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Management Of Healthcare Priorities By Single Natural Resource Driven Economies In Emerging Markets During Commodity Price Fluctuations
A674
VA L U E I N H E A LT H 2 0 ( 2 0 1 7 ) A 3 9 9 – A 8 1 1
Objectives: This study presents the development of acute and chronic inpatient bed numbers of neurological, neurosurgical and psychiatric professions between 2002-2016 in Hungary. Methods: During the analysis descriptive statistical methods were applied. Psychiatric (profession code 9), neurological (code 18) and neurosurgical (code 02) professions inpatient capacity data between 2002 and 2016 were examined in accordance with the National Health Insurance Fund Administration reports. Results: Referring to 1801 profession code, the number of psychiatric beds showed a steady decline, decreased from 4089 to 2689 in 2002, presenting the effects of capacity regulatory laws. The number of beds were complemented by 248 beds of the 1802 addictology profession introduced in 2013. The neurosurgery active bed numbers increased from 6.62% to 6.81%. Similarly, 0204 neurosurgery beds decreased from 607 to 493, however their proportion to the number of active beds showed a steady growth. Based on the 0900 neurological code data, due to the care development law, the number of beds reduced from 2599 with 22%. This tendency continued until 2012, when only 1844 neurological beds could be found. As a result of the Semmelweis Plan the number of beds increased by more than 8%, however, considering the 0901 stroke beds, the change was more than 10%. The number of chronic neurological beds increased from 187 to 346 in 2006, and from 2012 they merged into rehabilitation bed numbers. The law did not affect the 1804 chronic psychiatric bed numbers since the 5402 bed number in 2006 increased by 9.7%, followed by a slightly downward path by 2013. Conclusions: The neurological, neurosurgical and psychiatric bed numbers are markedly affected by the care development law, which induced a number of major changes in health care system. Semmelweis Plan had an effect on the healthcare system by the restructuring of the profession types instead the reduction of bed numbers. PHP127 Management Of Healthcare Priorities By Single Natural Resource Driven Economies In Emerging Markets During Commodity Price Fluctuations Egbo D1, Chowdhury CA2, Duttagupta S2 1CBPartners, London, UK, 2CBPartners, New York, NY, USA
Objectives: Emerging market (EM) countries dependent on single natural resource as the most viable source of revenue are vulnerable to cyclical government spending due to price volatility. During economic downturn, public healthcare expenditure falls due to an overall budget reduction and higher inflation rates. This research aimed to explore public healthcare expenditure in two oil dependent nations, Saudi Arabia and Nigeria, during cycles of volatile oil prices. Methods: Publicly available data on oil prices, GDP growth rate, GDP per capita, PPP, inflation rates, population and urbanisation growth rates, public health spending as a proportion of overall spending, and private healthcare investments as a proportion of total investments were analysed. Additionally, public health indicators representing crude outcome measure were assessed: infant mortality rates, life expectancy at birth, distribution of public and private hospital beds, and healthcare staff across the population. Results: Analyses showed that both Saudi Arabia and Nigeria undertook significant healthcare budget cuts relative to other sectors during downturn of oil prices. In both countries, spending cuts affected the growth of the public healthcare infrastructure and service provisions. However, private healthcare investments continued to rise stimulated by income growth in the previous years. In contrast to Nigeria, Saudi Arabia significantly boosted investments in public health infrastructure during times of economic growth. Spending cuts limited the ability of public healthcare facilities to maintain and expand treatment access, thus facilitating outward medical tourism. Conclusions: Prices of natural resources significantly impact public health expenditure in single-resource dependent EM countries. During the upturn of natural resource prices, governments should invest more in healthcare so that the population can sustain the benefits during the downturn. While volatility is hard to control, ring-fencing policies for health care expenditures during higher prices of natural resources could help EM countries manage the downturn more effectively, without drastic cuts. PHP128 Clinical Pharmacy Services And Workforce Requirements At Ministry Of Health Hospitals During Ten Years Mass Gathering Hajj (2006-2015) In Makah And Al-Medina Regions, Saudi Arabia Alomi YA1, Khayat NA2, Al-Hennawi KI1 of Health, RIYADH, Saudi Arabia, 2Makkah Medical Affairs, RIYADH, Saudi Arabia
1Ministry
Objectives: To explore the clinical pharmacy services and workforce requirements at Ministry of Health (MOH) Hospitals during mass gathering Hajj ten years (2006-2015) at Makah and Al-Medina Regions in Saudi Arabia Methods: It is a retrospective analysis of ten years (2006-2015) of MOH hospital pharmacies during mass gathering Hajj period (15-30 days). The clinical pharmacist should provide pharmaceutical to all patients either Pilgrim or not Pilgrim at Makah region. The workforce requirements calculated based on MOH workforce standards of hospitals. The clinical activities drive from MOH critical care services, and emergency services, and mortality rate data. American College of Clinical Pharmacy (ACCP) model of clinical activities used. Results: In Makah Region; The total number of prescriptions (99,886-257,545) with average (180,120), it represented (5.11-12.07%) with average (7.86%) of all pilgrims. In Al-Medina Region; the total number of prescriptions (35,149-207,444) with average was (142,080). It represented (1.48-8.35%) with an average (5.79 %) of all pilgrims. The average number of clinical pharmacists needed was (15.39 FTE) per each hospital at holy places, (21.69 FTE) per each hospital Makah city, and (18.54 FTE) per each hospital at Makah. The average number of clinical pharmacists needed was (15.6 FTE) per hospital in Al-Medina. The central pharmacy activities need (4 FTE) of clinical pharmacist per each hospital in Makah region, while in Al-Medina region was (3 FTE). The patient-centered clinical pharmacy services need (10 FTE) of clinical pharmacist per each hospital in Makah and Al-Medina regions. The administrative, clinical pharmacy activities need (4 FTE) of clinical pharmacist per each hospital, while (3 FTE) at Al-Medina region. Conclusions: The clinical pharmacy services are essential during mass gathering Hajj period.
The clinical pharmacy services prevent drug-related mortality and morbidity during Hajj period. Also, improve patient clinical outcome, patient quality of life, and avoid the unnecessary cost. PHP129 Development Of An Specific Evaluation Framework For Orphan Drugs Based On Multi-Criteria Decision Analysis (MCDA) For Health Care Decision Making In Catalonia Badia X1, Pontes C2, Fontanet M3, Obach M2, Vallano A2, Torrent J2, Guarga L1 Consulting, Barcelona, Spain, 2CatSalut, Barcelona, Spain, 3Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
1Omakase
Objectives: To develop a Multi-Criteria Decision Analysis (MCDA) framework specific for Orphan Drugs (OD) in Catalonia, aimed to facilitate and homogenize the assessment of OD by the decision-making committee of the Catalan Health Service (CatSalut). Methods: A preliminary framework based on EVIDEM (v.4.0) was developed for its use in OD evaluation and was validated by representatives of the decision-making committee of CatSalut. The final version of the framework was agreed and tested by this committee in 3 OD (tolvaptan for autosomal dominant polycystic kidney disease, Alpha 1-antitrypsin for Alpha1-antitrypsin deficiency and eliglustat for Gaucher disease). The committee members rated individually the EVIDEM matrix for each drug assessment according to their preferences and afterwards a reflective discussion was conducted amongst all the members. Results: In the validation phase, some criteria were removed or not considered from the standard framework based on EVIDEM (v.4.0) (i.e., “size of population”, “non-medical costs”, “rarity” and “rule of rescue”) or adapted (“therapeutic benefit”) for CatSalut purposes. The assessment of three OD was conducted to rate the evidence matrix. The reflective discussion was seen as very relevant to support inputs for health decision-making processes reflecting drug value and positioning medicines within therapeutic algorithms. Conclusions: A final MCDA framework specific for OD was developed and validated to be used for the orphan drug evaluations conducted by the CatSalut. The test of the three OD through the developed framework specific for OD showed that MCDA can be considered a useful methodology which adds transparency, predictability and allows a structured discussion that substantiates the agreements adopted by decision-making committees. PHP130 Evaluation Of Branding Impact On Iranian Pharmaceutical Market: A Qualitative Study Kamyabi A1, Zaboli P2, Kebriaeezadeh A3, Saeedi M1, Morteza-Semnani K1, Akbari J1, Rohani E4 1Mazandaran Univeristy of Medical Sciences, Sari, Iran (Islamic Republic of), 2Department of Pharmacoeconomics and Pharmaceutical Management, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of), 3Pharmaceutical Management and Economics Research Cente, Tehran, Iran (Islamic Republic of), 4Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
Objectives: Due to recent changes in global pharmaceutical marketing, companies’ interests are switching to focus on branding strategies. Iran is one of the largest pharmaceutical markets in Middle East which experienced a suitable growth in recent years; therefore, a proper framework for Iran’s pharmaceutical market branding strategy is necessary. This study aims to investigate branding impact on pharmaceutical market from Key Opinion Leaders (KOL) perspective. Methods: At first a systematic review was done. Studies were identified via searching electronic databases, search engine and reviewing citations (1990 – June 2016). Only articles published in English were included. Ninety six articles were reviewed and sixteen studies met inclusion criteria. Based on the aforementioned systematic review findings, qualitative questionnaire was designed. Semi-structured questionnaire with open ended questions had been applied as data collection tool. We conducted interviews and after fifteen interviews, tape recorded with participants’ consent, analysis showed that we had reached theoretical saturation. Results: Based on systematic review, four types of main branding strategies were recognized within pharmaceutical industry: Therapy area, Corporate, Product, and Condition branding. These strategies were applied as as questionnaire dimensions. As result, 54% of interviewees indicated that corporate branding is the best strategy to be implemented in Iran pharmaceutical industry from interviewees’ point of view. The rest of responses were as follows: 20% recommended therapy area branding, 26% recommended product branding and 0% recommended condition branding. Conclusions: This interview-based study provides new evidence on Iran’s pharmaceutical market branding position. It becomes clear that companies must be focused on branding strategies. Corporate branding strategy, detected to be the most useful approach in Iranian pharmaceutical market. In order to these strategies implementation, major modifications are needed in both legislation and policies. Further branding studies should be carried out focusing on how to change this behavioral algorithms to reach a sustainable success in branding. PHP131 Applying The Institute For Clinical And Economic Review’s (ICER) Methodology To Canada: An Improved Way To Take Into Consideration Drug Affordability Challenges? Mouallif S1, Chiva-Razavi S2, Barbeau M3 1University of Montreal, Montreal, QC, Canada, 2Novartis Pharmaceutical Canada Inc., Dorval, QC, Canada, 3Novartis Pharmaceuticals Canada Inc., Dorval, QC, Canada
Objectives: In Canada, drug prices and healthcare system affordability are under high scrutiny in order to better meet the needs of Canadians. Current health technology assessments (HTA), do not consider financial capacity of Canadian payers. In contrast, the United States’ Institute for Clinical and Economic Review (ICER) combines cost-effectiveness evaluations and an assessment of the affordability of a new therapy. The affordability concept is translated into an annual budget impact threshold that represents the maximum willingness to pay for a treatment. This study aimed to adapt ICER’s affordability budget impact threshold to the
VA L U E I N H E A LT H 2 0 ( 2 0 1 7 ) A 3 9 9 – A 8 1 1
Objectives: This study presents the development of acute and chronic inpatient bed numbers of neurological, neurosurgical and psychiatric professions between 2002-2016 in Hungary. Methods: During the analysis descriptive statistical methods were applied. Psychiatric (profession code 9), neurological (code 18) and neurosurgical (code 02) professions inpatient capacity data between 2002 and 2016 were examined in accordance with the National Health Insurance Fund Administration reports. Results: Referring to 1801 profession code, the number of psychiatric beds showed a steady decline, decreased from 4089 to 2689 in 2002, presenting the effects of capacity regulatory laws. The number of beds were complemented by 248 beds of the 1802 addictology profession introduced in 2013. The neurosurgery active bed numbers increased from 6.62% to 6.81%. Similarly, 0204 neurosurgery beds decreased from 607 to 493, however their proportion to the number of active beds showed a steady growth. Based on the 0900 neurological code data, due to the care development law, the number of beds reduced from 2599 with 22%. This tendency continued until 2012, when only 1844 neurological beds could be found. As a result of the Semmelweis Plan the number of beds increased by more than 8%, however, considering the 0901 stroke beds, the change was more than 10%. The number of chronic neurological beds increased from 187 to 346 in 2006, and from 2012 they merged into rehabilitation bed numbers. The law did not affect the 1804 chronic psychiatric bed numbers since the 5402 bed number in 2006 increased by 9.7%, followed by a slightly downward path by 2013. Conclusions: The neurological, neurosurgical and psychiatric bed numbers are markedly affected by the care development law, which induced a number of major changes in health care system. Semmelweis Plan had an effect on the healthcare system by the restructuring of the profession types instead the reduction of bed numbers. PHP127 Management Of Healthcare Priorities By Single Natural Resource Driven Economies In Emerging Markets During Commodity Price Fluctuations Egbo D1, Chowdhury CA2, Duttagupta S2 1CBPartners, London, UK, 2CBPartners, New York, NY, USA
Objectives: Emerging market (EM) countries dependent on single natural resource as the most viable source of revenue are vulnerable to cyclical government spending due to price volatility. During economic downturn, public healthcare expenditure falls due to an overall budget reduction and higher inflation rates. This research aimed to explore public healthcare expenditure in two oil dependent nations, Saudi Arabia and Nigeria, during cycles of volatile oil prices. Methods: Publicly available data on oil prices, GDP growth rate, GDP per capita, PPP, inflation rates, population and urbanisation growth rates, public health spending as a proportion of overall spending, and private healthcare investments as a proportion of total investments were analysed. Additionally, public health indicators representing crude outcome measure were assessed: infant mortality rates, life expectancy at birth, distribution of public and private hospital beds, and healthcare staff across the population. Results: Analyses showed that both Saudi Arabia and Nigeria undertook significant healthcare budget cuts relative to other sectors during downturn of oil prices. In both countries, spending cuts affected the growth of the public healthcare infrastructure and service provisions. However, private healthcare investments continued to rise stimulated by income growth in the previous years. In contrast to Nigeria, Saudi Arabia significantly boosted investments in public health infrastructure during times of economic growth. Spending cuts limited the ability of public healthcare facilities to maintain and expand treatment access, thus facilitating outward medical tourism. Conclusions: Prices of natural resources significantly impact public health expenditure in single-resource dependent EM countries. During the upturn of natural resource prices, governments should invest more in healthcare so that the population can sustain the benefits during the downturn. While volatility is hard to control, ring-fencing policies for health care expenditures during higher prices of natural resources could help EM countries manage the downturn more effectively, without drastic cuts. PHP128 Clinical Pharmacy Services And Workforce Requirements At Ministry Of Health Hospitals During Ten Years Mass Gathering Hajj (2006-2015) In Makah And Al-Medina Regions, Saudi Arabia Alomi YA1, Khayat NA2, Al-Hennawi KI1 of Health, RIYADH, Saudi Arabia, 2Makkah Medical Affairs, RIYADH, Saudi Arabia
1Ministry
Objectives: To explore the clinical pharmacy services and workforce requirements at Ministry of Health (MOH) Hospitals during mass gathering Hajj ten years (2006-2015) at Makah and Al-Medina Regions in Saudi Arabia Methods: It is a retrospective analysis of ten years (2006-2015) of MOH hospital pharmacies during mass gathering Hajj period (15-30 days). The clinical pharmacist should provide pharmaceutical to all patients either Pilgrim or not Pilgrim at Makah region. The workforce requirements calculated based on MOH workforce standards of hospitals. The clinical activities drive from MOH critical care services, and emergency services, and mortality rate data. American College of Clinical Pharmacy (ACCP) model of clinical activities used. Results: In Makah Region; The total number of prescriptions (99,886-257,545) with average (180,120), it represented (5.11-12.07%) with average (7.86%) of all pilgrims. In Al-Medina Region; the total number of prescriptions (35,149-207,444) with average was (142,080). It represented (1.48-8.35%) with an average (5.79 %) of all pilgrims. The average number of clinical pharmacists needed was (15.39 FTE) per each hospital at holy places, (21.69 FTE) per each hospital Makah city, and (18.54 FTE) per each hospital at Makah. The average number of clinical pharmacists needed was (15.6 FTE) per hospital in Al-Medina. The central pharmacy activities need (4 FTE) of clinical pharmacist per each hospital in Makah region, while in Al-Medina region was (3 FTE). The patient-centered clinical pharmacy services need (10 FTE) of clinical pharmacist per each hospital in Makah and Al-Medina regions. The administrative, clinical pharmacy activities need (4 FTE) of clinical pharmacist per each hospital, while (3 FTE) at Al-Medina region. Conclusions: The clinical pharmacy services are essential during mass gathering Hajj period.
The clinical pharmacy services prevent drug-related mortality and morbidity during Hajj period. Also, improve patient clinical outcome, patient quality of life, and avoid the unnecessary cost. PHP129 Development Of An Specific Evaluation Framework For Orphan Drugs Based On Multi-Criteria Decision Analysis (MCDA) For Health Care Decision Making In Catalonia Badia X1, Pontes C2, Fontanet M3, Obach M2, Vallano A2, Torrent J2, Guarga L1 Consulting, Barcelona, Spain, 2CatSalut, Barcelona, Spain, 3Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
1Omakase
Objectives: To develop a Multi-Criteria Decision Analysis (MCDA) framework specific for Orphan Drugs (OD) in Catalonia, aimed to facilitate and homogenize the assessment of OD by the decision-making committee of the Catalan Health Service (CatSalut). Methods: A preliminary framework based on EVIDEM (v.4.0) was developed for its use in OD evaluation and was validated by representatives of the decision-making committee of CatSalut. The final version of the framework was agreed and tested by this committee in 3 OD (tolvaptan for autosomal dominant polycystic kidney disease, Alpha 1-antitrypsin for Alpha1-antitrypsin deficiency and eliglustat for Gaucher disease). The committee members rated individually the EVIDEM matrix for each drug assessment according to their preferences and afterwards a reflective discussion was conducted amongst all the members. Results: In the validation phase, some criteria were removed or not considered from the standard framework based on EVIDEM (v.4.0) (i.e., “size of population”, “non-medical costs”, “rarity” and “rule of rescue”) or adapted (“therapeutic benefit”) for CatSalut purposes. The assessment of three OD was conducted to rate the evidence matrix. The reflective discussion was seen as very relevant to support inputs for health decision-making processes reflecting drug value and positioning medicines within therapeutic algorithms. Conclusions: A final MCDA framework specific for OD was developed and validated to be used for the orphan drug evaluations conducted by the CatSalut. The test of the three OD through the developed framework specific for OD showed that MCDA can be considered a useful methodology which adds transparency, predictability and allows a structured discussion that substantiates the agreements adopted by decision-making committees. PHP130 Evaluation Of Branding Impact On Iranian Pharmaceutical Market: A Qualitative Study Kamyabi A1, Zaboli P2, Kebriaeezadeh A3, Saeedi M1, Morteza-Semnani K1, Akbari J1, Rohani E4 1Mazandaran Univeristy of Medical Sciences, Sari, Iran (Islamic Republic of), 2Department of Pharmacoeconomics and Pharmaceutical Management, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of), 3Pharmaceutical Management and Economics Research Cente, Tehran, Iran (Islamic Republic of), 4Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
Objectives: Due to recent changes in global pharmaceutical marketing, companies’ interests are switching to focus on branding strategies. Iran is one of the largest pharmaceutical markets in Middle East which experienced a suitable growth in recent years; therefore, a proper framework for Iran’s pharmaceutical market branding strategy is necessary. This study aims to investigate branding impact on pharmaceutical market from Key Opinion Leaders (KOL) perspective. Methods: At first a systematic review was done. Studies were identified via searching electronic databases, search engine and reviewing citations (1990 – June 2016). Only articles published in English were included. Ninety six articles were reviewed and sixteen studies met inclusion criteria. Based on the aforementioned systematic review findings, qualitative questionnaire was designed. Semi-structured questionnaire with open ended questions had been applied as data collection tool. We conducted interviews and after fifteen interviews, tape recorded with participants’ consent, analysis showed that we had reached theoretical saturation. Results: Based on systematic review, four types of main branding strategies were recognized within pharmaceutical industry: Therapy area, Corporate, Product, and Condition branding. These strategies were applied as as questionnaire dimensions. As result, 54% of interviewees indicated that corporate branding is the best strategy to be implemented in Iran pharmaceutical industry from interviewees’ point of view. The rest of responses were as follows: 20% recommended therapy area branding, 26% recommended product branding and 0% recommended condition branding. Conclusions: This interview-based study provides new evidence on Iran’s pharmaceutical market branding position. It becomes clear that companies must be focused on branding strategies. Corporate branding strategy, detected to be the most useful approach in Iranian pharmaceutical market. In order to these strategies implementation, major modifications are needed in both legislation and policies. Further branding studies should be carried out focusing on how to change this behavioral algorithms to reach a sustainable success in branding. PHP131 Applying The Institute For Clinical And Economic Review’s (ICER) Methodology To Canada: An Improved Way To Take Into Consideration Drug Affordability Challenges? Mouallif S1, Chiva-Razavi S2, Barbeau M3 1University of Montreal, Montreal, QC, Canada, 2Novartis Pharmaceutical Canada Inc., Dorval, QC, Canada, 3Novartis Pharmaceuticals Canada Inc., Dorval, QC, Canada
Objectives: In Canada, drug prices and healthcare system affordability are under high scrutiny in order to better meet the needs of Canadians. Current health technology assessments (HTA), do not consider financial capacity of Canadian payers. In contrast, the United States’ Institute for Clinical and Economic Review (ICER) combines cost-effectiveness evaluations and an assessment of the affordability of a new therapy. The affordability concept is translated into an annual budget impact threshold that represents the maximum willingness to pay for a treatment. This study aimed to adapt ICER’s affordability budget impact threshold to the