In this article we shine the spotlight on Dr Yngve Mikkelsen. Yngve recently joined NDA and excels at advising companies on their development strategies identifying the optimal connection between products and market, facilitating the generation of evidence essential for market access and price optimization and communication of product value to stakeholders.
The Broader the better – how to make decisions in an uncertain environment.
When or where do you get your best ideas? In the shower? Just before you fall asleep or going for a run? Coming up with a breakthrough idea is hardly ever a result of putting on a thinking cap, or spending hours staring at a particular problem. Being able to change the game means having the vision to see what is not there, a creative spark and the confidence to execute the changes needed. Yngve Mikkelsen, advisory board member at NDA, has a broad range of experience which enables him to find solutions that are not necessarily obvious to everyone. A talent necessary to be able to establish the true value of a new medical treatment.
At age 18, Yngve and his family were dining in a restaurant with friends when suddenly a member of the public began to choke. One of the guests at Yngve’s table was a doctor, who immediately performed a successful abdominal thrust. From that moment, Yngve knew he wanted to become a doctor and be able to save people’s lives. After medical school, he specialised as an anaesthesiologist, but it didn’t take long for Yngve to make the transition to the hospital management.
"I am very passionate about helping patients,” Yngve shares, “but I realised that I have a skill set that could be of service to the healthcare system in a wider perspective, not just as a clinician”.
One of the skills he is referring to is the ability to identify drivers and barriers. Yngve’s purpose became overcoming the challenges in managing patients with complex diseases, advanced and expensive treatment, and the effectiveness and quality of care. When taking on management roles he developed his organisational and problem-solving skills and his career took a rather untraditional turn, with a Master’s in Management, a doctorate in Business Administration, and a Master’s in Science in Health Economics, Policy, and Management.
Thinking like there is no box
Yngve has a natural ability to reframe a problem to unlock the solution. Previously in Norway, Emergency Care medicine was not a stand-alone speciality, A&E was where young, recently qualified physicians started their career. The A&E department that Yngve was running was often overcrowded, exacerbated by the number of incoming patients with chest pains. Hospital policy prevented these patients from having their heart condition examined in A&E, which added to the overall time spent in the hospital, creating a bottleneck that needed to be addressed.
Yngve introduced a change in the A&E which paved the way for a policy disruption. By hiring an emergency medicine doctor to work exclusively in A&E, the other cardiologists at the hospital were more inclined to assist therefore alleviating the overcrowding situation. Where did this idea come from? Yngve recalled a situation that would often occur at his daughter’s childcare. Children fighting over toys that had just been discarded. As soon as one child started to play with it, the other children immediately came to claim the same toy. He facilitated change by adding some competitiveness which targeted the bottleneck and improved the trauma care for patients with chest pains. Later in his career, Yngve also played a part in the decision to make emergency care medicine a speciality in Norway in 2017.
"It is not only about management”, Yngve states, “it is also about leadership. While leadership is about motivating or influencing others to produce change, management is knowing how to achieve results by planning, organizing, and problem-solving”.
As a clinician and a health care manager, Yngve had the essential perspective needed to go into health technology assessment (HTA)
"The discipline of my second master's brought me into the HTA space”, Yngve explains. “It made me understand the logic of how a viable product can go from concept to market. I understand healthcare and its drivers: from a political, management, clinician’s and also from an economic perspective The combination of theory and practice has given me the proficiency needed to advance important decision-making in healthcare”.
Change is constant, manage it well
How can decision-makers make informed choices about new and emerging health technologies? As therapeutic compounds are becoming more complex and the timelines shorter, decisions must rest on a broader range of data as the evidence generated will not be sufficient at the time of the assessment. Yngves mission is to bridge the gap between the scientific evidence and health care decision-making. The key elements for driving the decision-making forward are the ever-growing information collected from extensive registries, real-world data and, although in its infancy, Artificial Intelligence.
One remaining factor that has not changed over the years, however, is the focus on cost.
"Of course, cost is the key determinator, Yngve says, but I think that focusing on cost alone is somewhat narrow-minded. At the end of the day, what regulates these decisions is information, and since the information technology continues to change rapidly it will have a major impact how decisions are being made, and at what level of confidence. What really makes my day is supporting strategies for evidence generation, so the available information leads to the most advantageous decisions”.
By facing challenges with a free-thinking mindset, Yngve provides innovative ways of making use of the available information to address any hurdles of any given stakeholder.
"In the future”, Yngve concludes, “you will miss the boat if you do not have a good grip on the technology and how it influences the information.”
Dr Yngve Mikkelsen
Advisory Board Member