Healthcare is a COMPLEX ADAPTIVE SYSTEM. If you allow solutions to emerge by following the rules of the road, then they do.
VISA started by Dee Hoek began with a simple set of rules and a clear objective. A powerful transaction infrastructure emerged.
We began the case with a clear understanding of the objective - to seek funding for the new drug.
By being curious, we discovered a number of solution providers in the community.
Each solution provider delivered a part of the total solution. Then we contracted with each of the local solution providers to deliver the total solution.
In this case, Seattle Genetics had discovered a highly effective new class of drugs - ADC for Hodgkins Lymphoma.
The oncologist had been informed about this drug by publications from researchers working with brentuximab in clinical trials.
An enterprising specialist in the patient's community had started an infusion centre. His staff were trained in safely infusing these complex medications.
A local licensed pharmacy had developed expertise in preparing these medications for the infusion centre.
The manufacturer, Seattle Genetics, had an outreach program to teach local teams about how to infuse brentuximab.
The private insurer (Sun Life) had sold pooled stop loss insurance to the employer.
This is an innovative new insurance solution that pools large numbers of employers and employees.
The annual cost of this drug was very high. Pooling by Sun Life allowed for funding without penalizing any specific employer in the pool who experienced a high cost drug claim.
