches and makes recommendations related to which medicines/treatments should be used in the Danish healthcare system [4]. Typically, cost-effectiveness and the impact on the healthcare budget are two important economic factors that national health authorities consider during such evaluations [3]. But what about the societal impact of new treatments? Does it receive sufficient consideration during the assessment procedures? 

Let’s take innovative digital health solutions as an example. If we purely consider the direct economic costs digital health solutions for mental health can help to reduce, such as the costs for (re)hospitalisation (e.g., DKK 6.000 per day), do we really get a full picture of the value of these innovations in healthcare? Potentially not, as the societal impact would not have been considered.

For instance, we would have not taken into account that digital health solutions for mental health can significantly improve the quality of life of individuals suffering from mental disorders [5], or that these innovations can enable mentally ill individuals to better recover and return to work faster. Neither would we have considered that digital solutions can facilitate making better use of resources available in the future, for instance by helping clinicians to handle growing patient data volumes they often feel overwhelmed with [6]. 

The societal impact of new treatments may be more difficult to quantify than the pure health economic impact, but we believe it is an important factor to consider when evaluating innovative approaches. At Monsenso, we have made it our mission to enable better mental health for more people at lower costs, and the positive societal impacts and increased quality of life that we help generate are as important to us as the pure health economic impact.
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About Monsenso
Monsenso is an innovative technology company offering a digital health solution used for decentralised trials, remote patient monitoring and treatment support. Our mission is to contribute to improved health for more people at lower costs by supporting treatment digitally and leveraging patient-reported outcomes data. Our solution helps optimise the treatment and gives a detailed overview of an individual’s health through the collection of outcome, adherence, and behavioural data. It connects individuals, carers, and healthcare providers to enable personalised treatment, remote care, and early intervention. We collaborate with health and social care, pharmaceuticals, and leading researcher worldwide in our endeavors to deliver solutions that fit into the life of patients and healthcare professionals. To learn more visit  www.monsenso.com

References: 

[1] European Commission (2021). State of Health in the EU · Denmark · Country Health Profile 2021.
https://eurohealthobservatory.who.int/docs/librariesprovider3/country-health-profiles/chp2021pdf/denmark-countryhealthprofile2021.pdf?sfvrsn=e79f1c55_7&download=true

[2] Statistics Denmark (n.d.). Health care expenditure.
https://www.dst.dk/en/Statistik/emner/oekonomi/offentlig-oekonomi/udgifter-til-sundhed

[3] European Parliament (2015). Towards a Harmonised EU Assessment of the Added Therapeutic Value of Medicines.
https://www.europarl.europa.eu/RegData/etudes/STUD/2015/542219/IPOL_STU(2015)542219_EN.pdf

[4] Medicinrådet (n.d.). Danish Medicines Council.
https://medicinraadet.dk/om-os/in-english

[5] Monsenso (2022). Key research findings.
https://www.monsenso.com/wp-content/uploads/2022/06/Monsenso-Key-Research-Findings.pdf

[6] Elsevier Health (2022). Clinician of the Future Report 2022.
https://www.elsevier.com/connect/clinician-of-the-future

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Stress Awareness Month 2023

Stress Awareness Month 2023

by | Apr 21, 2023 | Blog, Mental Illness

April is Stress Awareness Month, which aims to shine light on stress and its consequences on our well-being, removing stigma and shame around mental health.  

Stress is our bodies’ and brains’ response to environmental changes or adverse events [1;2]. When we experience a situation that provokes stress in us, we either react to it positively (pro-adaptively) and are able to adjust to the situation well, or we react negatively (maladaptively) and struggle to cope with the situation.

Most people feel stressed at times throughout their life. For some, the stress just lasts for a moment or a short period. For others, it, unfortunately, prevails longer and can have debilitating consequences [3]. Negative responses to stress often present themselves as “a state of worry or […] tension” and can have both physiological and mental effects [1;2]. Chronic stress has not only been identified as a major risk factor for mental illnesses, such as anxiety or depression, but has also been linked to physical illnesses, such as cardiovascular and metabolic diseases [2].

In Denmark, the number of adults experiencing stress has increased significantly over the last few years. In 2021, elevated stress levels were recorded among 29% of the adult population, with 16–24-year-olds being the most affected age group [3].

For some people, practicing mindfulness and making smaller life changes, such as establishing a daily routine, creating better eating habits, and exercising regularly can help alleviate stress levels. For others, when stress becomes chronic and begins affecting one’s mental and physical health, seeking professional help can bring relief and help people improve their well-being.
However, many individuals struggling with their mental health do not seek treatment out of fear of being stigmatized and treated “differently […] or losing their jobs and livelihood” [4].

This is where digital health solutions for mental health offer an opportunity to empower individuals suffering from stress to better manage their own mental health and regain control over how stressful situations impact them. At Monsenso, we have worked with a variety of mental health disorders in both research and clinical settings. Our digital mental health solution has helped many individuals struggling with their mental health to better understand their conditions and live a more independent life. We are proud to support Stress Awareness Month and will continue to spread knowledge about mental health conditions and offer our support to individuals affected.
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About Monsenso
Monsenso is an innovative technology company offering a digital health solution used for decentralised trials, remote patient monitoring and treatment support. Our mission is to contribute to improved health for more people at lower costs by supporting treatment digitally and leveraging patient-reported outcomes data. Our solution helps optimise the treatment and gives a detailed overview of an individual’s health through the collection of outcome, adherence, and behavioural data. It connects individuals, carers, and healthcare providers to enable personalised treatment, remote care, and early intervention. We collaborate with health and social care, pharmaceuticals, and leading researcher worldwide in our endeavors to deliver solutions that fit into the life of patients and healthcare professionals. To learn more visit  www.monsenso.com

References:
[1] World Health Organization (2023). Stress.
https://www.who.int/news-room/questions-and-answers/item/stress

[2] Musazzi, L., Tornese, P., Sala, N., & Popoli, M. (2017). Acute or chronic? A stressful question. Trends in Neurosciences, 40(9), 525-535.

[3] Sundhedsstyrelsen (2022). Tal og fakta om stress.
https://sst.dk/da/Viden/Forebyggelse/Mental-sundhed/Stress/Tal-og-fakta 

[4] American Psychiatric Association (n.d.). Stigma, Prejudice and Discrimination Against People with Mental Illness.
https://www.psychiatry.org/patients-families/stigma-and-discrimination#:~:text=Public%20stigma%20involves%20the%20negative,have%20about%20their%20own%20condition.

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World Bipolar Day 2023

World Bipolar Day 2023

by | Mar 30, 2023 | Blog, Mental Illness

March 30th is World Bipolar Day. The awareness day aims to inform about the mental illness and the struggles it can cause for individuals suffering from it, improving sensitivity and eliminating social stigma.

Bipolar disorder is a complex mental illness [1] and is more prevalent than one might think. In 2019, 40 million people globally suffered from the condition [2]. Typically, individuals with bipolar disorder “experience alternating depressive episodes with periods of manic symptoms”, where euphoric feelings and reckless behavior may occur [2].

Bipolar disorder is a mental illness that often requires treatment over the course of many years [1]. Although there are a variety of effective treatment options available for the condition today, including medication and psychoeducation [2], the disorder is linked to high risks of relapse and hospitalisation [1]. In addition, individuals suffering from bipolar disorder are at a higher risk of suicide [2]. Among the age group of 15–44-year-olds, bipolar disorder is one of the leading causes of disability [1].

At Monsenso, we have a long history of trying to help individuals struggling with bipolar disorder to better take care of their mental health. Originally a spin-out of the EU-funded MONARCA Research Project, which aimed to create an innovational system allowing for better management, treatment and self-treatment of bipolar disorder [3], and with our continuous involvement in bipolar research and treatment support, we are committed to helping people living with the condition to live better, more independent lives.

We are proud to support World Bipolar Day and will continue to spread awareness and offer our support to individuals affected and clinicians providing treatment for the mental illness.
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About Monsenso
Monsenso is an innovative technology company offering a digital health solution used for decentralised trials, remote patient monitoring and treatment support. Our mission is to contribute to improved health for more people at lower costs by supporting treatment digitally and leveraging patient-reported outcomes data. Our solution helps optimise the treatment and gives a detailed overview of an individual’s health through the collection of outcome, adherence and behavioural data. It connects individuals, carers and health care providers to enable personalised treatment, remote care and early intervention. We collaborate with health and social care, pharmaceuticals and leading researcher worldwide in our endeavours to deliver solutions that fit into the life of patients and health care professionals. To learn more visit  www.monsenso.com

References
[1] Faurholt-Jepsen, M., Vinberg, M., Christensen, E.M., Frost, M., Bardram, J., Kessing, L.V (2013). Daily electronic self-monitoring of subjective and objective symptoms in bipolar disorder–the MONARCA trial protocol (MONitoring, treAtment and pRediCtion of bipolAr disorder episodes): a randomised controlled single-blind trial. BMJ Open,  24;3(7), e003353. doi: 10.1136/bmjopen-2013-003353. PMID: 23883891; PMCID: PMC3731717.

 [2] World Health Organization (2022). Mental disorders.
https://www.who.int/news-room/fact-sheets/detail/mental-disorders 

[3] Europäische Kommission (2019). MONitoring, treAtment and pRediCtion of bipolAr Disorder Episodes. CORDIS Forschungsergebnisse der EU.
https://cordis.europa.eu/project/id/248545/de

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Artificial intelligence creates individually tailored treatment for depression

Artificial intelligence creates individually tailored treatment for depression

by | Mar 28, 2023 | Depression, News, Research Projects

A new innovation project “Personae” will provide easier access to personalised digital treatment for patients with depression through Monsenso’s digital health platform. The project leverages patient-reported outcomes and AI to screen patients and to deliver a treatment tailored to the individual patients’ needs.

According to the WHO, more than one billion people worldwide have mental disorders, but the number of individuals receiving help is alarmingly low. In Western Europe, for instance, only half of the citizens with anxiety or depression receive relevant treatment. At the same time, the healthcare system is challenged by a shortage of healthcare professionals.

Therefore, Innovation Fund Denmark is funding the development of a personalised treatment based on Monsenso’s digital health solution, which will leverage artificial intelligence to tailor the treatment to the individual patient’s needs.

Today, digital programs provide evidence-based treatment to citizens with depression, for example in the Danish clinic” Internetpsykiatrien”. Research shows that such programs have the same effect on citizens with mild to moderate depression as physical therapy sessions. The potential is huge, with thousands of citizens on waiting lists or receiving no relevant support at all. However, delivering a personalised intervention to everyone is challenging. Some patients benefit from a fully automated, digital treatment program, others need their treatment program supported by a psychologist, and yet other patients with complex life situations need physical meetings with their healthcare providers.

“The project enables us to use artificial intelligence, which, in collaboration with Monsenso’s digital health solution and the Internetpsykiatrien, can ensure that more people can quickly get access to the right treatment. This next generation of digital treatment will make it much easier to offer a fully or partially digital treatment that matches each individual’s needs,” says Kim Mathiasen, research director at the Center for Digital Psychiatry, who leads the Personae project.

”We see great potential in this project. It enables us to continue the development of our digital health solution and further validate it. It will improve the way we use people’s own health and behavioral data to keep them engaged, customise their treatment and support clinical decision-making at scale”, says Thomas Lethenborg, CEO at Monsenso.

”The unique, patient-reported data that will be generated from the screening and continuous use of Monsenso’s solution in Internetpsykiatrien is a fantastic foundation for development, training and validation of algorithms for automatisation of decision support and optimisation of treatment pathways”, says Dr. Pepijn Van de Ven, Senior Lecturer at Limerick University.

The primary ambition of the project is to develop intelligent adaptations of treatment content to match patients’ symptoms and life situations. The solution should be able to identify early signs of drop-out and support patients’ and healthcare providers’ decisions concerning treatment. The artificial intelligence solutions will be incorporated into both the public Internetpsykiatrien clinic, which the Center for Digital Psychiatry operates, and into the digital health solution of Monsenso.

The project is led by the Center for Digital Psychiatry, which, in Danish and international contexts, is a pioneer in internet-based therapy in terms of development, research, and operation. This project combines their research and extensive clinical experience with the competencies and commercial platform of Monsenso, as well as the unique competencies in artificial intelligence for mental health at the University of Limerick. 

Facts
Project title: Personae – Personalised Digital Treatment of Depression
Total budget: DKK 22.1 mio.
Innovation Fund Denmark investment: DKK 16.5 mio.
Net contribution to Monsenso: DKK 3.9 mio.
Duration: 4 years

About the partners
Center for Digital Psychiatry at Region Southern Denmark works to ensure that all Danes have easy and equal access to mental health. In a Danish and international context, the Center for Digital Psychiatry are frontrunners in the use of digital solutions for mental health promotion and psychiatric treatment and they are experts in matching the current needs of psychiatry with the right digital technology.

The University of Limerick, Department of Electronic & Computer Engineering, has high expertise in research and teaching in information and communication technology. The Department of Electronic & Computer Engineering is a leader in research on artificial intelligence for Internet-based therapy.

Odense University Hospital, the Danish Depression Association and the strategic innovation agency Is It a Bird are also involved in the project.

Further information:
Monsenso:
CEO
Thomas Lethenborg
Tel. +45 21 29 88 27
E-mail: lethenborg@monsenso.com 

Certified Adviser:
Norden CEF A/S
John Norden
Tel. +45 20 72 02 00
E-mail: jn@nordencef.dk

 

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PhaseV: Input from users and clinicians is essential in the development of new digital health solutions

PhaseV: Input from users and clinicians is essential in the development of new digital health solutions

by | Mar 9, 2023 | Blog, mHealth, Patient Engagement

User involvement is an important phase in the development of new solutions in healthcare. A digital health solution should fit into the patient’s life, should provide value for the patient, and should be easy to use. This is why the input from both end-users and clinicians is a crucial part of the design phase in the PhaseV decentralised trials innovation project, where Monsenso and partners will develop a range of new digital health solutions for future clinical trials.

“It is important that we get the users’ perspective already while we design the solution. We need to know what their everyday life is like as patients, and when and how it creates value for the individuals to use our solution. Therefore, the phase of user involvement is important, and it is equally important that we get help from research to qualify and nuance users’ input”, says Thomas Lethenborg, CEO of Monsenso.

PhaseV is an interdisciplinary project based on citizen-generated data. The project will develop three apps for patients suffering from cost-intensive chronic diseases. The three apps are developed on top of an existing solution from Monsenso and address:

  •   obesity
  •   diabetic foot ulcers, and
  •   chronic urticaria.

The three apps will collect data in real time and show the effect of a given treatment – also between consultations.

Researchers are an important intermediary between users and the company
Monsenso is assisted by researchers from Aarhus University and the Research Unit for General Practice (FEAP) in collecting and analyzing user feedback. For the digital health solution for diabetic foot ulcers, a group of interviewers visited both the Wound Healing Center at Bispebjerg Hospital and Steno Diabetes Center Aarhus. Here, they have been in dialogue with almost 30 patients and a number of clinicians and home care employees.

The research team has also visited the section for chronic urticaria at Bispebjerg Hospital, where they have been in dialogue with several patients and clinicians, explains Christa Thomsen, Professor at the Department of Business Administration, Aarhus University.

“We need a lot of data from both patients and caregivers to get an idea of ​​what solution is needed and how it should work. Patients’ and employees’ experiences should form the basis for the information we pass on to the company so they can develop the most valuable solution“, explains Christa Thomsen.

Later this spring, the team will delve into user involvement for Monsenso’s third app aimed at citizens with obesity.

Interviews, observations, and workshops
Researchers have, among other things, developed question guides, which are used as a guideline for interviews with patients and staff. In addition, the interview team has witnessed a number of consultations, which have given them insight into patients’ daily lives with their condition (in this case, with diabetic foot ulcers) and clinicians’ daily routines.

“The solution to be developed must help ensure the best personal treatment for each patient. Therefore, it is important for us to know what information the caregivers need and how this data should be collected to provide value for both caregivers and citizens“, explains Ida Hestbjerg, research assistant at the Research Unit for General Practice.

Researchers’ data provides valuable knowledge
Emil Meyland Kortsen is responsible for developing the three apps for patients with diabetic foot ulcers, obesity, and chronic urticaria, respectively, and he describes user input as indispensable.

“We have received extremely valuable knowledge from the research team about users’ and clinicians’ needs and desires for the new solution. As a developer, I can present the possibilities that exist in the technology, but I need qualified sparring from users, healthcare professionals, and research to be able to refine the drafts. The task now is to become even more specific about the different functions and to continue to optimize the solution,” says Emil Meyland Kortsen, Product Owner at Monsenso.

This article is a translation of an original Danish version written by Lotte Overbjerg, 01st March 2023.
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About Monsenso
Monsenso is an innovative technology company offering a digital health solution used for decentralised trials, remote patient monitoring and treatment support. Our mission is to contribute to improved health for more people at lower costs by supporting treatment digitally and leveraging patient-reported outcomes data. Our solution helps optimise the treatment and gives a detailed overview of an individual’s health through the collection of outcome, adherence, and behavioural data. It connects individuals, carers, and health care providers to enable personalised treatment, remote care, and early intervention. We collaborate with health and social care, pharmaceuticals, and leading researcher worldwide in our endeavours to deliver solutions that fit into the life of patients and health care professionals. To learn more visit  www.monsenso.com.

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