Budget Impact Model – Global Needs To Go Local

Budget Impact Model – Global Needs To Go Local

VA L U E I N H E A LT H 1 9 ( 2 0 1 6 ) A 3 4 7 – A 7 6 6 issued by NICE in March 2016 did not recommend use in melanoma. No other ATMP is curren...

65KB Sizes 1 Downloads 35 Views



VA L U E I N H E A LT H 1 9 ( 2 0 1 6 ) A 3 4 7 – A 7 6 6

issued by NICE in March 2016 did not recommend use in melanoma. No other ATMP is currently routinely commissioned.  Conclusions: All EMA approved ATMPs to date have faced EU5 market access challenges, with Germany being particularly complex. HTA assessments have been unfavourable largely due to the uncertainty with available data and – possibly – costs. The ATMP landscape is beginning to form and evolve. It will need to solidify for AMTPs to be viable for the companies seeking to market them and the patients who will benefit. PHP223 Budget Impact Model – Global Needs To Go Local Wang-Silvanto J, Buckland A, Hirst A, Shephard C, Vlachaki I WG Access Ltd, London, UK

Objectives: Healthcare decision-makers are increasingly using Budget Impact Models (BIMs) to evaluate the financial impact of adopting a new health technology. The requirements of BIMs vary by market, and the current BIM development strategy employed by global Health Economics teams do not always meet specific local requirements. The objective of this research was to understand the different requirements of BIMs at the local level, and to develop a method of creating a global BIM that is easily adaptable and/or usable by local markets.  Methods: A fourstep approach was taken: 1) countries that currently adopt HTA process (formal or informal) were identified in Europe, America, Asia-Pacific, and the Middle East; 2) a literature search was conducted to identify the budget impact requirements of different HTA bodies; 3) initial recommendations were outlined, and tested with external stakeholders; and 4) final recommendations were developed.  Results: 23 countries were identified that adopt HTA process; all of these were found to require some form of budget impact analysis. The requirements of the BIMs could be categorised into three groups, based on complexity. Our initial recommendation was to develop a global BIM that incorporates three components: 1) a simple cost analysis of the new health technology; 2) an additional module to include a range of comparators, resource use and healthcare costs; and 3) a cost sequence analysis with selected health outcomes derived from clinical trials. A global BIM should incorporate all three components that can be customised by local markets. This recommendation has been validated by local HTA experts.  Conclusions: In order to make a global BIM more suitable for local use, it should be developed in a modular fashion where local markets can choose which module(s) to adopt. PHP224 Estimation Of Value Of Life With A Model Approach Depending On Net Present Value For Austria, Canada, Japan And Usa Yenilmez FB1, Tuna E2, Kockaya G3 University, Ankara, Turkey, 2Polar Health Economics and Policy Consultancy, Ankara, Turkey, 3Health Economics and Policy Association, Ankara, Turkey 1Hacettepe

Objectives: Value of life is a marginal benefit of preventing death in a given lifetime. Human life is priceless. However, under limited supply of resources or infrastructure, it is important to estimate value of life. The Human Capital Theory(HCT) based on investments to human`s health which can reduce morbidity and mortality, but also improve macro and micro economic outcomes of societies. The aim of this analysis is to conduct a model for estimating value of life of countries depending on HCT for Austria, Canada, Japan and USA.  Methods: Net present value(NPV) of the taxes and spending of governments were calculated depending on population demographics and economic data as population distribution by age, employment compliance by age, average age of school enrollment, average schooling years, average year of retirement, unemployment rate, entry annual wage, healthcare spending per capita, education spending per capita, etc. The estimated produced economic value for a life time term for each country was assumed as the value of life. In additional, each decades NPV were calculated. The economic data for the model was taken from World Bank, UNESCO, OECD and WHO.  Results: Estimated produced economic value for a life time value for Austria, Canada, Japan and USA were found to be US$ 656,082, US$, 164,679, US$ 234,552 and US$ 445,845, respectively. The estimated values for Austria, Canada, Japan and USA were 12.97, 3.16, 6.07 and 8.46 times of each countries’ GDP per capita, respectively.  Conclusions: The value of life is estimated by a hypothetical model based on NPV with taxes and spending of government for each individual for a life-term. Model approaches includes value of life for each decades of age, which can guide for marginal benefit of preventing pre-mature deaths. This may be a guide for health policy authorities to make prioritization for treatment options for different decades.

PHP225 Rapid, Comprehensive Oral Nutritional Supplement Quality Improvement Program Reduces Length Of Stay In Malnourished Hospitalized Patients Summerfelt WT1, Sulo S2, Partridge J2, VanDerBosch G1, Hegazi R2, Sriram K1 Health Care, Downers Grove, IL, USA, 2Abbott Nutrition, Columbus, OH, USA

1Advocate

Objectives: Poor nutritional status is adversely associated with several functional, clinical, and economic outcomes. Malnourished patients are at risk for longer hospitalizations compared to well-nourished patients, thus increasing the likelihood for patients to experience serious safety events. We assessed the effect of the administration of a quality improvement program (QIP) integrating nutrition risk screening by nursing staff at the time of admission and oral nutrition supplementation (ONS) of hospitalized patients on length of stay as compared to pre-QIP historical controls.  Methods: Average hospital length of stay of historical controls pre-QIP was 7.2 days. The QIP patients were identified at risk for malnutrition or malnourished during their stay at one of the four participating hospitals. In all four QIP hospitals, the electronic medical record (EMR) was upgraded to include Malnutrition Screening Tool (MST) and condition-specific ONS was administered to all patients at risk for malnutrition (MST ≥  2). In two of the QIP hospitals (namely QIP+), in addition to the initiatives in QIP, aggressive nutrition-related procedures were implemented

A479

(faster administration of ONS, specific discharge instructions, ONS coupons, and 4 follow-up/compliance telephone calls).  Results: Data from 1269 patients enrolled between October 2014 and April 2015, and 1319 historical controls admitted at the four QIP hospitals a year prior to QIP implementation were analyzed. The post-QIP hospital length of stay of all four QIP hospitals was 5.4 days, showing an absolute rate reduction of 1.8 days, as compared to pre-QIP length of stay of 7.2 days (25% relative risk reduction, P< 0.001). Relative risk reductions for the two QIP+ versus two QIP hospitals were 26.4% and 25%, respectively (P values< 0.001).  Conclusions: Hospital length of stay among malnourished adult hospitalized patients can be significantly decreased through a comprehensive ONS QIP, thus enforcing the need to embed malnutrition risk screening and/or automatic nutritional interventions in routine clinical practice. PHP226 Comorbidity-Based Eq-5d Scores Of Primary Care Patients In Finland, Their Potential To Benefit And Unmet Medical Need Soini EJ1, Heinonen J2, Miettola E2, Ryynänen O3, Koskela T4 1ESIOR Oy, Kuopio, Finland, 2School of Medicine, University of Tampere, Finland, 3Faculty of Health Sciences, University of Eastern Finland, and Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland, 4Department of General Practice, University of Tampere, and Omapihlaja, Pihlajalinna Terveys Oy, Tampere, Finland

Objectives: Comorbidity-based health-related quality of life (HRQoL) scores from primary health care setting (PHCS) are needed frequently in the initiation of costutility simulation modelling. Yet, PHCS HRQoL studies and scores are rare – general population-based or specialist care setting HRQoL scores are more frequently available. We study PHCS HRQoL comorbidity-based. We also estimate the baseline potential to benefit (PTB) and 3-months unmet medical need (UMN) by applying a matched-adjusted indirect comparison (MAIC), which was developed by us to predict the multivariate matched general population control (MGPC) HRQoL scores at individual level.  Methods: Unselected PHCS patients (N 519) filled EQ-5D-3L questionnaire (British preferences) during Effective Health Centre Study in three Finnish health centres located in Pirkanmaa. 0.07 was considered to be the minimum clinically important difference (MID). Stata MP 14.1 was used.  Results: 0.74 and 0.78 mean baseline and three month EQ-5D-3L scores were observed, respectively. The lowest (0.54, 0.54 or 0.63) mean baseline scores were observed for patients with neck, back or neurologic comorbidity, respectively. Patients with diabetes, hypertension or coronary heart disease had the highest respective (0.75, 0.74 or 0.74) mean baseline scores. Patients with no, 1, 2, 3, 4 and 5 or more comorbidities had 0.82 (0.91), 0.75 (0.86), 0.74 (0.76), 0.73 (0.75), 0.69 (0.67) and 0.50 (0.53) scores at the baseline (three months), respectively. The highest and lowest PTB at baseline was estimated for patients with one and four comorbidities, respectively. Patients with 5 or more comorbidities and no comorbidity had the highest and lowest UMN at three months, respectively. MID UMN was observed for heart failure, asthma, neurologic disease or inflammatory bowel disease patients.  Conclusions: PHCS HRQoL scores are needed. The UMN seems to increase as the function of comorbidity. Yet, the PTB decreases as the function of comorbidity. Patients presenting with some spesific comorbidities had potentially persistent residual disutility. PHP227 Influencing Factors On Knowledge, Attitude And Behaviour Towards Antibiotic Usage Among Adults In Ho Chi Minh City, Viet Nam Ngo TN1, Tran MK2, Nguyen TT3 1University of medcine and pharmacy, Ho Chi Minh City, Ho Chi Minh, Viet Nam, 2University of medicine and pharmacy, HCMC, Ho Chi Minh, Viet Nam, 3University of medicine and pharmacy, Ho Chi Minh City, Ho Chi Minh City, Viet Nam

Objectives: Self-medication and antibiotic abuse have led to the alarming phenomenon of antibiotic resistance, which is a current big problem all over the world. The aim of this study was to determine the influencing factors on knowledge, attitude and behaviour towards antibiotic usage among adults in Ho Chi Minh City (HCMC), Viet Nam.  Methods: A cross-sectional survey using questionnaire based on previous studies and focus-group interview with a random sample of adults in 19 districts of HCMC. The Chi - squared test, One-way ANOVA test and Pearson’s correlation were used to evaluate the influencing factors and the association between knowledge, attitude and behaviour with 95% interval confidence.  Results: 523 adults participated in study with 56% females, 35% from 18 to 24 years old, 38.2% with monthly income of 5-10 million VND and 48.4% having at least university educational level. The mean scores of residents’ knowledge, attitude and behaviour regarding antibiotic usage were 6.11±2.136, 6.13±1.028 and 7.25±1.432, respectively. Significant positive correlation was noted between respondents’ antibiotic knowledge and attitude score (r =  0.318, p= 0.000), attitude and behaviour score (r = 0.225, p= 0.000). It has been shown that knowledge, attitude and behaviour towards antibiotic usage were significantly influenced by monthly income (p< 0.05) and educational level (p< 0.05). Workers had the lowest average knowledge, attitude and behaviour scores (5.75 ± 1.10) and were statistical significant different from all other groups (p< 0.05). Respondents with monthly income above 10 million VND had the highest scores (7.09 ± 1.03) compared with other froups (p <  0.05).  Conclusions: Monthly income and educational level significantly associated with knowledge, attitude and behaviour towards antibiotic usage. Some demographic groups have been indicated lacking of important knowledge and had poor attitude and behaviour. More antibiotic public campaigns and educational community initiatives should be conducted to improve people‘s antibiotics awareness especially these “high risk” groups. PHP228 Estimating Study Costs For Use In Voi, A Study Of Dutch Publicly Funded Drug Related Research van Asselt AD1, Ramaekers BL2, Corro Ramos I3, Joore MA4, Al MJ3, Lesman-Leegte I1, Postma MJ5, Vemer P5, Feenstra TF1