The document discusses strategies for managing the economic crisis in Spain's healthcare system. It proposes (1) collaborating with industry to improve quality and introduce new technologies, (2) implementing risk-sharing agreements to distribute financial risk, and (3) rationalizing priorities and empowering decision-makers to consider value, efficacy, safety, and costs. The goal is to balance innovation, access, and financial sustainability through evidence-based healthcare technology assessment.
Farmàcia Hospitalària. Oriol de Solà-Morales 20110416
1. Estratègies de Gestió per fer front a la crisi econòmica: l’avaluació de fàrmacs II Trobada de Farmacèutics d’Hospital de Catalunya SCFH- Sociietat Catalana de Farmàcia Hospitalària Mont St Benet, 16 d’Abril de 2011 Oriol Solà-Morales, HTA Director
18. Which is the current paradigm? cost Innovation ?
19. What the industry wants(HTAi Policy Forum, June 2010) Regulation only linked to scientific considerations, not economical All eligible patients have access, without restrictions Early dialogue with HTA/payers to align expectations and reduce development uncertainty Reduce the development costs Accept alternatives forms of evidence
20. What the industry wants(HTAi Policy Forum, June 2010) Regulation only linked to scientific considerations, not economical Eliminates equity and distributive justice All eligible patients have access, without restrictions No budget limits considerations Early dialogue with HTA/payers to align expectations and reduce development uncertainty Will that affect price seemingly? Reduce the development costs Introduces market imperfections Accept alternatives forms of evidence Reduces security? Are there any compensations? Risk Sharing?
23. Collaboration with the industry use time ‘competence’ / renovation Rearrangement / ‘Quality’ Evaluation Methodological evaluation / introduction Horizon Scanning
24. For who? Registry Price Reimbursement AEMPS Cabinet Insurer Prescription Only Non prescription / OTC Pharmacies ----- Physician Pharmacies Hospital Manager Hospital Promoter Insurer / Manager/ Physician MSyPS / AEMPS
29. Nudge (Thaler i Sundstein) Incentivar: conèixer qui utilitza, qui escull, qui paga i qui obté els beneficis d’una intervenció; Entendre els mapes mentals: transformar les variables de decisió complexes en variables assimilables pel decisor; Accions per defecte: determinar quines són les accions que es realitzaran quan hi hagi falta d’acció–decisió; Esperar l’error: determinar què es farà quan l’usuari no segueixi l’opció considerada prioritària perquè reavaluï si la seva decisió és coherent amb l’escenari o ha estat fruit d’un error; Estructurar decisions complexes: en cas de decisions en què intervinguin concurrentment múltiples variables, intentar presentar les possibilitats de decisió estructurades per grups categòrics de dificultat creixent.
40. Creating Value This suggests that the producer or source of value must understand the relative knowledge of potential users and the context in which the evaluation of novelty and appropriateness will take place Lepak, Acad Manag Rev 2007
41. Creating Value Value is ….. is subjective and related to individual WTP WTP > production cost Related to novelty appropriateness Related to competitive advantage, dynamic capabilities organisational knowledge Buyers …. Must have specialised knowledge Cannot be separated from their context
43. Conclusions En el context actual cal revisar les mesuresqueafecten a la oferta i a la demanda facilitar (estructurar) la presa de decisions prendre les decisions