Preparing Canadian healthcare systems for the future of complex interventions: Lessons from T-cell re-directing therapies
T-cell redirecting therapies (CAR-T and BiTEs) have improved cancer care but challenge the Canadian health system as they are complex interventions and rely on coordination and changing models of health service delivery.
To address a coming era of complex therapies, a new report has been released that recommends creating system-level oversight with dedicated leaders, developing specialized care programs for coordination and education, and ensuring transparent technology evaluation using implementation science and health technology assessment. It emphasizes improving data collection on costs and outcomes and adopting innovative financing models like risk-sharing and scale-up programs. These strategies promote safe, equitable, and sustainable access to complex therapies, offering a framework applicable to future complex healthcare interventions beyond T-cell redirecting therapies.
Some of the key takeaways that address actions to create more resilient healthcare systems in an emerging era of more complex therapies include:
Creating healthcare system level oversight for future complex care to facilitate changes in governance and service delivery models. This includes creating organizational change functions and leaders focused on health system transformation, and innovation spread, scale, and sustainability.
Creating specialized programs of care which coordinate service delivery, plan for future resource use, and oversee the development and implementation of navigational tools and educational strategies directed to providers and patients.
Ensuring there are transparent processes to develop and evaluate technologic developments, borrowing from best practices in implementation science and health technology assessment.
Improving data collection to measure the cost and impact of new complex interventions.
Revisiting approaches to financing new technologies to manage risk including programs of spread and scale, discretionary spending, and risk sharing