Health innovation through new medicines can benefit patients, healthcare systems, and societies in several ways: 1. Patients live longer, healthier lives with access to innovative treatments for diseases like cancer. 2. Healthcare systems see reduced costs in other areas like hospitalizations as innovative medicines treat diseases more effectively. 3. Societies benefit as individuals are able to continue being productive members of their communities through return to work after illnesses. However, current healthcare challenges include aging populations, rising costs, and constrained budgets. Ensuring access to innovation requires strategies like improving public health, maximizing generic competition, implementing health technology assessments, and embracing organizational innovation in healthcare systems.

1. HEALTH INNOVATION:
A PREREQUISITE FOR SUSTAINABLE
HEALTH CARE SYSTEMS
Agata Jakoncic
Managing Director MSD
Greece, Cyprus and Malta
17 May 2017

2. 2
Over 7000 medicines in development addressing health
challenges faced by patients and healthcare systems
Will Greece benefit from this tremendous wave of innovation?
Source: Health Advances analysis; Adis R&D Insight Database. March 2015, compiled by PhRMA

3. 3
PATIENTS
Patients live longer, healthier, more
productive lives
HEALTHCARE SYSTEMSHEALTHCARE SYSTEMS
Innovative medicines can put healthcare
systems on a more sustainable path by
reducing costs in other parts of the
healthcare system such as
hospitalizations
SOCIETY
Society benefits from health and wellness
as individuals are able to continue being
productive members of the community
ECONOMIES
The biopharmaceutical industry generates
essential economic value in terms of job
creation, R&D investment, and
medications that improve patient
productivity
Why is health innovation beneficial to patients, health care
systems and society

4. 4
Today, 2 out of 3 people diagnosed with cancer survive at least 5 years1.
Percent Decline in Cancer Mortality Rates (1991 to 2011 - All Cancers2)
EU5 South KoreaJapanCanada
-21%
-8%-21% -22%
-17%
-15%
USA
-24%
Source: Health Advances analysis; 1PhRMA 2016 Prescription Medicines: Costs in Context; 2WHO
Mortality Database (accessed February 2016).

5. Significant health gains and savings in other parts of the
healthcare systems
5
1.6-2.1 million
The number of influenza cases averted with the
current use of seasonal influenza vaccination in
Europe.1
Total influenza-related costs saved annually from
averted GP visits, hospitalizations, and lost days of
work as a result of the current use of seasonal
influenza vaccination in Europe.1
€250-330 million Per capita expenditure on cardiovascular
hospitalizations would have been $89 (70%)
higher in 2004 had new cardiovascular
medicines not been introduced in the period
1995–2004.2
New Cardiovascular Medicines Led to Direct Savings on
Hospitalizations in 20 OECD Countries*, 1995-2004
$24
-$89-$100
-$80
-$60
-$40
-$20
$0
$20
$40
Cost of New Medicines Hospitalization
* Countries included: EU5, Australia, Austria, Belgium, Canada, Czech Republic, Finland, Hungary, Japan, Korea, New Zealand, Norway, Poland, Slovak
Republic, Spain, Switzerland, Turkey, USA.
Source: Health Advances analysis; 1Preaud 2014 Annual public health and economic benefits of seasonal influenza vaccination; 2Lichtenberg 2009 Have newer CV
drugs reduced hospitalization in 20 OECD countries Health Econ.

6. Innovative therapies allow patients to continue contributing
to the society
6
Cancer: The overall rate of returning to work following a cancer diagnosis has
grown to over 75% due to innovative therapies2
In France, 82.1% of
working women
diagnosed with breast
cancer returned to work
after a median sick leave of
10.8 months4
In the Netherlands, 83% of
working individuals
diagnosed with head and
neck cancer returned to
work, and most often within
6 months after treatment5
In Japan, 81% of
patients diagnosed
with cancer returned
to work within 12
months of their initial
sick leave3

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44%of the total increase in
the longevity of the Greek
2.2% annual
reduction in hospital
discharges.
62%offset of the
increase in pharma
expenditure by reducing
in hospital expenditure
The new innovative treatments introduced during 1995-
2010 contributed to:
Source: Lichtenberg F et al Pharmaceutical Innovation, Longevity, and Medical Expenditure in Greece, 1995-2010 CESIFO Centre for Economic Studies & IFO
Institute WORKING PAPER NO. 5166 JANUARY 2015

8. Current health system challenges
8
AGING POPULATION
MULTI – MORBIDITY
CONDITIONS
GROWING CHRONIC
DISEASE BURDEN
INCREASING SOCIAL/POLITICAL
PRESSURES
CONSTRAINED
BUDGETS
PERSISTANCE OF RISK
FACTORS
LACK OF DATA FOR
INFORMED DECISION-MAKING

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Source: Rand Corporation

10. How can we ensure access to innovative treatments in a
financially sustainable system?
10
Cost

11. Step 1. Develop public health and disease management strategies
to fight unhealthy lifestyles and support people on multi-
morbidity conditions
11
Cardiovascular disease (CVD) causes
more than half of all deaths across
the European Region.1
Combination drug therapy for CVD
(such as aspirin, beta blockers, diuretics
and statins) prevents serious
complications, and has led to a 75%
reduction in myocardial infarction
among high risk individuals1 2
Source: Health Advances analysis; 1WHO 2006 Gaining Health: The European
Strategy for the Prevention and Control of Noncommunicable Diseases; 2WHO
2005 Preventing Chronic Diseases: A Vital Investment
“We have to create an environment
conducive to healthier living. […]
All sectors of government and the private
sector have to be involved; it is not just
the responsibility of the Ministry of Health
alone.”
WHO on World Health Day 2013
(http://www.euro.who.int/en/about-us/partners/observatory/studies/health-in-all-
policies-seizing-opportunities,-implementing-policies)
“All ministers are health
ministers”
Sir Michael Marmot, Professor
of Epidemiology and Public
Health at University College
London

12. Step 2: Off patent sector can free health care resources to
fund innovation
12
Source: IMS Health. Price for 30 days treatment (30 pills package) of the
highest selling generic and of the original at time of patent loss

13. Step 3. Introduce proper HTA mechanisms so that every patient is
reimbursed to receive the appropriate treatment
13
EuNEΗΤΑ CORE HTA MODEL
1. Health Problem and current treatment
2. Description and technical aspects of new
technologies
3. Safety
4. Clinical effectiveness
5. Cost and economic evaluation
6. Moral issues
7. Health Care Organizational Issues
8. Social Aspects
9. Legal Aspects

14. Step 4. Improve the managerial capabilities of the system.
Embrace organizational health innovation
14
Enhance prescribing monitoring capabilities: Electronic Controls but also medical department
in EOPYY, academic detailing etc.
Establish therapeutic protocols and disease registries
Implement negotiated agreements in areas of high innovation, high budget but also
positive health impact (i.e. HepC, but other areas as well
Exclude vaccines, HIV, plasma products or other special therapeutic areas from
clawback targets
Implement disease management strategies in high priority areas
Placing Patient at the center of everything we do

15. A value driven health care system is affordable for the benefit of the
patients and society as a whole
15
Delayed Access
Low Innovation
External Ref. Pricing
Narrow Use
of HTA
Parallel
Trade
Therapeutic
Ref Pricing
Clawbacks
Price Cuts
Sound Value
Assessment
Transparent and Predictable
Decision Making Process
Generic Price
Competition
Access, Innovation and Affordability
Differential Pricing
Short-sighted and arbitrary
decisions

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