Public-private partnerships (PPPs) in healthcare: Lessons from the PrOSPeCT model

• Innovation in the life sciences industry has been fast-paced in the last decade bringing new treatments and technologies to market
• Access challenges mean the latest innovations remain out of reach for some patients
• One solution to address access gaps in healthcare is showcased by the public-private partnership model, PrOSPeCT

The past decade has seen incredible advances in medical innovations, bringing the opportunity for marked improvements in areas of healthcare such as vaccines, genomics, and personalized medicine.¹ Innovation and continuous improvement in healthcare is important not only for patients and their families, but also for the wider population. Economists estimate that about one-third of economic growth in advanced economies in the last century can be attributed to improvements in the health of global populations.²

At the same time, barriers exist that stand in the way of some patients receiving optimal care. Funding, disease awareness, healthcare capacity, and infrastructure can all create access challenges. Given that medical innovations can only create positive change if they reach the people who need them, these challenges must be overcome.³ As the World Economic Forum put it ahead of their 2024 annual meeting, ‘Enabling health systems globally to keep pace with the rate of life sciences innovation must be recognized as a priority and foundational to the world’s shared response to economic, political and technological shifts’.⁴

Addressing existing healthcare barriers and prioritizing innovation across the globe presents a huge challenge. One which is too large and too complex for any one party to tackle alone. Instead, change will require a ‘whole society’ approach,  requiring cooperation between multiple partners from public, private, academia, and other sectors.^5,6 In other words, public-private partnerships (PPPs).

A PPP goes beyond the traditional idea of a partnership, requiring both sides to share risks, resources, and decision-making authority. PPP models aim to extend the reach of healthcare by leveraging the specific strengths of the public and private sectors. Public sector regulatory oversight, combined with private sector innovation and efficiency, works together to create economies of scale and enables expanded healthcare access to underserved populations.⁵

Historically, PPPs in healthcare focused on creating or improving infrastructure such as hospital buildings, but more recently have been utilized to enhance or expand service delivery and access to new technologies.⁷

At the Roche Experience Days 2024, Professor David Thomas, Director of the Centre for Molecular Oncology School of Biomedical Sciences at the University of New South Wales in Australia, shared the center’s real-world experience with one such PPP – the PrOSPeCT initiative.

Professor Thomas explains that PrOSPeCT arose to bridge a “widening gap between public healthcare, single payer healthcare systems, and where science and the healthcare industry is leading”. Thomas notes that in oncology, there are increasing numbers of biomarker-dependent drugs entering practice, but that in the public system in Australia, molecular profiling to guide the use of these drugs is not routine practice. “Our solution to this problem has been to develop a public-private partnership, which I think is absolutely critical to any future integration into systems healthcare,” says Professor Thomas.

Omico is the national, independent, not-for-profit organization leading the PrOSPeCT initiative, bringing together the Australian Government, the New South Wales Government and partnering with world-class cancer institutes, researchers, and industry partners. By leveraging a nationwide network of expertise and resources, the aim is to improve outcomes for all Australian cancer patients through facilitating clinical trials and pioneering the use of genomic and molecular screening for the prevention and treatment of cancer.

Over 27 months, PrOSPeCT’s Cancer Screening Program (CaSP) aims to provide free genomic profiling to 23,000 Australians with advanced, incurable, or poor prognosis cancers and identify potential matches for patients to clinical trials with new targeted therapies. “We are also creating a real-world data set in real time where we can show the outcomes from these patients that will help guide appropriate development of these therapies,” explains Professor Thomas.

By working together in this way, there are benefits for all groups involved.⁸ Patients will have access to the latest biomarker-dependent treatment as a result of comprehensive genomic profiling (CGP). This process is also beneficial for clinicians who can access a patient’s CGP and use this information to inform further personalized treatment decisions and care.

For the government, it is estimated that PrOSPeCT will result in considerable savings for the healthcare system in terms of avoided health interventions, including medicines, tests, and additional hospital costs. In addition, the program also expects to generate economic growth and create hundreds of new jobs, bringing new opportunities for research scientists involved in genomics, clinical trials and diagnostics. There are also benefits to the life sciences industry through reduced cost and time needed for precision oncology clinical trials.

The importance of demonstrating the benefits of PPPs in healthcare is something that Professor Thomas is acutely aware of, and the team has been tracking metrics across MoST and PrOSPeCT initiatives. To date:⁹

• 20,000 patients being referred for screening
• 17,000 have been enrolled
• 13,000 have received a complete molecular profiling
• 12,000 have received a recommendation
• 1400 patients have gone on to receive matched therapy

“Within PrOSPeCT itself, these numbers are absolutely critical to government,” says Professor Thomas, “We have to show that healthcare is not simply an expenditure cost, but rather, the most important industry on the planet. So, we’ve also been capturing evidence like the investment in clinical trials, the trial values that we’re supporting, and the number of jobs that we’re creating directly and indirectly through the programs we’re running. We need the government to see this not as an area of health that will simply blow out the deficits, but rather as an important part that combines both the generation of wealth as well as health. And that’s what we’re trying to test with the model that we’re developing now.”

Outside of Australia, increasing numbers of governments are embracing the PPP model to access private sector expertise and resources.¹⁰ By reducing reliance on subsidies and accelerating the pace of innovation, PPPs have the potential to improve healthcare outcomes through increased access, quality, and efficiency.⁶ It is a model that could prove how health systems can keep pace with innovations in the life sciences.

To watch the full video of Dr. Thomas’s presentation at RED 2024 click here.