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Denjoy, Nicole - The importante of innovative technologies in healthcare. COCIR’s viewpoint


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Track 1: Conocimiento clínico y gestión de la innovación: de la idea al mercado …

Track 1: Conocimiento clínico y gestión de la innovación: de la idea al mercado
1.4. La visión de la industria

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  • 1. The Industry Vision Session S 1.4 RoundtableThe importance of innovative technologies in healthcare COCIR’s viewpoint Nicole Denjoy COCIR Secretary General 25 May, Barcelona (Spain)
  • 2. COCIR
  • 3. What is COCIR?• It represents the industry leading voice in Europe and beyond for: • Medical Imaging, • Health ICTs, • Electromedical Industry. June 17, 2009, page 3
  • 4. COCIR Member Companies
  • 5. COCIR National Trade Associations Belgium Hungary Italy UK Spain Netherlands Finland NetherlandsFrance Germany Sweden Turkey Germany
  • 6. COCIR’s focus: improve market access• Provide COCIR’s members with competence towards policy makers in Europe and outside• Contribute to sustainability of healthcare systems through integrated care approach• Promote Research and Innovation as a key enabler for economic growth• Drive global regulatory convergence (registered once, accepted everywhere)• Optimise use of International standards• Push for national and regional deployment (eHealth)• Pro-active in Green Technology (Eco-Design)
  • 7. Strategic Global Presence IMDRF June 17, 2009, page 7
  • 8. Challenges
  • 9. Challenges 1 35 million deaths from chronic disease 2 60% of all deaths result from chronic disease 3 Deaths from chronic disease will increase by 17% by 2015 2 17.5mm Chronic disease deaths Worldwide 7.6mm 4.1mm 1.4mm Cardiovascular diseases Cancer Chronic Diabetes respiratory disease
  • 10. Societal health challenges• An ageing population• Growing prevalence of chronic diseases• A declining labour force• Rising health care costs June 17, 2009, page 10
  • 11. Challenges for our Industry• Highly regulated industry (under revision!)• Lack of harmonisation in regulatory framework globally & insufficient use of international standards• Various HTA & reimbursement systems in EU• Still fragmented business in eHealth• Lack of proper research funding & insufficient use of structural funds in health June 17, 2009, page 11
  • 12. The industry cannot solve alone some key challenges faced by innovations• Investment and research are associated with high risks  Toward personalized medicine (niche markets) versus ROI  Innovative technologies to be integrated into a new, not yet defined Healthcare System paradigm• Low speed of adoption of new technologies with derived clinical and economic benefits  New role of diagnostic & reimbursement issues (biomarkers, companion diagnostic,…)• Lack of standards to accelerate research and defragment the market (globally)  Need for large clinical trials led by Clinical/Scientific experts groups (e.g: AD taskforce, EORTC,…) supported by EC/EMA to validate new medical practices to be reimbursed June 17, 2009, page 12
  • 13. Proven successes 2 examples
  • 14. Innovation in Medical Devices … support improving outcomes in Cardiology US Life Expectancy at Birth 1950-2000 80 75 70 Cancer Heart 65 1950 1960 1970 1980 1990 2000 Disease Heart Cancer 5 out 7 years gained due Disease to better heart care Sources: NCHS, Cutler 2006“Around 70% of the survival improvement in heart attackmortality is a result of changes in technology.”Cutler & McClellan, 2001 June 17, 2009, page 14
  • 15. Innovation in Medical Devices … support improving outcomes in Oncology Prostate cancer deaths Breast cancer deaths Colorectal cancer deaths 60 45 45 Per 100K femalesPer 100K males Per 100K pop Deaths down 4.9% 40 30 30 Breast Male Prostate 20 15 15 Female Deaths down 4.1% Deaths down 3.5% Deaths down 4.5% 0 0 0 1975 2003 2008 1975 2003 2008 1975 2003 2008 • Prostate cancer mortality continues to fall: screening, PSA • Breast cancer mortality decreased 3.5%: first drop in 20 years • Colorectal cancer 5yr survival: 10% late stage; 90% early detection “The decline in cancer has little to do with improvements in late stage treatment...but more to do with screening, earlier detection and treatment." Prof. Gordon McVie, European Institute of Oncology, Milan June 17, 2009, page 15
  • 16. Opportunities
  • 17. Medical Imaging innovations can turn societal challenge into growth• Yesterday  Patient stratification  Patient monitoring• Tomorrow  Early diagnosis  Targeted treatment selection  Minimally invasive treatment  Treatment efficacy monitoring Better quality & access to healthcare Lower healthcare cost INNOVATIONS Quicker recovery of patients, quicker return to daily activities Economic Growth (incl. jobs in EU for global markets) June 17, 2009, page 17
  • 18. Medical Imaging sector is strong in Europe…• 3 of the global medical imaging industrial leaders are headquartered in Europe, with strong R&D presence in Europe• Strong academic presence and Intellectual Property in Europe can be leveraged for innovation (Patents registered in 2010: 39% European, 26% US, 18% Japan and 5% China and Korea) June 17, 2009, page 18
  • 19. Leverage the Power of Health ICT Hospital Government Polyclinic• Healthcare IT and eHealth  proven high clinical and societal value• Telehealth  linking patients with care providers Home Central Pharmacy Patient’s• IT infrastructure  ensure that systems derive maximal EHR value from medical technology (Cloud computing) Laboratory• IT connectivity through IHE (Integrating the Healthcare Enterprise)  improving quality and reducing cost• More investment in eHealth  best-practice clinical pathways / patient’s mobility throughout Europe June 17, 2009, page 19
  • 20. Technology is advancing fast….. Diagnostics Biotech & Genomics IT & bioengineering• Faster, accurate imaging • Targeted therapy • eHealth/Telemedicine• Molecular imaging • Proteomics/DNA • Mobile solutions• Miniaturisation/portability • Biomarkers • BioSensors• Point of Care diagnostics • Rapid screening tools • Computer Aided Diagnostics• Therapy selection/monitor • Vaccine development • Patient monitoring June 17, 2009, page 20
  • 21. BUT…change is slow Needpolicies that facilitate diseasemanagement approaches: o Focus on disease risk stratification, prevention & screening programmes o Encourage ‘best practice’ patient centric processes o Health ICT solutions to drive quality, safety and efficiency, and telemedicine o Encourage more integrated care delivery o Use of regulatory & procurement to accelerate uptake of proven technologies June 17, 2009, page 21
  • 22. Two COCIR initiatives:1. PPP in Research and Innovation2. More effective PPP models: key best practices on integrated care at hospital level June 17, 2009, page 22
  • 23. 1. PPP for Research & Innovation• Create an industry driven public-private partnership (PPP) to accelerate Research and Innovation• Together with Academics, Research Centers and Public Authorities• Join forces with other industry sectors (pharma, cosmetics, etc….)… in the context of “Horizon 2020” objectives of the European CommissionThe third objective, Societal challenges will see €31.7billion allocated to tackling the major issues affectingthe lives of European citizens, including Health,demographic change and wellbeing (€8.6 billion – upfrom €6.1 billion in FP7). June 17, 2009, page 23
  • 24. Benefits for European Commission and Member States• Better quality and lower cost healthcare for the most important disease areas in EU and globally  Acceleration of efficient technology uptake, increasing ROI of investments in healthcare technologies• European Industrial and Scientific leadership  Prioritization of R&I in line with the industry needs to tackle major global societal challenges  Better leverage of technology and clinical research outputs  PPP collaboration leads to better insights to jointly address future problems• Growth  Jobs creations derived from innovations commercialization  Indirect economic benefits of better management of chronic diseases June 17, 2009, page 24
  • 25. 2. Hospital Of Today (HOT) What you plan Today will remain optimal Tomorrow A COCIR Initiative to maximizeinvestments at hospital level on integrated solutions June 17, 2009, page 25
  • 26. Characteristics of a PPPPPP has a number of characteristics which differentiates it from more traditionalforms of contracting between the public and private sectors:1. Long term –Typically contracting period of 25 – 30 years. Over this period of time the private sector will operate and maintain the facility.2. Transfer of risk – certain financial, technical and operational risks are passed to the private sector for the duration of a PPP contract.3. Limited recourse finance – the financing within the Special Purpose Vehicle (SPV) is secured against the project cash flows rather than the balance sheets of the SPV’s shareholders.4. Payments over life of PPP contract– the Procuring Authority pays an annual Unitary Charge to the private sector once service delivery has commenced (or in the case of toll funded projects payments are made by the users of the service).5. Private sector ownership – the private sector usually owns the asset for the duration of the contract. Upon completion of the contract term, ownership of the asset can be transferred to the Procuring Authority.6. Involves a range of partners – a number of private sector entities come together to form a consortium to deliver the project.26 June 17, 2009, page 26
  • 27. Alternative Model PPP De-couple Infrastructure from Technology Government Hospital Managed Building Service Concession Technology Consortium Partner• Construction Company – Turnkey DBFMO model to provide infrastructure on 20 – 30 years lease basis Design Build Finance Maintain Operate• Equipment Technology Partnership – Via a Managed Service based on Service Model and Service Level Agreement – Providing flexibility in 10 – 15 years term June 17, 2009, page 27
  • 28. Valencia Region South Integrated Patient Care System- Full integrated patient care- No waiting lists- Patient has free choice to choose hospital- 600 € per capita, per year Capitated payment Property refund to Valencia GovernmentPublic and free healthcareservices Controlled Project June 17, 2009, page 28
  • 29. What we need….
  • 30. Innovative technology will enable a shift in care • Focus on acute conditions  Focus on acute & long term conditions • Hospital centred  Community centred • Physician dependent  Team based • Episodic, reactive care  Integrated preventive care • Passive patient  Knowledgeable patient • Slow uptake of technology  Localised integrated high tech solutions • Budget silos  Fund continuum of care Hospital Community Home clinicUtilization PRESENT FUTURE High Acuity Low June 17, 2009, page 30
  • 31. Importance of prevention & personal initiative for healthier and more active lifestyles• Industry strongly supports government policies and educational programs that encourage individuals to make informed choices and take personal initiatives for leading healthier and more active lives June 17, 2009, page 31
  • 32. Collaborative partnership approach…• Non-communicable diseases are multi-factorial in nature, thus requiring a multi-stakeholder and horizontal approach to ensure healthier and informed life-styles• Effective strategies must involve all levels of government as well as all key stakeholders June 17, 2009, page 32
  • 33. Expectations to foster an innovation- friendly environment in Europe1.Establish a mechanism to ensure a robust evaluation ofinnovations during the product-development cycle2.Enable rapid access to market for innovative productsand services with added value3.Adopt a clear strategy at EU level to support innovations4.Access to further financing Research and Developmentinvestments5. Better leverage the use of Structural Funds for Health June 17, 2009, page 33