Value-Based Healthcare Health Economics Value-Based Procurement Martin Bergius Project Manager Nordic Medtech Growth 2 martin.bergius@bsci.com +46 72 501 46 88
Health Economics NMG2 Value-Based Healthcare Value-Based Procurement MEAT HTA
Reality of today
Increase productivity or lower your cost
(Source: BCG) Part of presentation references to Medtech Europe project MEAT
6 Part of presentation references to Medtech Europe project MEAT
Value-Based Healthcare: definition Key challenge to health systems: Increasing value of health care delivery Value = Health Outcomes that matter to patients, institution, society Cost of delivering the outcomes What Is Value in Health Care? Michael E. Porter, Ph.D. New England Journal Medicine 363;26 nejm.org December 23, 2010 Part of presentation references to Medtech Source: BCG analysis Europe project MEAT 7
Value-Based Healthcare: definition better outcomes, same or lower cost
Value-Based Healthcare - Finland
Value-Based Procurement :MEAT
Part of presentation references to Medtech Europe project MEAT
Objective and timings of Medtech Europe s MEAT project Part of presentation references to Medtech Europe project MEAT
Experts in MEAT project: Part of presentation references to Medtech Europe project MEAT
Nordic MedTech Growth 2 (NMG2) 1. Funded by the Nordic Minister Council via Nordic Innovation 2. 3 year project 3. Driven by Nordic MedTech org. http://www.nordicinnovation.org/fi/meista/tietoja-nordic-innovationista/
Organization Sailab FiHTA Swedish Medtech Medtek Norge Medicoindustrien, DK
Scope of NMG2 Nordic network for collaboration on health economics and HTA with relevant authorities and customers Practical guidance and tools for HTA and health economics in public procurement (Value-Based Procurement)
Project Groups Project Management Trond Dahl Hansen, Medtek Norge Martin Bergius, Project Leader Steering group Trond Dahl Hansen, Medtek Norge Anna L. Skjöldebrand, Swedish Medtech Peter Huntley, Medicoindustrien Tom Ståhlberg, FiHTA Laura Simik, Sailab Nordic reference group Malin Blixt, TLV Morten Rasmussen, Danske regioner Vidar Halsteinli, St.Olavs hospital/ntnu Nordic project group Henriette Ellefsen Jovik, Medtek Norge Tove Ofstad, Medtek Norge (Roche) Petrus Laestadius, Swedish Medtech Sofia Medin, Swedish Medtech Anne Englev, Medicoindustrien Elisabeth Reimer Rasmussen, Medicoindustrien (Medtronic) Tom Ståhlberg, FiHTA Laura Simik, Sailab
Next step Nordic pilots of MEAT concept tenders Project report January 2018 Publish two reports -HTA -Value-Based Procurement
Value-Based Procurement From administrative work to creating value Kjetil Istad Managing Director Sykehusinnkjöp, Norway
Part of presentation references to Medtech Europe project MEAT
MEAT procurement tool Part of presentation references to Medtech Europe project MEAT
art of presentation references to Medtech urope project MEAT
Procurement tool : Summary Part of presentation references to Medtech Europe project MEAT
Part of presentation references to Medtech Europe project MEAT
International Consortium for Health Outcomes Measurement = ICHOM
Health economics - X vs Y effect / outcome or cost - Patient perspective quality of life - Budget impact calculations Health Technology Assessment HTA Reimbursement system Global budget vs DRG based
How is it linked Value-Based Healthcare Paradigm shift: From Production to Outcome Methodology to generate Evidence Methodology to buy Outcome Health Economics Value-Based Procurement
How much is there to gain? -a practical example better outcomes, same or lower cost
ECONOMIC IMPACT OF LONGER CRT-D BATTERY LIFE IN SWEDEN Fredrik Gadler, MD, PhD 1 Yao Ding, PhD 2 Nathalie Verin, MS 3 Martin Bergius, BSc 4 Jeffrey D. Miller, MS 5 Gregory M. Lenhart, MS 5 Mason W. Russell, MAPE 5 1 Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden 2 Truven Health Analytics, an IBM Company, Bethesda, MD, USA 3 Boston Scientific Corporation, Hemel Hempstead, Hertfordshire, UK 4 Boston Scientific Nordic AB, Helsingborg, Sweden 30 5 Truven Health Analytics, an IBM Company, Cambridge, MA, USA Adapted from: Gadler F, et al. Economic impact of longer battery life of cardiac resynchronization therapy defibrillators (CRT-D) in Sweden. Clinicoecon Outcomes Res. November 2016.
STUDY OBJECTIVE The objective of this study was to quantify the impact that longer battery life of CRT-D devices has on reducing the number of device replacements and associated costs of these replacements from a Swedish healthcare system perspective. STUDY METHODS We developed an Excel economic model based on real-world published data Model data were derived from: -published literature (mainly Swedish) -Swedish ICD and Pacemaker Registry -Swedish public tendering data 31
STUDY METHODS (cont.) Cost parameters in the model included: 32
ANALYSES SCENARIOS (2) Our base-case analysis estimated year-by-year and cumulative expenditure of CRT-D replacements over a 6-year time horizon in SWE As a sensitivity analysis, we evaluated CRT-Ds as well as ICD-VR and ICD-DR devices over a longer 10-year period. 33
ANALYSES RESULTS base case analysis 34
ANALYSES RESULTS sensitivity analysis Evaluating CRT-D, ICD-VR, and ICD-DR devices together over a longer 10-year period, the sensitivity analysis showed 2,820 fewer replacements and associated cost savings of SEK 249.3 million 35
Final Report Medical Device Assignment published 2016-12-19 means that the 2800 changes have been made in vain for a ten-year period at a cost of 250 million kronor. This is, among other things, a consequence of the absence of any healtheconomic evaluation before decisions about the introduction or procurement." Also to that, it would have been better, both for patient health and for county and regional costs, to use a pacemaker with longer battery life. The Dental and Pharmaceutical Benefits Agency, TLV, is a central government agency whose remit is to determine whether a pharmaceutical product, medical device or dental care procedure shall be subsidized by the state. 36
A few words....to Medtech Companies Premium price = Premium data..to Medtech Buyers Ask for Value Reward Evidence
Is Value-Based Healthcare the way forward?
Value-Based Healthcare What's the alternative?
Thank you for listening! Value based healthcare Health economics Value based procurement Martin Bergius Project Manager Nordic Medtech Growth 2