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Poster.PCE.Final.Agosto 2015 copy


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Poster.PCE.Final.Agosto 2015 copy

  1. 1. THE PILLARS OF COST-EFFECTIVENESS A PRACTICAL GUIDELINE FOR NEW TECHNOLOGY COST-EFFECTIVE DECISION-MAKING Mario-Ricardo Calderón, Alejandro Salvatierra & Roel Roording Novartis Pharma AG, Central America & Caribbean Presented at ISPOR 20th Annual International Meeting, 16 – 20 May, 2015, Philadelphia, USA. INTRODUCTION ABSTRACT #55053 PRESENTATION CODE PHP187 The critical importance and use of health technology assessment in health care decisions towards improved health is practically nonexistent in many Central American and Caribbean countries. A culture with a health economics mindset that enhances access to new technologies is needed; one that increases the knowledge and application of economic evaluation among health stakeholders to make cost-effective decisions that improve health. Health care progress depends on the effective use of resources including knowledge of what drugs or interventions work, how much they cost and how they are administered or implemented. Patients, providers, policy makers and payers share universal goals in terms of drugs and technology use and acquisition --best quality, lowest cost and reasonable access. This has resulted in (1) greater focus on healthcare spending, cost-containment, prescribing behavior control and smaller perceived drug differentiation within the healthcare industry, and (2) increased need for differentiated products, compelling value propositions and better support and patient access strategies in the pharmaceutical industry. The rising costs of healthcare and limited resources have spurred the need for evaluating the economic viability of any drug or intervention. However, evaluation of health technologies and economic evaluations represent only one of the components of a comprehensive strategy to make technologies more accessible to patients. OBJECTIVES patients, healthcare providers, governments and society as a whole. industries to make new technologies more cost-effective and available to patients in resource-limited settings. METHODS AND DISCUSSION A needs assessment was conducted among key internal (pharmaceutical and the Caribbean to gain insight about their behaviors, patterns and practices regarding new technology acquisition. Health stakeholders were interviewed at Panama and the Dominican Republic during 2014. A literature review of lessons learned and best practices around the world complemented information collected from local stakeholders. No standardized way to make budget allocations or procurement decisions was based on empiric estimates, previous year consumption, earmarked budgets, drugs is critically important but, due to limited budgets and lack of cost-effectiveness evidence or knowhow, the key driver behind most decisions is price, the lowest price possible. Stakeholders acknowledge that inexpensive drugs may turn out expensive at the end in terms of increased tangible (direct and indirect) and intangible costs and poor health outcomes. A simple, useable, read-do Checklist could guide stakeholders to select cost-effective health technologies, particularly new, innovative high cost drugs. The Checklist concept has been used effectively for over 75 years by the aeronautical Boeing Corporation, October 1935). The World Health Organization translated this concept intuitively to the operating room to reduce the number of surgical deaths around the world in conjunction with the Harvard School of Public Health (WHO Surgical Safety Checklist, 2008). A basic organization tool –the simple Checklist—when properly conceived has proven effective in a wide range of cases, protect personnel and respond appropriately (U.S. Centers for Disease save lives and cope with extreme weather conditions and disasters (American Red Cross), etc. In pharmacoeconomics, as in aviation, medicine and public health, checklists can help ensure consistency and completeness in carrying out complex tasks. Hence, a practical Checklist with all knowledge domains needed to select new drugs and technologies could improve the decision makers´ communication and consistency of information and data, facilitate the decision-making process and determine the most cost-effective options for the health system. RESULTS CONCLUSIONS REFERENCES possible. cost drugs and technologies more cost-effective. technology selection and acquisition. policy-makers and payers to (1) get the best drug and technology quality at the lowest cost with reasonable access, and (2) enhance healthcare partnerships and solutions towards improved individual and population health outcomes. NP4 #C61505330213 CLINICAL EFFECTIVENESS MEDICAL ACCESS EFFECTIVENESS ECONOMIC EFFECTIVENESS 1. EFFICACY 4. VALUE-ADDED SERVICES 7. COST OF ILLNESS 2. SAFETY 5. MANAGED-ENTRY AGREEMENTS 8. COST-EFFECTIVENESS EVIDENCE 3. QUALITY 6. IMPACT INFORMATION 9. BUDGET IMPACT ANALYSIS Symptoms Relief Training Programs Direct Costs Survival Diagnostic Tools Indirect Costs Quality of Life Patient or Provider Services Intangible Costs Frequency of Adverse Events Performace-Based Agreements Cost-Utility Analysis Serious Adverse Events Financial-Based Agreements Cost-Benefit Analysis Risk Management Plan Risk-Sharing Arrangements Cost-Effectiveness Analysis Good Manufacturing Practices Epidemiological Burden Current Technology Mix Cost Bioavailability Evidence-Based Clinical Research New Technology Mix Cost Bioequivalency Real World Evidence Research Comorbidity Related Costs Table 1 NEW TECHNOLOGY COST-EFFECTIVENESS CHECKLIST * (FIRST EDITION)