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Background The value equation of value-based healthcare (VBHC) as a single figure remains ambiguous, closer to a theoretical framework than a useful tool for decision making. The challenge lies in the way patient-centred outcomes (PCOs) might be combined to produce a single value of the numerator. This paper aims to estimate the weights of PCOs to provide a single figure in the numerator, which ultimately will allow a VBHC figure to be reached. Methods A cohort of patients diagnosed with breast cancer (n  = 690) with a 6-month follow-up recruited in 2019–20 across six European hospitals was used. Patient-reported outcomes (PROs), clinical-related outcomes (CROs), and clinical and socio-demographic variables were collected. The numerator was defined as a composite indicator of the PCOs (CI-PCO), and regression analysis was applied to estimate their weights and consequently arrive at a single figure. Results Pain showed as the highest weight followed by physical functioning , emotional functioning , and ability to work , and then by a symptom, either arm or breast. PCOs weights were robust to sensitivity analysis. The CI-PCO value was found to be more informative than the health-related quality of life (HRQoL) value. Conclusions To the best of our knowledge, this is the first research to combine the PCOs proposed by ICHOM to provide a single figure in the numerator of the value equation. This figure shows a step forward in VBHC to reach a holistic benchmarking across healthcare centres and a value-based payment. This research might also be applied in other medical conditions as a methodological pathway. [ABSTRACT FROM AUTHOR]

Research background: Internal business factors are vital to how a company achieves its goals. The present study of internal drivers of pharmaceutical company performance is very insightful, as it has the potential to boost further competitiveness, it may allow health authority personnel to have guidelines to make strategic decisions, as well as inspire investor confidence, ensure regulatory compliance and performance benchmarking, and support talent acquisition and retention. In addition, it can identify the important internal factors that need to receive more priority. Purpose of the article: The European pharmaceutical industry is currently facing multiple challenges. This paper aims to map the relative relationships among the internal factors that influence the business performance of pharmaceutical companies in Europe by using the DEMATEL approach. Method: There are two phases of the present study, an extensive literature review and the use of the decision-making trial and evaluation laboratory (DEMATEL) technique. To identify the key internal drivers and their cause-and-effect relationship with pharmaceutical company performance in Europe, data from experts were obtained using the predesigned DEMATEL questionnaire. Findings & value added: The extensive literature review from the Web of Science and Scopus databases found that seven internal factors are very demanding in the case of European pharmaceutical business performance. The main elements that have the highest impact on pharmaceutical business performance in Europe are human resources competencies, the information system, technological competitiveness, and the patent system. However, financial profitability, research and development competencies, alliances with other companies, and supply chain management are the factors that are affected more by other factors. The study is the first attempt to identify the internal business performance of the pharmaceutical sector in Europe by working with pragmatic and perceptive decisions from pharmaceutical stakeholders in Europe. [ABSTRACT FROM AUTHOR]

Background Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with a data-driven approach among healthcare organizations from different health systems. Methods In the VOICE community—a European healthcare centre cluster intending to address VBHC from theory to practice—information on patient-reported, clinical-related, care-process-related and economic-related outcomes were collected. Patient archetypes were identified using clustering techniques and an indicator set following a modified Delphi was defined. Benchmarking was performed using regression models controlling for patient archetypes and socio-demographic characteristics. Results Six hundred and ninety patients from six healthcare centres were included. A set of 50 health, care-process and economic indicators was distilled for benchmarking. Statistically significant differences across sites have been found in most health outcomes, half of the care-process indicators, and all economic indicators, allowing for identifying the best and worst performers. Conclusions To the best of our knowledge, this is the first international experience providing evidence to be used with VBHC benchmarking intention. Differences in indicators across healthcare centres should be used to identify best practices and improve healthcare quality following further research. Applied methods might help to move forward with VBHC benchmarking in other medical conditions. [ABSTRACT FROM AUTHOR]