This presentation summarises the results of experts interviews aiming to identify the key factors which have influenced the access and the uptake of direct acting antivirals (DAAs) in selected European countries. This qualitative piece of analysis was conducted as part of a larger project studying the development and the diffusion of innovation in the market of treatments for hepatitis C. The interviews shed light on the reimbursement strategies and other factors, relating to the ability of individual health care systems to supply the treatments, which may have influenced, positively of negatively, access and speed of uptake of DAAs in Europe.
Author(s) and affiliation(s): Margherita Neri, Office of Health Economics; Mikel Berdud, Office of Health Economics; Martina Garau, Office of Health Economics; Phill O’Neill, Office of Health Economics; Chris Sampson, Office of Health Economics; Adrian Towse, Office of Health Economics.
Conference/meeting: EuHEA Conference 2018
Location: Maastricht, Netherlands
Date: 11/07/2018
In a research report by Berdud, M., Drummond, M. and Towse, A. (2018), a reasonable price for an orphan drug was established based on the proposition that rates of returns from investments in developing orphan drugs should be no greater than the industry average (for all drugs). At the 2018 EuHEA conference held in Maastricht, The Netherlands, 11-14 July, Mikel showed (i) how the reasonable price should be established and (ii) how NICE's cost-effectiveness threshold should be adjusted to ensure a reasonable price for an orphan drug. In slides results are discussed and conclusions showed too.
Author(s) and affiliation(s): Mikel Berdud, PhD (OHE); Prof. Mike Drummond (University of York); Prof. Adrian Towse (OHE)
Conference/meeting: EuHEA 2018
Location: Maastricht, The Netherlands
Date: 12/07/2018
The Value of Targeted Sequencing in Advanced Cancer: DCE to Elicit the Public...Office of Health Economics
This project seeks to elicit the public’s preferences for different features of a genomic test to sequence advanced solid cancer tumours. Understanding the relative preferences for various attributes of targeted testing are useful for determining the value of sequencing approaches, and informing technology adoption decisions. A discrete choice experiment (DCE) survey was designed to assess the preferences of members of the Australian general public for targeted sequencing in advanced cancer. The survey presented respondents with 12 questions in which they had to choose between two unlabelled tests (Test A and Test B). Tests were specified in terms of five attributes: time to receive the test result; cost of the test; likelihood that the test result will lead to a change in treatment; length of time health care professionals spend describing the test; and type of health care team who explains the test result. Respondents were sampled from an online panel and also completed questions related to demographic and socio-economic factors, experiences of cancer and familial history. We found that cost, timeliness, expertise/location and likeliness of changing treatment regimes were identified as attributes of genomic sequencing that are most valuable to a sample of the public. These results will ultimately be compared with the results of an ongoing DCE being conducted with patients with advanced cancer who are undergoing sequencing.
Author(s) and affiliation(s): Paula Lorgelly (OHE), Grace Hampson (OHE), James Buchanan (Oxford), Melissa Martyn (MGHA), Jayesh Desai (PeterMac), Clara Gaff (MGHA), and iPREDICT MGHA Flagship collaborators
Conference/meeting: EuHEA 2018
Location: Maastricht, the Netherlands
Date: 12/07/2018
R&D, Competition and Diffusion of Innovation in EU: The Case of Direct Acting...Office of Health Economics
An OHE research studies the role of R&D incentives and market competition in facilitating the diffusion of pharmaceutical innovation across European countries. The research studies the case of the DAA treatments for hepatitis C. Methods and results were presented and discussed at EUHEA conference 2018 held in Maastricht, The Netherlands, 11-14 July. The analysis concludes that (i) R&D incentives may have encouraged in-patent competition of DAAs and (ii) competition had a positive impact on uptake and adoption of DAA treatments in the countries studied (top-5 European plus Portugal).
Author(s) and affiliation(s): Mikel Berdud (OHE), Phill O'Neill (OHE), Martina Garau (OHE), Adrian Towse (OHE)
Conference/meeting: EUHEA Conference 2018
Location: Maastricht, The Netherlands
Date: 12/07/2018
Eligibility for national screening programmes can be personalised according to individual risk in order to improve outcomes and reduce costs. Existing methods of economic evaluation can be adapted to identify risk thresholds and help optimise services. We describe the development of a decision model used to evaluate the cost-effectiveness of risk-based screening for diabetic retinopathy.
Author(s) and affiliation(s): Chris Sampson, Office of Health Economics Marilyn James, University of Nottingham David Whynes, University of Nottingham Antonio Eleuteri, University of Liverpool Simon Harding, University of Liverpool.
Conference/meeting: Health Technology Assessment International (HTAi) 2018
Location: Vancouver, Canada
Date: 03/06/2018
OHE Lunchtime Seminar with Associate Professor Paula Lorgelly, Deputy Director, Office of Health Economics
From the Antipodes to the Motherland: reflections on HTA decision makers as budget takers and budget makers
In a research report by Berdud, M., Drummond, M. and Towse, A. (2018), a reasonable price for an orphan drug was established based on the proposition that rates of returns from investments in developing orphan drugs should be no greater than the industry average (for all drugs). At the 2018 EuHEA conference held in Maastricht, The Netherlands, 11-14 July, Mikel showed (i) how the reasonable price should be established and (ii) how NICE's cost-effectiveness threshold should be adjusted to ensure a reasonable price for an orphan drug. In slides results are discussed and conclusions showed too.
Author(s) and affiliation(s): Mikel Berdud, PhD (OHE); Prof. Mike Drummond (University of York); Prof. Adrian Towse (OHE)
Conference/meeting: EuHEA 2018
Location: Maastricht, The Netherlands
Date: 12/07/2018
The Value of Targeted Sequencing in Advanced Cancer: DCE to Elicit the Public...Office of Health Economics
This project seeks to elicit the public’s preferences for different features of a genomic test to sequence advanced solid cancer tumours. Understanding the relative preferences for various attributes of targeted testing are useful for determining the value of sequencing approaches, and informing technology adoption decisions. A discrete choice experiment (DCE) survey was designed to assess the preferences of members of the Australian general public for targeted sequencing in advanced cancer. The survey presented respondents with 12 questions in which they had to choose between two unlabelled tests (Test A and Test B). Tests were specified in terms of five attributes: time to receive the test result; cost of the test; likelihood that the test result will lead to a change in treatment; length of time health care professionals spend describing the test; and type of health care team who explains the test result. Respondents were sampled from an online panel and also completed questions related to demographic and socio-economic factors, experiences of cancer and familial history. We found that cost, timeliness, expertise/location and likeliness of changing treatment regimes were identified as attributes of genomic sequencing that are most valuable to a sample of the public. These results will ultimately be compared with the results of an ongoing DCE being conducted with patients with advanced cancer who are undergoing sequencing.
Author(s) and affiliation(s): Paula Lorgelly (OHE), Grace Hampson (OHE), James Buchanan (Oxford), Melissa Martyn (MGHA), Jayesh Desai (PeterMac), Clara Gaff (MGHA), and iPREDICT MGHA Flagship collaborators
Conference/meeting: EuHEA 2018
Location: Maastricht, the Netherlands
Date: 12/07/2018
R&D, Competition and Diffusion of Innovation in EU: The Case of Direct Acting...Office of Health Economics
An OHE research studies the role of R&D incentives and market competition in facilitating the diffusion of pharmaceutical innovation across European countries. The research studies the case of the DAA treatments for hepatitis C. Methods and results were presented and discussed at EUHEA conference 2018 held in Maastricht, The Netherlands, 11-14 July. The analysis concludes that (i) R&D incentives may have encouraged in-patent competition of DAAs and (ii) competition had a positive impact on uptake and adoption of DAA treatments in the countries studied (top-5 European plus Portugal).
Author(s) and affiliation(s): Mikel Berdud (OHE), Phill O'Neill (OHE), Martina Garau (OHE), Adrian Towse (OHE)
Conference/meeting: EUHEA Conference 2018
Location: Maastricht, The Netherlands
Date: 12/07/2018
Eligibility for national screening programmes can be personalised according to individual risk in order to improve outcomes and reduce costs. Existing methods of economic evaluation can be adapted to identify risk thresholds and help optimise services. We describe the development of a decision model used to evaluate the cost-effectiveness of risk-based screening for diabetic retinopathy.
Author(s) and affiliation(s): Chris Sampson, Office of Health Economics Marilyn James, University of Nottingham David Whynes, University of Nottingham Antonio Eleuteri, University of Liverpool Simon Harding, University of Liverpool.
Conference/meeting: Health Technology Assessment International (HTAi) 2018
Location: Vancouver, Canada
Date: 03/06/2018
OHE Lunchtime Seminar with Associate Professor Paula Lorgelly, Deputy Director, Office of Health Economics
From the Antipodes to the Motherland: reflections on HTA decision makers as budget takers and budget makers
This timely presentation addresses the changes that are proposed under NICE's new value-based assessment (VBA) approach to assessing health technologies. It reviews NICE's current approach and decisions to date for all technologies and separately for orphan and cancer drugs. VBA's proposed calculations for burden of illness and societal impact use estimates of 'shortfall' are illustrated in the presentation. Also discussed are changes in QALY thresholds.
Prof Angela Timoney
Presentation at EIPG - Royal Pharmaceutical Society Scientific Symposium "Advances in Technology Impacting the Pharmaceutical Industry" at the University of Strathclyde, Glasgow 2015.
OxfordSM's pharma case studies - providing a call to actionOxfordSM
Brand teams have to be increasingly innovative when finding ways to prompt patients and physicians to intervene at the right time.
Campaigns such as GSK’s Greatest Season Ever for FLONASE®, implemented last year in the United States which made the decision to prepare for the allergy season easier for patients by linking the proactive purchase of the brand to the start of the baseball season.
Providing A Call To Action:
We find that examples from within and outside of healthcare can often prompt this innovation. They act as a way of bringing in new perspectives and allowing teams to explore new avenues and new ideas.
So, in the spirit of hoping this will prompt some new ideas in your brand team, here are our favourite case studies that speak to the need to provide a call to action.
Understanding Regulatory and Payer Requirements Throughout CommercializationPAREXEL International
Learn about regulator and payer evidence requirements as well as other key market access considerations in drug development. Read this presentation from PAREXEL Consulting experts.
Global HTA and pricing mechanisms
What can we learn about national medicines pricing and procurement?
Led by Janssen UK
Day One, Pop-up University 3, 16.00
Ομιλία - Παρουσίαση: “Βιοδείκτες: Η Κλινική τους Αξία και η Σχέση τους με τον ΕΟΠΥΥ”
Νικόλαος Τσούλος, MSc, MBA, Βιοχημικός, Διευθύνων Σύμβουλος GeneKor Medical SA
Ομιλία-Παρουσίαση: Edith Frénoy, Director of Market Access/HTA, European Federation of Pharmaceutical Industries Associations (EFPIA)
Τίτλος Ομιλίας: «HTA cooperation in Europe: can it support the Greek debate?»
Leveraging Imaging and Wearable Technology For Agile Clinical TrialsPAREXEL International
Learn how to manage and overcome key challenges to deploying imaging and wearable technology effectively in clinical trials from PAREXEL Consulting experts.
Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...Office of Health Economics
Jorge Mestre-Ferrandiz also presented a guest lecture at City University, London, on 17 March 2016, on the topic of the economics of the market for medicines.
The first half of the lecture included an overview of the global challenges facing medicines manufacturers, discussion of the ‘supply side’ (focusing on research and development of new drugs), and evidence relating to the ‘demand side’ which suggests that UK spending on medicines as a percentage of GDP is already amongst the lowest in developed countries.
The second half of the lecture looked at NICE and the ‘hurdle’ of demonstrating cost-effectiveness, as well as an overview of pricing regulation, and specific characteristics of the UK market.
Reimbursement and pricing strategies for drugs for ultra rare diseases: What can Canada learn from experiences across the pond?
Tania Stafinski, University of Alberta
Rare Disease Day Conference 2020 March 9-10
R&D, Competition and Diffusion of Innovation in EU: The Case of Direct Acting...Office of Health Economics
Mikel Berdud, PhD (Office of Health Economics) discussed on the role of incentives for Pharmaceutical innovation (with especial attention to IP rights) and in-patent competition on facilitating access to DAAs across European countries. Other factors affecting access to DAAs in European countries beyond incentives for R&D and market competition were also discussed in the presentation.
Author(s) and affiliation(s): Mikel Berdud (Office of Health Economics) Martina Garau (Office of Health Economics) Margherita Neri (Office of Health Economics) Phill O’Neill (Office of Health Economics) Chris Sampson (Office of Health Economics) Adrian Towse (Office of Health Economics)
Project funded by: Gilead Sciences Ltd.
Conference meeting: XXXVII Jornadas de Economía de la Salud
Location: Auditorio Alfredo Kraus, Las Palmas de Gran Canaria, Canarias, Spain
Date: 20/06/2018
This timely presentation addresses the changes that are proposed under NICE's new value-based assessment (VBA) approach to assessing health technologies. It reviews NICE's current approach and decisions to date for all technologies and separately for orphan and cancer drugs. VBA's proposed calculations for burden of illness and societal impact use estimates of 'shortfall' are illustrated in the presentation. Also discussed are changes in QALY thresholds.
Prof Angela Timoney
Presentation at EIPG - Royal Pharmaceutical Society Scientific Symposium "Advances in Technology Impacting the Pharmaceutical Industry" at the University of Strathclyde, Glasgow 2015.
OxfordSM's pharma case studies - providing a call to actionOxfordSM
Brand teams have to be increasingly innovative when finding ways to prompt patients and physicians to intervene at the right time.
Campaigns such as GSK’s Greatest Season Ever for FLONASE®, implemented last year in the United States which made the decision to prepare for the allergy season easier for patients by linking the proactive purchase of the brand to the start of the baseball season.
Providing A Call To Action:
We find that examples from within and outside of healthcare can often prompt this innovation. They act as a way of bringing in new perspectives and allowing teams to explore new avenues and new ideas.
So, in the spirit of hoping this will prompt some new ideas in your brand team, here are our favourite case studies that speak to the need to provide a call to action.
Understanding Regulatory and Payer Requirements Throughout CommercializationPAREXEL International
Learn about regulator and payer evidence requirements as well as other key market access considerations in drug development. Read this presentation from PAREXEL Consulting experts.
Global HTA and pricing mechanisms
What can we learn about national medicines pricing and procurement?
Led by Janssen UK
Day One, Pop-up University 3, 16.00
Ομιλία - Παρουσίαση: “Βιοδείκτες: Η Κλινική τους Αξία και η Σχέση τους με τον ΕΟΠΥΥ”
Νικόλαος Τσούλος, MSc, MBA, Βιοχημικός, Διευθύνων Σύμβουλος GeneKor Medical SA
Ομιλία-Παρουσίαση: Edith Frénoy, Director of Market Access/HTA, European Federation of Pharmaceutical Industries Associations (EFPIA)
Τίτλος Ομιλίας: «HTA cooperation in Europe: can it support the Greek debate?»
Leveraging Imaging and Wearable Technology For Agile Clinical TrialsPAREXEL International
Learn how to manage and overcome key challenges to deploying imaging and wearable technology effectively in clinical trials from PAREXEL Consulting experts.
Presentation - The Economics of the Market for Medicines, Jorge Mestre-Ferran...Office of Health Economics
Jorge Mestre-Ferrandiz also presented a guest lecture at City University, London, on 17 March 2016, on the topic of the economics of the market for medicines.
The first half of the lecture included an overview of the global challenges facing medicines manufacturers, discussion of the ‘supply side’ (focusing on research and development of new drugs), and evidence relating to the ‘demand side’ which suggests that UK spending on medicines as a percentage of GDP is already amongst the lowest in developed countries.
The second half of the lecture looked at NICE and the ‘hurdle’ of demonstrating cost-effectiveness, as well as an overview of pricing regulation, and specific characteristics of the UK market.
Reimbursement and pricing strategies for drugs for ultra rare diseases: What can Canada learn from experiences across the pond?
Tania Stafinski, University of Alberta
Rare Disease Day Conference 2020 March 9-10
R&D, Competition and Diffusion of Innovation in EU: The Case of Direct Acting...Office of Health Economics
Mikel Berdud, PhD (Office of Health Economics) discussed on the role of incentives for Pharmaceutical innovation (with especial attention to IP rights) and in-patent competition on facilitating access to DAAs across European countries. Other factors affecting access to DAAs in European countries beyond incentives for R&D and market competition were also discussed in the presentation.
Author(s) and affiliation(s): Mikel Berdud (Office of Health Economics) Martina Garau (Office of Health Economics) Margherita Neri (Office of Health Economics) Phill O’Neill (Office of Health Economics) Chris Sampson (Office of Health Economics) Adrian Towse (Office of Health Economics)
Project funded by: Gilead Sciences Ltd.
Conference meeting: XXXVII Jornadas de Economía de la Salud
Location: Auditorio Alfredo Kraus, Las Palmas de Gran Canaria, Canarias, Spain
Date: 20/06/2018
The data and analytics of the new life sciences marketplace handoutFrank Wartenberg
Trends in the global healthcare market. Development of pharmaceuticals, market data and insights.
Presentation delivered at the 9th International Pharmaceutical Compliance Congress and Best Practices Forum, Brussels, 2015
The role of health technology assessment bodies in the value of cancer care i...Francois MAIGNEN
This presentation details the role of European HTA bodies in the value of new cancer therapies in Europe. The presentation also describes the NICE scientific advice activities and the activities of the HTA / regulatory parallel advice.
Μάκης Παπαταξιάρχης - 6th Clinical Research ConferenceStarttech Ventures
Ομιλία: Μάκης Παπαταξιάρχης, Διευθύνων Σύμβουλος Janssen Ελλάδος, Pharmaceutical Companies of Johnson & Johnson, Πρόεδρος του PhRMA Innovation Forum, Πρόεδρος του AmCham Pharmaceutical Committee
Ομιλία - Παρουσίαση: “The Value of Innovation to Patients & Health Systems”
Clare Hague PhD, Therapy Area Market Access Leader for Hematology, Janssen EMEA Region
The Conference Board of Canada - Tuesday, April 11, 2017 - Toronto, ON
"Leveraging Change Leadership: Driving Innovation Procurement Forward"
Presentació a càrrec de Antoni Gilabert, director de l'àrea de Farmàcia i del Medicament del CSC
APIFARMA, the Portuguese pharmaceutical industry assocation, holds a series of conference throughout they year. OHE's Jorge Mestre-Ferrandiz, an expert on pricing and reimbursement (P&R) in Europe, was the lead speaker at the October 2014 conference on access to innovation. His presentation covers existing and potential approaches to evaluating new medicines as a condition for P&R in France, Germany and the UK.
This presentation by the Martin Wenzl (Policy Analyst, OECD Health Division) was made during a workshop on “Regulation and competition in light of digitalisation” held by the OECD in Paris on 31 January 2018. More papers and presentations on the topic can be found out at oe.cd/wrcd.
EUPATI 2013 Conference: Vision on Patient involvement in medicines R&D: Here...EUPATI
"Patient involvement in medicines R&D: Here we are, and where we want to be in 2020" by Nicola Bedlington, Executive Director of European Patients' Forum and Coordinator of the EUPATI project, at the EUPATI 2013 Conference on 19 April 2013.
Scaling up innovation in healthcare - A Methodology Framework 2015Marc Lange
This presentation introduce a methodology scaling-up developed by "doers and shapers" internationally known for their expertise in eHealth and digital health
On 31 October 2019, Adrian Towse and Chris Henshall from the Office of Health Economics (OHE) presented at the G20 meeting on antimicrobial drugs R&D in Paris organised by the Wellcome Trust. The topic of their presentation was HTA and payment mechanisms for new drugs to tackle antimicrobial resistance.
This presentation looks at ways in which governments can set prices, including “cost plus”, value, and the external referencing of prices elsewhere. It looks at the role that competition can play in keeping down prices. In that context it briefly discusses pricing proposals being considered in Malaysia. It makes the case for using HTA to inform pricing decisions.
Adrian Towse
% GDP spending in UK, G5 countries and OECD upper middle income countries. W...Office of Health Economics
This presentation looks at rates of GDP spend on health care, distinguishing between categories of country (i.e. levels of GDP pre capita). It looks at the relationship between rates of spending and moves to universal health coverage, and explores alternative ways of increasing expenditure and making decisions about which services to provide with the money available.
The role of real world data and evidence in building a sustainable & efficien...Office of Health Economics
This presentation defines RWD and RWE in the context of digital health, and looks at potential uses for RWD and RWE. It briefly sets out the current landscape in Malaysia and looks at the challenges in using RWE. In particular, the issues of access, governance and ensuring good quality are considered.
The aim of this educational symposium was to discuss why we should seek value across the health care system and how we can apply existing research methods to measure the value of services. While considerable political attention in developed countries continues to be focused on drug spending, there is also growing awareness of the significant contribution of non-drug components of health care (e.g., hospital services and inefficient care delivery) to overall spending growth and patient affordability. At the same time, there is growing interest in making greater use of value assessment and value-based payment to control spending and better align it with care quality. In order to promote greater value, and to do so in ways that respond to the needs of payers and patients, it is essential to assess value across both drug- and non-drug interventions and health care services. This panel will offer expert viewpoints to identify and discuss gaps in value information, rationale and approaches to track and reduce system-wide low value care, and research methods for how to measure health care services.
Role Substitution, Skill Mix, and Provider Efficiency and Effectiveness : Les...Office of Health Economics
Graham participated in an organised session on Monday July 15th 2019. In the session he presented his paper with his co-author Ioannis Laliotis from the London School of Economics. The paper revisits the relationship between workforce and maternity outcomes in the English NHS in an attempt to contribute knowledge to an important policy question for which there has been a paucity of research.
This research explores the feasibility of introducing an Outcome-Based Payment approach for new cancer drugs in England. A literature review explored the current funding landscape in England, the available evidence on existing OBP schemes internationally, and
which outcomes cancer patients value most. Two focus groups and an online survey with patients and carers, as well as interviews with NHS and government stakeholders, healthcare
professionals, and pharmaceutical industry representatives, provided additional evidence on the feasibility and suitability of OBP schemes
Understanding what aspects of health and quality of life are important to peopleOffice of Health Economics
Poster presentation from the EuroQol Plenary Meeting 2019, Brussels, Belgium. By Koonal Shah, Brendan Mulhern, Patricia Cubi-Molla, Bas Janssen, and David Mott.
Koonal presented as part of an organised session on ‘moving beyond conventional economic approaches in palliative and end of life care’. He summarised the empirical evidence on the extent of pubic support for an end of life premium, before discussing some novel approaches that have been used in recent studies. His presentation was discussed by Helen Mason of Glasgow Caledonian University.
Author(s) and affiliation(s): Koonal Shah, Office of Health Economics
Event: iHEA Congress
Date: 17/07/2019
Location: Basel, Switzerland
Assessing the Life-Cycle Value Added of Second Generation Antipsychotics in S...Office of Health Economics
This research presented in a poster at HTAi 2019, Cologne (Germany) by a team of OHE and IHE researchers, estimates the value added by second generation antipsychotics over their life-cycle in the UK and Sweden. It concludes that considering the entire life-cycle, the value added by SGAs to the system is higher than the expected value estimated at launch. P&R decisions should consider how to measure, capture and take into account the value added by medicines over the long-run.
Author(s) and affiliation(s): Mikel Berdud (Office of Health Economics, London), Niklas Wallin-Bernhardsson (Institute for Health Economics, Stockholm), Bernarda Zamora (Office of Health Economics, London), Peter Lindgren (Institute for Health Economics, Stockholm), Adrian Towse (Office of Health Economics, London)
Event: HTAi 2019 Annual Meeting
Date: 18/06/2019
Location: Cologne, Germany
There is growing recognition that HTA and contracting systems for antimicrobials need to be adapted to help fight the threat of antimicrobial resistance (AMR), but there is little agreement on how. This poster reports findings from a literature review, expert interviews and face-to-face discussions at a Forum on the current HTA and payment systems for antibiotics across Europe and a number of recommendations for adapting these systems to respond to the challenges of AMR.
Author(s) and affiliation(s): Margherita Neri (OHE) Grace Hampson (OHE) Christopher Henshall (OHE visiting fellow, independent consultant) Adrian Towse (OHE)
Event: HTAi annual conference 2019
Date: 18/06/2019
Location: Cologne, Germany
Assessing the Life-cycle Value Added of Second-Generation Antipsychotics in S...Office of Health Economics
This study aims to guide access decisions and drive the discussion on access and price, through recognition of the dynamic nature of value added by pharmaceutical innovation over the long-run. The analysis of the life-cycle value of risperidone estimates the value generated in the UK and Sweden. Results show that health systems were able to appropriate most of the life-cycle value generated, and this is larger than estimated at launch.
Author(s) and affiliation(s): Mikel Berdud(1), Niklas Wallin-Bernhardsson(2), Bernarda Zamora(1), Peter Lindgren(2), and Adrian Towse(1) (1) Office of Health Economics (2) The Swedish Institute for. Health Economics
Event: XXXIX JORNADAS DE ECONOMÍA DE LA SALUD
Date: 12/06/2019
Location: Albacete, Spain
Prescribed Specialised Services (PSS) Commissioning for Quality and Innovation (CQUIN) schemes were launched in 2013 in England with the aim of improving the quality of specialised care and achieving value for money. During this presentation, Marina Rodes Sanchez described the key features of the schemes and discussed its strengths and weaknesses based on international pay-for-performance literature.
Author(s) and affiliation(s): Yan Feng, Queen Mary University of London; Søren Rud Kristensen, Imperial College London; Paula Lorgelly, King’s College London; Rachel Meacock, University of Manchester; Marina Rodes Sanchez, Office of Health Economics; Luigi Siciliani, University of York; Matt Sutton, University of Manchester
Event: XXXIX Spanish Health Economics Association Conference
Date: 12/06/2019
Location: Albacete, Spain
In this session, Meng Li sets out estimates of real option value for drugs arguing that option value matters and can be calculated. Adrian Towse sets out likely payer concerns about incorporating real option value into decision making. Meng Li responds to these concerns. Jens Grueger sets out how industry considers investment opportunities, arguing that if patients (and society) have preferences these need to be reflected in P&R decisions.
Author(s) and affiliation(s): Meng Li, Postdoctoral Research Fellow, Leonard D Schaeffer Center, University of Southern California, Los Angeles, CA, USA. Adrian Towse, Emeritus Director, Office of Health Economics, London, UK Jens Grueger, formerly Head of Global Access, Senior Vice President at F. Hoffmann-La Roche
Event: ISPOR 2019
Location: New Orleans, USA
Date: 21/05/2019
MCDA OR WEIGHTED CEA BASED ON THE QALY? WHICH IS THE FUTURE FOR HTA DECISION ...Office of Health Economics
In this ISPOR session Chuck Phelps and Adrian Towse debated the case for and against using MCDA to support HTA decision making, as compared to weighting or augmenting a QALY based ICER approach. Chuck Phelps argued for use of MCDA, Adrian Towse for weighting the QALY. Nancy Devlin set the scene and moderated.
Author(s) and affiliation(s): Nancy Devlin, Director, Centre for Health Policy, University of Melbourne, Australia Adrian Towse, Emeritus Director, Office of Health Economics, London, UK Chuck Phelps, University of Rochester, Rochester, NY USA
Event: ISPOR 2019
Location: New Orleans, USA
Date: 21/05/2019
The issue of open-source models in the cost-effectiveness and disease-level (collaborative) models has been brewing for many years. There has been a marked growth in open science, and funding bodies and publishers increasingly require that research data be made available. As mentioned in our previous Issue Panel, “cost-effectiveness models synthesise a wide range of evidence to facilitate extrapolation over time and from intermediate to final decision endpoints. These models are often statistically sophisticated and require assumptions that are not directly testable. This can lead to decision-makers “discounting” the results of cost-effectiveness analyses, particularly if the developer is seen as partial.” Open-source models, then, would encourage greater transparency in pharmacoeconomic modeling and the reuse and updating of the best/most useful models; they are essential if cost-effectiveness analyses are to be widely accepted to reduce bias, increase transparency, improve model access, and allow for faster access to critical knowledge. The ISPOR-SMDM guidelines and the EUnetHTA joint action projects, are supportive of these views on collaboration, transparency, confidentiality, processes and consistency offered by the availability of open-source models to improve decision-making around health care and reimbursement. With openness and sharing, however, come issues of copyright and access and a need to define how model sharing can be achieved in a fair and equitable manner. There is, therefore, a need to develop an ongoing dialog on openness, especially where the research may be considered precompetitive and not worthy of IP investment. The pros and cons of open source models and the proposed mission of the Open Source Model SIG to curate an ongoing dialog regarding issues around creating, disseminating, sharing, evaluating, and updating open source cost-effectiveness and comparative effectiveness models will be debated amongst SIG members.
Author(s) and affiliation(s): Nancy Risebrough, Senior Principal, ICON plc, Toronto, Canada Jeroen P Jansen; Innovation & Value Initiative; Precision Medicine Group; and Stanford University Lotte Steuten, Vice President & Head of Consulting, Office of Health Economics, UK Renée JG Arnold, PharmD, RPh, ICON plc, New York, NY and Icahn School of Medicine at Mount Sinai, New York, NY, USA
Event: ISPOR 2019 Annual Meeting
Date: 20/05/2019
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
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Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
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Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Key factors driving access and uptake of hepatitis C treatments in Europe. Results from experts interviews
1. Key factors driving access and
uptake of hepatitis C treatments
in Europe. Results from experts
interviews
Margherita Neri, Office of Health Economics (OHE)
EuHEA Conference
11-14 July 2018, Maastricht
2. The key factors for the access and uptake of hepatitis C
treatments in Europe
Acknowledgements
This study was funded by a research grant
from Gilead Sciences Ltd
I thank the other authors of the study:
Mikel Berdud, Martina Garau, Phill O’Neill,
Chris Sampson, Adrian Towse
3. The key factors for the access and uptake of hepatitis C
treatments in Europe
Outline
1. Aims
2. Methods
3. Results
4. Discussion
5. Limitations
6. Conclusions
4. The key factors for the access and uptake of hepatitis C
treatments in Europe
Aims
• Berdud M, Garau M, Neri M, O’Neill P, Sampson C, Towse A, “R&D,
competition and diffusion of innovation in EU: the case of Direct Acting
Antivirals (DAAs) for hepatitis C”
• The objectives of Berdud et al. were to explore whether:
i. Existing IP incentives – including SPCs – allow in-class competition whilst
on-patent in European markets for DAAs (i.e. France, Germany, Italy,
Portugal, Spain, UK)
ii. In-class competition led to price decreases, hence facilitated patient
access to and uptake of DAAs in European markets
iii. Other factors related to the characteristics of the healthcare system and of
the condition, played a role in determining prices and access to DAAs
• Use results from quantitative analysis (interviews) to interpret uptake patterns
of the quantitative analysis
5. The key factors for the access and uptake of hepatitis C
treatments in Europe
Methods
• Semi-structured interviews to identify key factors that have influenced
positively and negatively access and uptake in the selected countries
(France, Germany, Italy, Portugal, Spain, UK)
• For each country, we recruited interviewees with clinical and decision
making expertise (HTA or payers representatives) on the provision of
HCV treatments
• We secured interviews with 12 experts
Clinicians
HTA experts/ payers
representatives
France x
Germany x x
Italy x x
UK x x
Spain x x
Portugal x x
Pan-European expert
x
6. The key factors for the access and uptake of hepatitis C
treatments in Europe
Results
• We identified factors with an impact on (i) uptake onset, (ii)
speed of adoption and (iii) degree of competition
• We classify these factors into “Pricing & Reimbursement (P&R) and
funding mechanisms” and “other factors”
• Budget impact was very large and represented a challenge for all
countries
P&R and funding mechanisms
• Controlling the patient population
treated
• Funding arrangements (budget cap,
specific budget for HCV treatment)
• Commercial agreements impacting price
• Encouraging market forces
• Enabling early access
Other Factors
• Nature of treatment
• Service delivery
• Health system capacity
7. The key factors for the access and uptake of hepatitis C
treatments in Europe
Results - P&R and funding mechanisms
• In the UK, 12-week treatment was first authorised for
compassionate use and then annual patient quotas were
introduced (10,000 patients per year)
• Italy established seven eligibility criteria (extended to 11 in
2017)
• In Spain and France, priority was given to patients with liver
fibrosis, or patients awaiting transplant/ with liver transplant
complications
In the first years of DAAs, eligibility criteria were
introduced to prioritise the most severe HCV patients
1. Controlling the
patient population
treated
8. The key factors for the access and uptake of hepatitis C
treatments in Europe
Results - P&R and funding mechanisms
In the UK, the budget for HCV was increased to £190 million in
2015 from £40 million the year before (NHS England, 2015)
France set annual caps on HCV total spending, the so called ‘W
rate’ (€450 million in 2014, €700 million in 2015 and €600
million in 2016 and 2017)
Some countries such as Portugal, Italy and Spain set specific
budgets for funding DAAs and chose other mechanisms to limit
total expenditures (price-volume agreements)
Some countries set budget caps to control
expenditures, others introduced specific budgets for
funding DAAs
2. Funding
Arrangements
9. The key factors for the access and uptake of hepatitis C
treatments in Europe
Results - P&R and funding mechanisms
• The UK, Portugal and Germany achieved direct discounts on
list prices
• Italy and Spain used price-volume agreements
• In Portugal, outcome-based agreements (pay-for-cures) not
considered effective at lowering prices due to poor monitoring
of patient outcomes and high cure rates of DAAs
Negotiation of deals on DAAs prices, price-volume
and outcome-based agreements
3. Commercial
agreements
impacting price
10. The key factors for the access and uptake of hepatitis C
treatments in Europe
Results - P&R and funding mechanisms
• In the UK, biannual tendering processes: access is provided to
the treatment associated with the lowest price bid
• Italy, and Spain, accelerated their HTA or P&R processes to
foster access of new entrants
Use of market forces to reduce prices and acceleration of
HTA/ P&R processes to accelerate access of new entrants
4. Encouraging
market forces
• In France, sofosbuvir was reimbursed through a temporary
authorisation for market use (ATU)
Authorisation for reimbursement and/or use before
marketing authorisation
5. Enabling early
access
11. The key factors for the access and uptake of hepatitis C
treatments in Europe
Results - P&R and funding mechanisms
1. Controlling
the patient
population
treated
X X X X
2. Funding
Arrangements
(budget caps,
specific
budgets for
HCV)
X
(budget cap)
X
(specific
budget for
HCV)
X
(specific
budget for
HCV)
X
(specific
budget for
HCV)
X
(budget cap)
3. Commercial
agreements
impacting price
X X X X X
4. Encouraging
market forces X X X
5. Enabling
early access X X X
12. The key factors for the access and uptake of hepatitis C
treatments in Europe
Results – other factors
• Diagnosis and treatment with DAAs are seen as worthwhile and
effective by patients and clinicians
Expanded patient population suitable for treatment, improved
efficacy compared to interferon-based treatments
1. Improved nature
of treatment
Opportunity to decentralise and localise the system of
prescribing, to be driven by addiction centres and general
practitioners (GPs)
2. Possible
simplification of
service delivery
• More effective at reaching ‘vulnerable’ patient groups including
people who inject drugs (PWID)
• However, this transition appears not to have taken place yet in
the countries considered:
• In Germany and the UK nurses cannot prescribe new treatments
for HCV
13. The key factors for the access and uptake of hepatitis C
treatments in Europe
Results – other factors
• Testing is common among high risk groups, drug and alcohol clinics and, to
a certain extent, in prisons
• The effort to identify new patients has increased over time in response to
the availability of budgets for treatment and lower prices. Nonetheless,
current testing strategies are still patchy
Testing for HCV is routinely performed in specific patient groups
and settings
3. 1 Health system
capacity
The capacity of health systems to prescribe and administer
treatments for HCV varied across countries
3. 2 Health system
capacity
• Appropriate distribution and number of HCV treatment centres in Germany,
Spain and the UK
• In Italy and France, capacity constraints resulting in some instances in
waiting lists
14. The key factors for the access and uptake of hepatitis C
treatments in Europe
Discussion
• How do the factors identified relate to the (i) uptake onset, (ii) speed
of adoption and (iii) degree of competition, as observed in the
uptake analysis?
0
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France ItalyGermany
Portugal Spain UK
15. The key factors for the access and uptake of hepatitis C
treatments in Europe
Discussion – uptake onset
• Part of the fast access of DAAs in all countries was due to
DAAs’ improved clinical outcomes compared with
interferon-based treatments and their cost-effectiveness
• In France, early adoption was facilitated by existing
arrangements that prioritise early access to medicines
(e.g. ATU in France)
• In Germany and the UK early adoption was facilitated by
the launch-HTA sequence
Uptake charts
16. The key factors for the access and uptake of hepatitis C
treatments in Europe
Discussion – speed of adoption
• In France and Italy, restrictions on patients eligibility and
bottlenecks due to health system capacity constraints may have
limited the speed of uptake
• In the UK, the uptake has been slow due to strict treatment
eligibility, as determined by compassionate use and patient
quotas (10,000 patients per year c.ca).
Patient volumes have increased over time as a result of lower
prices and the eradication target
Uptake charts
17. The key factors for the access and uptake of hepatitis C
treatments in Europe
Discussion – degree of competition
• In Spain and Italy, competition has been encouraged through
accelerated HTA and P&R timelines of competing products.
Both countries struck price-volume agreements leading to
potential discounts in the order of 60% of the list price
• In the UK, the tendering process introduced in 2016 is based
on the awarding large market shares to the companies bidding
the lowest prices
• Portugal is the only country showing “limited competition”.
The small size of the market may have rewarded first entrant
and not attracted additional entrants
Uptake charts
18. The key factors for the access and uptake of hepatitis C
treatments in Europe
Limitations
1. The information collected in the interviews was based on
convenience sample of 12 interviews
• Although we covered most relevant expertise in most
countries, a larger sample including both national and
regional (or local) payers and HTA bodies would have
increased the accuracy of the evidence
2. We were not able to collect information with the
same level of detail and consistency for all countries.
Information on price agreements was confidential or not
readily available in certain countries (e.g. Germany and
Portugal)
19. The key factors for the access and uptake of hepatitis C
treatments in Europe
Conclusions
• The uptake analysis showed that the European system of
IP incentives has not hindered the development of in-class
and in-patent competition in the market of DAAs
• In-class and in-patent competition is a necessary but not
sufficient condition for early adoption and fast uptake
• Results from the interviews suggest that characteristics of
the healthcare system and institutional factors of each
country can affect, positively or negatively, the adoption
of new medicines
20. The key factors for the access and uptake of hepatitis C
treatments in Europe
References
INFARMED, 2015. Define os critérios clínicos de doentes no acesso a medicamentos para o tratamento da
Hepatite C e a assunção de garantias de cumprimento de prazos e critérios que assegurem equidade de acesso
dos doentes aos respetivos tratamentos e por consequência a integração no Formulário Nacional de
Medicamentos. In: Contencioso, G. J. e. (ed.). Legislação Farmacêutica Compilada.
Mouterde, A.-L., Bocquet, F., Fusier, I. and Paubel, P., 2016. Hepatitis C: how has France limited the expenses
related to new treatments? : Taylor & Francis.
NHS England, 2015. Thousands more patients to be cured of hepatitis C [Online]. Available:
https://www.england.nhs.uk/2015/06/patients-hep-c/.
21. The key factors for the access and uptake of hepatitis C
treatments in Europe
To enquire about additional information and analyses, please contact
Margherita Neri at mneri@ohe.org
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