Making comparative effectiveness reward innovation rather than limiting choice

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Making comparative effectiveness reward
innovation - rather than limiting choice

• Waldemar Ingdahl
• President
• The Eudoxa Think Tank

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What will be covered

• Cost effectiveness and HTA
• The European experience of HTA
• Cost effectiveness in practice for better or
  worse
• Conclusions for a free market

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Whats around the corner?

• Vaccines against cancer
• Neuropharmacology delearning phobias
• Better systems of diagnostics
• Personalized drugs
• Medical nanotechnology
• Cure for Alzheimers

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Nairobi Declaration1985

• Principles of rational drug use

• the right drug.
• for the right patient.
• at the right dose.
• and at an affordable cost!

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Resource Constraints
Figure Health expenditure as share of GDP, OECD
countries 2004 U.S. Health Costs are
70 greater than the median of other countries
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Average Annual Growth Rates in Total Health
Expenditures Per Capita
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What is a HTA

• Stands for Health Technology Assessment
• Used when a new drug is introduced
• Using QUALY

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HTA guidelines

• Clinical guidance
• Technology appraisals
• Clinical guidelines
• Interventional procedures
• Public health guidance
• Interventions
• Guidelines

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Technology appraisals

• Pharmaceuticals
• Procedures
• Devices
• Diagnostic methods
• Patient training

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QUALY

• Quality Adjusted Life Year
• Tool of estimation
• Measures additional life span given by a
  treatment in years, and survey data estimating
  quality of life in these years

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Keeping the threshold

• There is no known piece of work which tells you
  what the threshold should be
• Sir Michael Rawlins, Chairman of NICE
• (Select Committee on Health First Report,
• December 2007)

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Mrs. Linda OBoyle
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Conclusions

• Economic evaluation of new (and existing)
  technologies inevitable?
• Demonstrating value-for-money is necessary in all
  healthcare systems. The question is for whom?
• So-called value-based pricing, is it
  unavoidable?
• Needs to balance efficiency with availability,
  not equity

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• If you wish a presentation with additional text
  or have any further questions, please contact me
  at
• waldemar.ingdahl_at_eudoxa.se
• 46 883 87 73

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Thank you for your attention!
www.eudoxa.se
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