MONDAY, 6 MARCH 2006
16:30-17:30 SESSION I:

HEALTH CARE DELIVERY AND REIMBURSEMENT POLICIES IN PAKISTAN
Shanghai Room 1

Aamir Hameed FCPS, MBBS, BSc, Senior Instructor & Consultant Cardiologist, Department of Medicine, The Aga Khan University, and Member of the Scientific Council on Atherosclerosis and Thrombosis of the Pakistan Cardiac Society for STEMI Guidelines Task Force, Karachi, Pakistan

Access to health care is a basic human right, which is instilled in the constitution of Pakistan. It is both the mandate and responsibility of the Government to ensure the health and well being of the country's population. At least one third of the population lives below the poverty line. The Government is trying to alleviate poverty through better health care in the country. The pubic health sector has always been the center of criticism for its failure to deliver health care to the people. It is has a complex matrix organizational set-up which lacks coordination between different cells. Planning is mostly on a bureaucratic ad hoc basis. General taxation is the major source of the Government's financing for health and it spends only 0.9% of the GDP on health. Major bulk of the budget goes into salaries of the health personnel. Funds are channeled through three levels, the federal, provincial and district governments. The recent political and administrative devolution empowers the districts with 60% of the budget utilization. The health care delivery system consists of public and private institutions, Non governmental organizations and Traditional medicine set-ups, which deliver allopathic, traditional and homeopathic medicine to the masses. The public health care system comprises of outreach and community based activities, primary care facilities, Tehsil and district hospitals that provide basic inpatient and outpatient care and tertiary care hospitals based in major cities that provide specialized care. The poor quality of primary health facilities cause patients to be shunted to tertiary care facilities that remain overburdened handling problems of a primary care nature. The principal modes of financing remain through out of pocket payments and tax based revenues. In the private sector, reimbursement is mainly out of pocket payment, with a thin minority being reimbursed through group insurance in large organizational set-ups. Donor funds, social security schemes and safety nets comprise the minor rest. The private institutions are more geared towards tertiary care delivery and even in the public sector a tertiary care bias is noted in the utilization of funds, which are channeled to provide high tech care, at the cost of much needed primary care and thus a hiatus exists. Currently, the health policy is under review and a major overhaul that will bring relief is expected.


EVIDENCE-BASED DECISION-MAKING AND HEALTH TECHNOLOGY ASSESSMENT IN SOUTH KOREA
Shanghai Room 2

Sang Moo Lee MD, PhD, Director, Health Technology Assessment System Group, and Medical Consultant, Health Insurance Review Agency, South Korea; Seong-Hi Park PhD, Director, Health Technology Assessment Team in Health Insurance Review Agency, South Korea

In the health care system, government level policy decision making has many variables and the need for explicit and transparent decision-making processes are increasing amongst public reimbursement policies. Many countries are confronted with increasing healthcare costs. Evidence-based decision-making becomes an essential element in the rational use of health care resources. In South Korea, past health care policy making decisions had been based solely on the authors' opinion. Authors' opinions are criticized because they may be unclear or too subjective. The demand for an objective rational system of decision-making is increasing. Health care decisions should be balanced and supported by evidences obtained by comprehensive, explicit and systematical health technology assessment.South Korea is developing a health technology assessment (HTA) system. Most recently, HTA was temporarily used for public funding of the national health insurance program. In July 2003, HTA task force team introduced the HTA system and the Korean Medical Law, which assures the safeties and effectiveness of a medical technology, was amended to include the HTA system. HTA task force team has published three HTA reports. The cost-effectiveness of a Korean technology is assessed by Medical Insurance Act.
 

PHARMACISTS AND PHARMACOECONOMIC DISCIPLINE UNDER DYNAMIC HEALTH CARE SYSTEM IN THAILAND Shanghai Room 5

Sunibhond Pummangura, PhD, President of The Pharmaceutical Association of Thailand under the Royal Patronage, Thailand

With the progress of social welfare system development, Thailand has been moving to National Health Insurance system toward universal coverage direction. Not surprisingly that such system must require quality, efficiency, and equity of the health care services for the beneficiaries. As various new health care technologies are emerging at very fast speed, health care decision makers have been facing with the decision to balance between opportunity to consume new technologies and the rising of expense of overall health care system. Thai pharmacists, who have their role to improve pharmaceutical care, also have their responsibilities to make decisions on providing pharmaceutical under the cost-conscious environment. Triangular decision based on efficacy, treatment cost, and equity to access of new technology of overall patients requires new emerging science, pharmacoeconomics, to support pharmacists to fulfill their role on pharmaceutical care philosophy. As a dynamic health professionals, pharmacists have their role at the level of health system, health care institution, and individual patient. The Pharmaceutical Association of Thailand under the Royal Patronage as a focal point of pharmacy profession will promote the concept of pahrmacoeconomics to assure the balance between cost and outcome. Pharmacoeconomic aspect will be integrated in the decision at every level, at the national level when selecting drug in national formulary, at managed care level when establishing pharmaceutical benefit package, and at individual patient level when acting as a partnership with a patient for the treatment decision. The Pharmaceutical Association will work together with health system pharmacist, hospital and managed care pharmacist, and community pharmacist in Thailand to further improve essential and appropriate drug treatment. Emerging of the pahrmacoeconomic discipline, at present, stimulate pharmacy profession to keep pace with the decision that concern overall health care system and patients' accessibility to advance technology which will consequently result in overall improvement of health and quality of the Thai population under efficiency and equity direction.

ISPOR LOCAL CHAPTERS OUTCOMES RESEARCH INITIATIVES
Shanghai Room 6

Moderator: Jawahar S. Bapna PhD, MD, MB, Professor, Pharmaceutical Management, Indian Institute of health Management Research, Jaipur, India
Isao Kamae, MD, DrPH, President, ISPOR Japan Chapter and Professor, Graduate School of Medicine, Kobe University, Kobe, Japan
Tony Yen-Huei Tarn, PhD, President, ISPOR Taiwan Chapter and Director, Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
Wen Chen PhD, Representative, ISPOR Chinese Medical Doctor Association PE Chapter & Professor and Associate Dean, School of Public health, Fudan University, Shanghai, China
Vithaya Kulsomboon PhD, President, ISPOR Thailand Chapter, and Assistant Professor in Social Pharmacy and Chair of Social Pharmacy Department, Chulalongkorn University, Bangkok, Thailand

ISPOR Taiwan Chapter, Japan Chapter, Chinese MDA-PE Chapter and Thailand Chapter present their actives and initiatives in advancing the science of pharmaconomics and outcomes research in their regions.

TUESDAY, 7 MARCH 2006
16:00-17:00 SESSION II:

EVIDENCE-BASED MEDICINE IN CHINA
Auditorium (Chinese translation available)
Youping Li PhD, President, Chinese Cochrane Center and Professor, West China Center of Medical Sciences, Sichuan University, Sichuan, China

Since its introduction to China in 1996, evidence-based medicine has been receiving increasing attention and is playing an important role in healthcare and clinical decision-making. The Chinese Evidence-Based Medicine Center and the Chinese Cochrane Centre, which are the only authorized academic organizations of evidence-based medicine in China, have assumed the responsibilities of developing and promoting the production and use of high-quality evidence in health decision-making of all levels. As internally recognized academic entities, the Centers are taking the leadership in evidence-based medicine in China. In this session, a delegate from these Centers will discuss evidence-based medicine initiatives in China in terms of its history of development, the achievements, and the challenges and opportunities that are confronted.


INTERNATIONAL COMPARISON OF THE PHARMACEUTICAL EXPENDITURES AND PHARMACEUTICAL POLICY IN JAPAN
Shanghai Room 5
Hiroyuki Sakamaki, MBA, Director and Chief Researcher, Research Department, Institute for Health Economics and Policy, Japan

In drafting domestic policies, countries refer to the situation of medical expenditure in other nations. When comparing the expenditure internationally, we have to take account of differences in the definition and use of drugs among countries. This presentation will discuss differences in drug expenditure and drug use among Japan and Western countries and will report the policies for controlling expenditure for drugs in Japan.


FORMULARY ASSESSMENT AND DRUG CONTROL IN MALAYSIA
Shanghai Room 6
Samsinah Hussain PhD, Associate Professor, Head of Department of Pharmacy, University of Malaysia, and Member of the Drug Control Authority (DCA) and Pharmacy Board, Ministry of Health, Malaysia

Formulary management is one of the strategies that can be implemented to curb increasing drug cost. This presentation will explore hospital drug use issues and formulary assessment. An overview of the regulatory functions of the Malaysian regulatory agency will be presented. Suggestions to control drug price through medication regulation will be discussed.


SINGAPORE HEALTH AUTHORITY CENTER FOR DRUG ADMINISTRATION FORUM
Shanghai Room 1

Moderator: Phua Kai Hong PhD, Joint Professor of Health Policy and Management, Lee Kuan Yew School of Public Policy and Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Shu-Chen Li PhD, MS, MBA, Visiting Specialist and Consultant, Center for Drug Administration, Health Science Authority, and Associate Professor, Department of Pharmacy, National University of Singapore, Singapore;
Eileen Lim, Official, Center for Drug Administration, Health Science Authority, Singapore

The drug regulatory framework and process, the finance of the system in Singapore and its implication for the maintenance of the Ministry of Health Standard Drug List will be discussed.

ISPOR ASIA MEDICAL DEVICE & DIAGNOSTICS COUNCIL FORUM
Shanghai Room 2

Welcome & Opening Remarks
Nancy S. Travis, Chair, ISPOR Asia Pacific Medical Device & Diagnostics Council Steering Committee, Associate Vice President (Asia), Advanced Medical Technology Association (AdvaMed)
Marilyn Dix Smith PhD, ISPOR Founding Executive Director, ISPOR  

ISPOR and the Medical Device World - Synergies and Unique Issues
Michael Drummond PhD, Professor of Health Economics, University of York, Centre for Health Economics and ISPOR President-elect

Medical Device Outcomes Research Issues
Isao Kamae MD, PhD, Professor of Biostatistics and Health Decision Sciences, Graduate School of Medicine, Kobe University, Kobe, Japan
Jie Chen PhD, Director, Key Lab of Health Technology Assessment, Ministry of Health and Professor, Fudan University, Shanghai, China
Ashoke Bhattacharjya PhD, Executive Director, Health Policy and Economics, Johnson & Johnson, Titusville, NJ, USA

During this forum, unique aspects of medical device development and assessment (distinct from pharmaceuticals), such as statistical issues in dealing with smaller sample sizes or using real world evidence (distinct from RCTs) will be discussed. The ISPOR book initiate, Medical Devices & Diagnostics Outcomes Research: Issues & Good Research Practices will be presented.

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