Context
The Bulgarian healthcare system confronts significant hurdles. The rising costs of innovative drugs strain budgets, while the traditional fee-for-service model struggles to keep pace. The National Council on Prices and Reimbursement of Medicinal Products (NCPR), acknowledging this pressing issue, initiated the ‘Enhancing Healthcare Policy Evaluation through the AI-Driven Analytics Platform for the National Public Administration’ project. This project signifies a critical shift towards performance-based care, aiming to make informed decisions regarding drug reimbursement.
Objectives
The project’s primary objective is to leverage the power of artificial intelligence (AI) and big data to assess the effectiveness of expensive, innovative medications in real-world clinical settings. This real-world data will empower the NCPR and healthcare professionals with actionable insights. These insights will optimise public spending on pharmaceuticals, ultimately leading to enhanced patient care and informed decision-making throughout the healthcare system. Notably, the project prioritises data security and ensures compliance with General Data Protection Regulation (GDPR) standards throughout its implementation.
Implementation
To achieve these goals, the project established a multidisciplinary team comprised of data scientists, healthcare professionals and IT specialists. This team played a crucial role in various aspects, including data extraction, AI algorithm development, data security maintenance and crucially, stakeholder engagement. A dedicated Project Management Committee (PMC) was formed, consisting of key stakeholders from the NCPR, healthcare institutions and the technology provider. The PMC’s responsibility encompassed overseeing project milestones, addressing challenges that arose and making data-driven decisions based on the AI model’s performance and data quality. Regular communication was paramount, and a comprehensive plan ensured transparent information sharing among stakeholders. Dissemination of regular reports and updates fostered project visibility and maintained stakeholder buy-in. Stakeholder involvement, particularly consultations with healthcare professionals and experts, ensured the project’s analyses remained relevant and aligned with national healthcare policy goals.