Cadth 2015 a2 juzwishin valuing medical technologies
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The document discusses Alberta's approach to valuing medical technologies through collaborative partnerships between Alberta Health, Alberta Innovates Health Solutions, and Alberta Health Services. It outlines the formation of Strategic Clinical Networks to focus on unmet needs, facilitate technology pull, and identify opportunities for disinvestment. The networks aim to bring research and innovation users together on the same team to generate new knowledge with value.
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Cadth 2015 a2 juzwishin valuing medical technologies
- 1. Valuing Medical Technologies: An Alberta Perspective Don Juzwishin PhD. Director Health Technology Assessment and Innovation April 13, 2015
- 2. 2 The Context • Transformation • Structural changes • Process challenges • Fiscal challenges • Implementation • Relevance • Timeliness • Opportunity for refinement
- 3. 3 The Approach • Collaborative Partnership of AH, AIHS & AHS • Review and refine AACHT • Formation of SCNs • Focus on unmet needs • Facilitate technology pull • Identify disinvestment • Collaboration with IHE, U of A, U of C, CADTH • Top down meets bottom up Research + Innovation Users of Knowledge On the same team New Knowledge with value
- 4. 4 1. Diabetes, Obesity and Nutrition - SCN 2. Seniors’ Health - SCN 3. Bone & Joint Health - SCN 4. Cardiovascular and Stroke - SCN 5. Cancer - SCN 6. Addiction & Mental Health - SCN 7. Emergency - SCN 8. Critical Care - SCN 9. Surgery – SCN 10. Respiratory - SCN 11. Primary Care & Chronic Disease 12. Maternal, Child, Newborn & Youth Health 13. Kidney 14. Diagnostics (Imaging/Lab Medicine) 15. Gastrointestinal 16. Neuroscience, Vision, ENT 2012 - 2014 (others under consideration) Strategic Clinical Networks (SCNs) – each has SD
- 5. 5 Opportunities • ICER and DCF become confluent and below the WTP threshold • Request for innovation • Stimulate commercialization • Replenish research feedstock
Editor's Notes
- The cost-effectiveness plane or matrix graphically depicts ICER-based merit of assessed projects plotted into four quadrants (increased cost/decreased benefit, increased cost/increased benefit, decreased cost/decreased benefit, and decreased cost/increased benefit). This graphical depiction thus stratifies the meaning of the ICER into four meaningful outcomes.5 Furthermore, circumstances in which cost and effectiveness are equally lowered or increased yielding identical ICER values are mapped according to cost and effectiveness coordinates, providing the basis for the ICER numeric value. Points in this Bayesian coordinate scheme are plotted along the x-axis according to the value ε1 − ε0, where ε1 is the experimental effectiveness and ε0 is the control effectiveness—or difference in effectiveness.6 Points are plotted along the y-axis γ1 − γ0, where γ1 is the experimental cost and γ0 is the control cost—or difference in cost. The result is a logical framework in which each quadrant represents an experimental outcome compared with the mean. Quadrants are numbered I-IV (see figure 1) and each connotes a different cost/effectiveness outcome with respect to the control. New interventions typically plot into in quadrant I with higher cost and effectiveness compared with established treatments. Experimental treatments in quadrant II cost more and decrease effectiveness compared with the control, while treatments in quadrant III decrease both cost and effectiveness and treatments in quadrant IV decrease cost and increase effectiveness. This system has obvious benefits when the potential for ambiguity in ICER is considered. For example, if an experimental treatment increases costs by 10 units and effectiveness by 5 units—plotting into quadrant I—and another treatment decreases costs by 10 units and decreases effectiveness by 5 units—plotting into quadrant III—the ICER is 2 for both treatments, despite their contradictory attributes. While this tetralogical framework simplifies the significance of the ICER, there is proportional significance to the points within the Cartesian system. For example, lower ICER values in quadrant I denote greater benefit per unit cost, approaching quadrant IV spatially and in terms of value. Likewise, higher ICER values in quadrant III approach quadrant IV and boast greater savings per unit of effectiveness sacrificed