Thu 12 Sep
8:00 - 12:00
SHORT COURSE MORNING SESSION
Calidad De Vida Relacionada Con La Salud / Medidas De Utilidad
Level: Intermediate
Track: Patient-Centered Research
Presentado en español / Presented in Spanish Durante este curso se presentarán aspectos conceptuales, metodológicos, y prácticos sobre la medición y descripción de calidad de vida relacionada con la salud y sus diferentes usos en la investigación.
También será analizado el enfoque valorativo de la evaluación de la calidad de vida que comprende el uso y la obtención de las preferencias o utilidades a través de diferentes métodos como el riesgo estándar (Standard Gamble —SRG) y el intercambio temporal (Time Trade-Off —TTO), experimentos de elección discreta (Discrete Choice Experiments —DCE), y la escala análoga visual (EVA). Se describirán los cuestionarios específicos y genéricos, y dentro de estos últimos, aquellos basados en preferencias (EQ-5D, SF6D, HUI).
El propósito fundamental de este curso es entender estas medidas de preferencias para asistir a la toma de decisiones en salud, por ejemplo, con la interpretación de un análisis de costo utilidad. Para ello, es necesario conocer las deficiencias de las medidas de utilidad disponibles y las soluciones potenciales. También se discutirá el uso de la medición de la calidad de vida para el monitoreo del funcionamiento del sistema sanitario y la salud poblacional (usos en registros y estudios poblacionales). Por último, se realizará un debate sobre la insensibilidad potencial de los instrumentos genéricos y hasta qué punto la adaptación de los instrumentos de calidad de vida pueden ofrecer una solución. Este curso es para aquellos que tienen poca experiencia con las medidas de calidad de vida en la evaluación económica de la salud. Este curso es para aquellos que tienen poca experiencia con las medidas de calidad de vida en la evaluación económica de la salud.
Faculty Member
Yajaira Bastardo, PhD
Universidad Central de Venezuela, Caracas, Venezuela (Bolivarian Republic of)
Yajaira Bastardo es profesora y jefe de la Catedra de Farmacoeconomía y Administración de Farmacia de la Universidad Central de Venezuela. Ella también imparte cursos de postgrado en farmacoeconomía en el Postgrado de Vigilancia Sanitaria de Medicamentos del Instituto Nacional de Salud "Rafael Rangel" en Caracas, Venezuela. Ella recibió su título de farmacéutico de la Universidad Central de Venezuela y, en 2010, completó un doctorado en Administración de Atención Farmacéutica en la Universidad de Florida.
La Dra. Bastardo ha ocupado varios cargos en la Facultad de Farmacia de la Universidad Central de Venezuela incluyendo director administrativo (2010-2011), director del Departamento Administrativo y Legal, coordinadora de la Mención Sanitario Asistencial y de la Mención de Microbiología Aplicada, jefe de la Cátedra de Microbiología Aplicada, y jefe de la Sección de Medios de Cultivo. Ella ha realizado investigaciones y publicado en la investigación de resultados de salud. Sus principales intereses de investigación incluyen la calidad de vida, la toma de decisión en salud, y la adherencia a la terapia.
Ella es miembro fundador del Consorcio ISPOR para América Latina y presidente fundador del capítulo regional ISPOR Venezuela. Ha servido ISPOR en varias funciones: copresidente del Subcomité de cursos cortos de conferencias ISPOR para América Latina durante del 2010-2012, copresidente del Subcomité de Investigación durante la 3ª Conferencia ISPOR para América Latina, miembro del grupo de trabajo para la implementación de la Visión ISPOR 2020, editor en jefe del boletín electrónico News Across Latin America. Actualmente, es presidente electa del capítulo regional ISPOR Venezuela y presidente electa del Consorcio ISPOR para América Latina para 2018-2020.
Dra. Lucila Rey-Ares, MSc
Centro de Educación Médica e Investigación Clínica “Norberto Quirno”, Buenos Aires, Argentina
Lucila Rey-Ares is head of the Medical Audit Department of the Center for Medical Education and Clinical Research “Norberto Quirno” (CEMIC) in Argentina where she is also a member of the Health Technology Assessment Committee. Since July 2019, she is an adviser to the Ministry of Health, dedicated mostly to HTA issues. She is a public health teacher at the CEMIC University Institute and is a member of the EuroQol Research Group and secretary of the Health-Related Quality of Life Group of the Argentine Society of Pediatrics.
She worked as a researcher at the Institute for Clinical Effectiveness and Health Policy (IECS) for six years until December 2016. Her research focused on health technology assessment, economic evaluations, systematic reviews, and health-related quality of life (HRQOL).
Lucila is a physician, trained in pediatrics, and she has a Master of Science degree. Both of her degrees were obtained at the University of Buenos Aires.
Introducción a La Modelación
Level: Intermediate
Track: Methodological & Statistical Research
Presentado en español / Presented in Spanish
Este curso incluye una introducción a los Modelos de Markov, Modelos de Eventos Discretos, y otras técnicas de modelaje y sus aplicaciones incluyendo una revisión de los Principios de buenas prácticas ISPOR para la modelación de decisión analítica en las evaluaciones de los cuidados de la salud . Se utilizarán una serie de ejemplos prácticos para desarrollar los contenidos mencionados incluyendo la selección del tipo de técnica de modelaje, la forma en trabajar con los parámetros a ser incluidos en los modelos y generalidades respecto al análisis de incertidumbre (como el Análisis Determinístico y Probabilístico, simulaciones de Monte Carlo, tipo de distribuciones a ser utilizadas). Este curso introductorio requiere una familiaridad básica con el análisis de decisiones.
Faculty Member
Dr. Federico Augustovski, MSc, PhD
Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
Federico Augustovski es médico de la Universidad de Buenos Aires (UBA) galardonado con un diploma de honor. Se graduó de Máster en Ciencias en Epidemiología en la Harvard School of Public Health y es doctor en Medicina con orientación en Salud Pública (UBA). Realizó cursos de posgrado y experiencias de formación e investigación en evaluaciones económicas y ciencias de la decisión en distintos centros internacionales como la Universidad de York, la Universidad de Texas, y el Baylor College de Medicina de Houston, Estados Unidos. Actualmente, se desempeña como director del Departamento de Evaluación de Tecnologías Sanitarias y Economía de la Salud del Instituto de Efectividad Clínica y Sanitaria, y como profesor adjunto de Salud Pública de la Facultad de Medicina de la UBA. Es investigador del Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina.
En 2017, fue elegido presidente de la Sociedad Internacional de Farmacoeconomía e Investigación de Resultados (ISPOR), el primero en no proceder de Norteamérica o Europa. Es el director del Centro Colaborador OMS/OPS de Evaluación de Tecnologías Sanitarias, y del Centro PROVAC de Argentina para la excelencia en evaluaciones económicas y la toma de decisiones en inmunizaciones. También es médico de familia (se desempeñó como médico de planta de la Unidad de Medicina Familiar y Preventiva del Hospital Italiano de Buenos Aires durante algo más de 20 años) y es director de los cursos de Análisis de Decisiones Sanitarias, de Desarrollo de Cuestionarios en Salud, Evaluaciones Económicas y Sanitarias, Evaluaciones de Tecnologías Sanitarias, y Modelos de Decisión I y II de la Maestría en Efectividad Clínica de la UBA. Fue el primer editor en jefe de la revista Value in Health Regional Issues (hasta diciembre de 2017), publicación con revisión de pares de economía de la salud e investigación de resultados indizada en MEDLINE, y es uno de los fundadores del Consorcio ISPOR para América Latina.
Ha coordinado diversos proyectos académicos y de investigación en el área de la evaluación de tecnologías sanitarias y las evaluaciones económicas en Argentina, Bolivia, Brasil, Chile, Colombia, México, Perú, y Uruguay. Cuenta actualmente con más de 80 publicaciones indizadas en MedLine.
Dr. Sebastián García-Martí, MSc
Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
Sebastián García-Martí, MD, MSc, is a physician, graduated from the University of La Plata, Argentina. He has a Master of Science in Clinical Epidemiology from Buenos Aires University. He also received training in Health Administration and Medical Informatics as an intern in Hospital Italiano Buenos Aires. Sebastián is the coordinator of the Health Technology Assessment and Economic Evaluations Department of the Institute for Clinical Effectiveness and Health Policy. He is a researcher at the National Scientific and Technical Research Council and professor of the following courses: HTA for Decision Makers, HTA Postgraduate, and Economic Evaluation Modeling, introductory and advanced. He is also a researcher in the Argentina Cochrane Center at IECS. He has conducted several training, research and implementation projects in HTA and health economic evaluations in cooperation with government agencies, academic, and private institutions in Argentina, Brazil, Chile, Colombia, Mexico, Panama, Peru, and Uruguay. His main areas of interest include evidence synthesis, health technology assessment, and knowledge translation to promote evidenced-based decision making.
Dr. Andrés Pichon-Riviere, MSc, PhD
Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
Andrés Pichon-Riviere es médico de la Universidad de Buenos Aires. Se graduó como Máster en Ciencias en Epidemiología en la escuela de Salud Pública de la Universidad de Harvard y como doctor en medicina con orientación en Salud Pública. Es director del Departamento de Evaluación de Tecnologías Sanitarias (ETS) y Economía de la Salud del Instituto de Efectividad Clínica y Sanitaria y director del Centro Colaborador de la OPS/OMS en ETS. Es profesor de Salud Pública de la Universidad de Buenos Aires e investigador del Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina. Fue vicepresidente de la International Network of Agencies for Health Technology Assessment de 2011 a 2014 y miembro del Directorio de Health Technology Assessment International (2013-2015). Ha coordinado proyectos de evaluación de tecnologías sanitarias y evaluaciones económicas en cooperación con gobiernos, agencias internacionales, e instituciones académicas y privadas en Argentina, Bolivia, Brasil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, México, Panamá, Perú, Uruguay, y Venezuela. Sus trabajos más recientes están relacionados con el establecimiento de mecanismos de priorización de recursos sanitarios y agencias de evaluación de tecnologías sanitarias, la definición de paquetes de beneficios, y la evaluación del impacto y la costo-efectividad de medicamentos, dispositivos, programas y políticas sanitarias.
New! Introduction to Real-World Evidence- Between Epidemiology and Digital Tools / ¡Nuevo! Introducción a La Evidencia Del Mundo Real- Entre La Epidemiologia y Las Herramientas Digitales
Level: Introductory
Track: Real World Data & Information Systems
Presented in English and Spanish with simultaneous English / Spanish interpretation
Presentado en inglés y español con interpretación simultánea al español / inglés
La evidencia de la vida real (RWE, por sus siglas en inglés), que se origina de los datos de la vida real (RWD, por sus siglas en inglés) (datos no generados en estudios clínicos aleatorizados), está generando creciente atención y uso debido a su potencial para mejorar la calidad y controlar los costos en los sistemas de salud. Aún si la RWE se asemeja a la epidemiología tradicional en muchos aspectos, existen también características distintivas tales como un fuerte foco en bases de datos secundarias y enfoques novedosos a los que contribuyen la evolución de la informática en salud y métodos farmacoepidemiológicos y estadísticos en evolución. Esta introducción se focalizará en la intersección entre los métodos tradicionales y las nuevas herramientas. Luego de presentar temas de RWE y RWD (definiciones, fuentes de RWD con foco en data secundaria generada en el proceso de atención de la salud, tales como datos de facturación e historia clínica electrónica, usos de RWE), nos enfocaremos en aspectos metodológicos clave para conducir y evaluar la calidad de un estudio de RWE: diseños de estudios, identificación y remediación de sesgos de selección, confusión y medición y consideraciones sobre modelado estadístico. Finalmente, reuniremos estos temas en un taller de demostración en tiempo real utilizando las herramientas desarrolladas por el consorcio colaborativo en datos observacionales e informática conocido como “Observational Health Data Sciences and Informatics ” (OHDSI), lo cual nos permitirá presentar los conceptos de modelos de datos común y herramientas de desarrollo y uso abierto para realizar análisis descriptivos y estimaciones de efectos de tratamiento a nivel poblacional. Finalmente, cerraremos con algunos comentarios sobre la gobernanza en RWE y tendencias futuras. Los participantes que deseen participar en un ejercicio práctico deben llevar una computadora portátil.
Faculty Member
M Sanni Ali, DVM, MSc, PhD
London School of Hygiene and Tropical Medicine, London, United Kingdom
Dr. M Sanni Ali is a senior researcher in pharmacoepidemiologic methods at the Center for Statistics in Medicine, University of Oxford, Oxford, and an assistant professor of epidemiology at the Department of Non-Communicable Disease Epidemiology London School of Hygiene and Tropical Medicine, LSHTM, London, UK.
He studied Veterinary Medicine and has an MSc in epidemiology and economics, and a PhD in epidemiology with specialization in pharmacoepidemiologic methods at Utrecht University, the Netherlands. He has experience in the design, analysis, and interpretation of electronic medical records including data from several European countries including the Netherlands (Mondriaan), Spain (BIFAP), UK (THIN and CPRD), and the USA (MarketScan), as well as simulation studies on validating and improving different statistical methods.
Sanni is primarily interested in causal inference in clinical and pharmacoepidemiology, methods dealing with confounding, mediation, effect modification, and missing data. He works on large (linked) electronic healthcare record databases (to generate evidence on comparative effectiveness and safety, benefits, and risks) of medications, medical devices, and (surgical) interventions.
Gerardo Machnicki, MSc, PhD
Janssen LATAM, Buenos Aires, Argentina
Gerardo is director, Real World Evidence at Janssen Latin America. He has spent 18 years in the pharmaceutical industry (country, region, and global levels) in roles involving health economics, outcomes research and analytics across different therapeutic areas (cardiovascular, diabetes, hematology, immunology, neurology, oncology, and respiratory). He has an international education in economics (Universidad Católica Argentina), health economics (University of York, UK), and epidemiology/public health/biostatistics (Saint Louis University, USA).
Gerardo has been an invited lecturer for several health economics/health management programs (Universidad Isalud, Universidad de San Andres, Universidad de Buenos Aires, and Universidad Maimónides). He has been co-instructor for economic analysis short courses presented by ISPOR and also serves as the chair of the 2018-2019 ISPOR Research Methods Awards Committee. Additionally, he has authored 20 peer reviewed journals and has developed other forms of communication which includes participating as author in scientific books, editorials, oral and poster presentations at international scientific meetings.
His skills include the design and analysis of epidemiological studies, economic evaluation of healthcare technologies, health technology assessment, health outcomes research with large databases, patient-reported outcomes, and resource allocation in healthcare and statistical modeling. Gerardo is also interested in big data in healthcare, creating impactful real-world evidence (RWE) strategies, and innovative epidemiologic and statistical methods.
New! Evaluation of Medical Devices- How to Manage Htas / ¡Nuevo! Evaluación De Los Dispositivos Médicos- Cómo Manejar Los ETS
Level: Intermediate
Track: Health Technology Assessment
Presented in English and Spanish with simultaneous Spanish / English interpretation The objective of this short course is to promote understanding of the key challenges associated with the evaluation of medical devices for HTA and provide robust alternative solutions. The course will begin by exploring core differences between HTA for drugs and medical devices. We will reflect on the international experience on evaluation of medical devices for HTA and compare this with the approaches currently implemented by HTA agencies in Latin America to evaluate these health technologies. Exemplary case studies will be used to illustrate potential solutions to key methodological challenges in the evaluation of medical devices for HTA. The potential contribution of real-world evidence and real-world data to address core methodological issues associated with medical device evaluation for HTA will be considered. Participants will have the opportunity to apply the theoretical concepts considered in the lectures by developing a protocol for HTA evaluation of a medical device. By the end of the course, participants will have a clear understanding of core challenges associated with HTA evaluation of medical devices and information on robust alternative methods to address these.
Presentado en inglés y español con interpretación simultánea al español / inglés
El objetivo de este curso corto es de promover la comprensión de los desafíos clave asociados con la evaluación de los dispositivos médicos para la ETS y suministrar unas soluciones alternativas robustas. El curso se inicia con la exploración de las diferencias principales entre una ETS de drogas y la de los dispositivos médicos. Reflexionaremos en la experiencia internacional sobre la evaluación de los dispositivos médicos para la ETS y comparar esta con las metodologías que las agencias de ETS actualmente implementan en América Latina para evaluar estas tecnologías de salud. Se empleará los casos de estudio ejemplares para ilustrar las posibles soluciones a los desafíos metodológicos clave en la evaluación de los dispositivos médicos para la ETS. Se considerará la aportación potencial de la evidencia del mundo real y data del mundo real para abordar las cuestiones metodológicas principales asociadas con la evaluación de los dispositivos médicos para la ETS. Los participantes tendrán la oportunidad de aplicar los conceptos teóricos considerados durante la clase al desarrollar un protocolo para la evaluación de la ETS para un dispositivo médico. Al concluir el curso, los participantes tendrán una comprensión clave de los desafíos principales asociados con la evaluación de la ETS de los dispositivos médicos e información sobre métodos alternativos robustos que abordan estos desafíos.
Faculty Member
Ramiro E. Gilardino, MD, MHE, MSc
ISPOR, Lawrenceville, NJ, USA
Ramiro Eugenio Gilardino, MD, MHE, MSc, is an experienced outcomes researcher, health economics and global health policy professional with a medical background. Over the last 10 years, he has been working in the health economics and outcomes research field having served as HEOR and market access leader for pharmaceuticals and medical devices as well as several positions in healthcare management.
In 2016, he joined ISPOR as lead in Latin America global engagement and developed health economics and health policy content, health policy initiatives, and stakeholder engagement to advance HEOR and improve the decision-making process across the region. Currently, he is Director of Consulting & Content Strategy at ISPOR. Before joining ISPOR, he served as Health Economics & Market Access lead for Johnson & Johnson MD responsible for HEOR and market access leadership in Latin America (South region), for all business operations followed up by an extended role as HEOR leader for the Cardiovascular Care Business across Latin America. Ramiro has previous experience in healthcare management including serving as advisor to the Argentinean Ministry of Health and other positions such as the Head of Disease Management and Medical Director in Social Security, and private payers where he oversaw the management of funds for chronic conditions, health technology incorporation, and coverage policies.
Dr. Gilardino’s research interests include medical devices comparative effectiveness, health technology assessment for medical devices, pricing, stakeholder involvement and non-traditional outcomes like PRO and ClinRO. He is particularly interested in health systems sustainability within the Latin America region. He has edited a publication related to establishing health technology assessment in Latin America as well as written chapters for publications and published more than 30 articles in both indexed and non-indexed peer-reviewed journals. He continues teaching Health Economics Evaluations and Health Technology Assessment as a part-time Professor at the Universidad ISALUD in Argentina.
Dr. Gilardino received his MD degree from the Universidad Abierta Interamericana in 2003 and was trained in pulmonary and critical care medicine (Buenos Aires, Argentina). He holds a master’s in Healthcare Economics and Administration from the Universidad ISALUD (2010) and is a master’s candidate (2019) in Global Health Policy at the London School of Hygiene and Tropical Medicine.
Cynthia P. Iglesias, MSc, PhD
University of York, Heslington, York, United Kingdom
Cynthia is a health economist and health services researcher with a 20-year experience in applied health research (AHR) working at the crossroad between various disciplines in health services research (eg, nursing, midwifery, medicine, epidemiology, sociology, and health economics). She has a first degree as an Actuary (Mexico), an MSc in Health Economics (York), and a PhD in Health Sciences (York).
Her research focuses on the role of health technology assessment (HTA) for decision making and the contribution that quantitative and, more recently, mixed methods can make to address core challenges associated with the use of existing evidence to determine the value for money of complex interventions (eg, medical devices, self-management of chronic conditions, and global health interventions). Most of her methodological work (innovative epidemiological study design; Bayesian methods such as value of information, elicitation, evidence synthesis, bias adjustment, and complementary use of RCT and observational data) has been embedded as part of AHR using and extending existing research methods to accommodate key characteristics of the available data and contextual factors, when necessary.
She has an established national and international reputation in HTA and medical devices evaluation. Since 2012, Cynthia has been serving on the National Institute for Health and Care Excellence (NICE) Medical Technologies Advisory Committee (MTAC). This group of experts is responsible for producing guidance and making recommendations on the introduction and use of medical devices in the NHS in England and Wales. She is one of only two health economists serving on this Committee.
Robbert Zusterzeel, MD, PhD, MPH
National Evaluation System for Health Technology Coordinating Center (NESTcc), Arlington, VA, USA
Robbert Zusterzeel, MD, PhD, MPH, is the Data Network Director for the NEST Coordinating Center. He joins from the U.S. Food and Drug Administration (FDA) where he led multiple groups conducting translational regulatory research. Dr. Zusterzeel earned his MD and PhD from Maastricht University, The Netherlands, as well as a Master of Public Health (MPH) in epidemiology from Harvard University. He has published numerous peer-reviewed journal articles related to the safety and effectiveness of medical devices and drugs and predicting individualized response to therapies using and creating study data across the full product life cycle.
Meta-Análisis En Red
Level: Experienced
Track: Study Approaches
Presentado en español
¿Cuál es el mejor tratamiento para detener crisis convulsivas? ¿Cuál es la terapia que mejor alivia el dolor en la enfermedad degenerativa vertebral? Cuando no disponemos de estudios que cotejen directamente las ventajas y desventajas de dos intervenciones, o cuando se necesita un ranking de eficacia o seguridad de múltiples intervenciones para una misma condición, los meta-análisis en red (MAR) ofrecen la mejor respuesta con la evidencia disponible. Este tipo de estudios (también llamados “meta-análisis con comparaciones múltiples” o “meta-análisis con comparaciones mixtas”) proporciona un método integrado y unificado que incorpora toda la evidencia comparativa directa e indirecta sobre los tratamientos. Las agencias de evaluación de tecnologías y también Cochrane (estándar de calidad en el área de las revisiones sistemáticas y meta-análisis), consideran los resultados de los MAR como una fuente de información de importancia para guiar la toma de decisiones en distintos niveles. De hecho, su número ha crecido de manera vertiginosa en especial desde 2009. Presentaremos los fundamentos y conceptos del MAR así como el abordaje GRADE para evaluar la credibilidad de un MAR a través de ejemplos de la vida real.
Faculty Member
Dr. Agustín Ciapponi, MSc
Instituto de Efectividad Clínica y Política de Salud, Buenos Aires, Argentina
Agustín Ciapponi es un médico de familia e investigador enfocado en la síntesis de evidencia y la transferencia de conocimientos. Es médico del Servicio de Medicina Comunitaria y Familiar en el Hospital Italiano de Buenos Aires y fue Secretario Científico de la Asociación Argentina de Medicina Familiar. Después de graduarse como Magister de Efectividad Clínica de la Universidad de Buenos Aires y de realizar varias revisiones sistemáticas, se convirtió en coordinador del Centro Cochrane local y, más recientemente, como Director de Cochrane Argentina. También es editor de Clinical Cochrane Answers.
Lleva a cabo actividades docentes como Profesor Asistente de Salud Pública en la Escuela de Medicina de la Universidad de Buenos Aires, Argentina y como Director de los cursos de posgrado de "Revisión sistemática y meta-análisis" y "Medicina basada en la evidencia". Tiene responsabilidades editoriales como Editor de la revista " Archivos de Medicina Familiar y General", y miembro del Consejo Editorial de "EVIDENCIA en la práctica ambulatoria ” (revista bimestral EBM española).
Fue miembro de la Junta de Investigación Clínica del Hospital Italiano de Buenos Aires y coordina investigaciones clínicas primarias, pero su experiencia principal es el campo de la Revisión Sistemática y el Meta-análisis. Agustín es autor de más de 70 publicaciones en revistas científicas y libros revisados por pares, incluidas 25 revisiones sistemáticas Cochrane. Tiene actividades de defensa como Campeón de Pacientes para la Seguridad del Paciente - Alianza Mundial para la Seguridad del Paciente. En los últimos años ha participado en varias investigaciones de traducción de conocimiento a consumidores con varios grupos de la Colaboración Cochrane. También participó como socio latinoamericano de SUPPORT. red de colaboración internacional que implica una entre LMIC y científicos europeos y formuladores de políticas de LMIC para brindar capacitación y apoyo para alentar a los investigadores y formuladores de políticas a que realicen investigaciones de colaboración relevantes para las políticas.
8:00 - 17:00
FULL-DAY SHORT COURSES
Multi-Criteria Decision Analysis / Análisis De Decisión Multi-Criterio
Level: Intermediate
Track: Health Technology Assessment
Presented in English and Spanish with simultaneous Spanish / English interpretation Many healthcare decisions—such as portfolio optimization, benefit-risk assessment (BRA), health technology assessment (HTA), and shared decision making (SDM)—require a careful assessment of the underlying options and the criteria used to judge these options. This assessment can be challenging given the trade-offs between multiple value criteria. Considering this, many decision makers have begun investigating the use of multi-criteria decision analysis (MCDA) in support of these decisions. This course provides an introduction to MCDA for healthcare. The course will focus on the use of MCDA for HTA and will be organized around the following parts: (1) Introduction to MCDA: What is it and how is it being used in HTA?; (2) Implementing MCDA 1: Practical tips when implementing MCDA; (3) Implementing MCDA 2: Methodological options when designing an MCDA; and (4) Using MCDA for HTA: Challenges and possible solutions. These parts are designed to familiarize participants with the steps involved in undertaking an MCDA, the alternative ways of implementing these steps, and good practice guidelines. The course will also review the current MCDA HTA landscape, including current use of MCDA for HTA and the challenges this poses. The course is designed for those unfamiliar with MCDA, but who have a basic understanding of other evaluation methodologies. Participants who wish to participate in a practical exercise should bring a Windows laptop computer with Microsoft Excel® installed and running .
Presentado en inglés y español con interpretación simultánea al español / inglés
Muchas decisiones de la salud—tales como la optimización de portfolio, evaluación de beneficio-riesgo, evaluación de la tecnología sanitaria (ETS), y la toma de decisiones compartida—requieren una evaluación cuidadosa de las opciones subyacentes y el criterio utilizado para juzgar estas opciones. Esta evaluación pueda ser desafiante dado las compensaciones entre el criterio de los valores múltiples. En vista de esto, muchos tomadores de decisiones han comenzado a investigar el uso del análisis de decisión multi-criterio (ADMC) en apoyo de estas decisiones. Este curso suministra una introducción al ADMC para el cuidado de la salud. El curso se enfocará en el uso de ADMC para la ETS y se organizará según las siguientes partes: (1) introducción al ADMC: ¿Qué es cómo se usa en la ETS?; (2) implementación del ADMC 1: Consejos prácticos cuando se implementa el ADMC; (3) implementación del ADMC 2: Opciones metodológicos cuando se diseña un ADMC; y (4) utilizando ADMC para la ETS: Desafíos y posibles soluciones. Estas partes están diseñadas para familiarizar a los participantes con los pasos necesarios al realizar un ADMC, las medidas alternativas de implementar estos pasos, y directrices para la buena práctica. El curso también repasará el panorama del ADMC ETS, incluyendo el uso actual del ADMC para la ETS y los desafíos que suponen. El curso está diseñado para participantes que no tienen familiaridad con el ADMC, pero tienen una comprensión básica de otras metodologías de evaluación. Los participantes que deseen participar en un ejercicio práctico deben llevar una computadora portátil Windows con Microsoft Excel® instalado y funcionando.
Faculty Member
Manuel A. Espinoza, MD, MSc, PhD
Catholic University of Chile, Santiago, Chile
Manuel Espinoza is associate professor in the Department of Public Health and Chief of the Health Technology Assessment Unit, both at Pontificia Universidad Católica de Chile. He is also visiting honorary fellow in the Centre for Health Economics at University of York and Consultant of the Interamerican Bank of Development.
Manuel holds a medical doctor degree and master in epidemiology both from Pontificia Universidad Católica de Chile, a master in biostatistics from Universidad de Chile, and master and PhD in Health Economics, both from University of York in the UK. Manuel´s work has included the development of methods and processes for prioritization in health care as well as applied research in health economic evaluation of healthcare technologies. After running the first exercise of MCDA to support the update of the health benefit plan in the Dominican Republic, Manuel has run MCDA workshops in Mexico, Ecuador, Colombia, and Argentina to explore the potential use of this type of analysis in health priority settings in the region.
Praveen Thokala, MASc, PhD
School of Health and Related Research (ScHARR), The University of Sheffield, SHEFFIELD, United Kingdom
Praveen Thokala joined the School of Health and Related Research (ScHARR) at the University of Sheffield after completing an MASc from the University of Toronto and a PhD from the University of Southampton.
During this time, he has completed several health economics projects including single technology appraisals (STA), multiple technology appraisals (MTA), and diagnostic assessment reports (DARs) for NICE. He has also recently led a modeling project for Institute for Clinical and Economic Review (ICER) in the US. His research interests include health economic modeling, multi-criteria decision analysis (MCDA), discrete event simulation modeling, and optimization. He co-supervised four PhD students to completion and currently co-supervises four PhD students.
In terms of MCDA, he has worked with the National Institute of Health and Care Excellence decision support unit (NICE DSU) in the UK on exploring the applicability of MCDA in HTA. He co-chaired the ISPOR Task Force on the use of MCDA in healthcare decision making and has been involved in several MCDA studies including supporting priority setting and benefit-risk analysis. He also co-edited a book titled, Multi-Criteria Decision Analysis to Support Healthcare Decisions.
Introduction to Health Economics / Introducción a La Economía De La Salud
Level: Introductory
Track: Economic Evaluation
Presented in English and Spanish with simultaneous Spanish / English interpretation This course is designed to teach clinicians and new researchers how to incorporate pharmacoeconomics/health economics into study design and data analysis. Participants will learn how to collect and calculate the costs of different healthcare or healthcare economic evaluation alternative treatments, determine the economic impact of clinical outcomes, and how to identify, track, and assign costs to different types of healthcare resources used. The development of economic protocols and data collection sheets will be discussed. Different health economics models and techniques will be demonstrated with case studies. These include: cost-minimization, cost-of-illness, cost-effectiveness, cost-benefit, and cost-utility analysis. Decision analysis, sensitivity analysis, and discounting will also be demonstrated and practiced. Participants will learn to compare and evaluate interventions such as drugs, devices and clinical services. This course is suitable for those with little or no experience with pharmacoeconomics.
Presentado en inglés y español con interpretación simultánea al español / inglés
Este curso está diseñado para instruir a clínicos y a investigadores nuevos cómo incorporar la farmacoeconomía / economía de la salud en el diseño de un estudio y el análisis de datos. Los participantes aprenderán cómo recoger y calcular los costos de distintos tratamientos alternativos del cuidado de la salud o de la evaluación económica del cuidado de la salud, determinar el impacto económico de los resultados clínicos, y cómo identificar, rastrear, y asignar costos a los distintos tipos de recursos de cuidado de la salud utilizados. Se discutirán el desarrollo de protocolos económicos y hojas de recolección de datos. Se demostrarán distintos modelos y técnicas de la economía de la salud con casos de estudios. Estos incluyen: minimización de costos, costo de la enfermedad, efectividad de costos, costo-beneficio, y análisis de costo-utilidad. También el análisis de decisión, análisis de sensibilidad, y descuentos serán demostrados y practicados. Los participantes aprenderán a comparar y evaluar intervenciones como los fármacos, dispositivos, y servicios clínicos. Este curso es apto para participantes con poco o ninguna experiencia en la farmacoeconomía.
Faculty Member
Renée JG Arnold, PharmD
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Renée JG Arnold is currently adjunct associate professor, Master of Public Health program, Department of Preventive Medicine at the Icahn School of Medicine at Mount Sinai, New York, New York, where she has developed and teaches the pharmacoeconomics coursework. She is also president & CEO of Arnold Consultancy & Technology, LLC where she oversees outcomes research and develops affiliated software for pharmaceutical and federal government programs. Her special interest in evidence-based health derives from her research that deals with use of technology to collect and/or model real-world data for use in rational decision making by healthcare practitioners and policy makers. Dr. Arnold completed her undergraduate training at the University of Maryland and received her Doctor of Pharmacy degree from the University of Southern California in Los Angeles. She also completed a one-year post-doctoral residency at University Hospital in San Diego/University of California at San Francisco School of Pharmacy. Dr. Arnold was previously vice president of HEOR at Quorum Consulting, Inc./Navigant Consulting; principal of IMS Health (IQVIA); and president and co-founder of Pharmacon International, Inc. Center for Health Outcomes Excellence.
Dr. Arnold is a founding member of ISPOR and is the head of both the ISPOR Distance Learning Program, as well as the head of the newly-developed Open Source Models Special Interest Group. She is an author/co-author of numerous articles, book chapters, and books in the areas of pharmacology, pharmacoeconomics, and cost-containment strategies.
Diego Rosselli, MD, MEd, MHP
Pontificia Universidad Javeriana, Medical School, Bogota, Colombia
Diego Rosselli is a Colombian neurologist trained at the London Institute of Psychiatry. He began his academic career as a neuroscience teacher. After obtaining his Master’s degree in Education in Harvard in 1993, he joined the Colombian Ministry of Health as Director for Scientific and Technological Development in charge of performing health technology assessments. He then obtained a second master's degree in Health Policy at the London School of Economics. Since then (1997), he has been teaching Health Economics at the Universidad Javeriana, in Bogotá. Rosselli has authored 7 books and more than 100 scientific articles in many aspects of clinical epidemiology, real-world evidence and health economics. He has lectured in pharmacoeconomics in 17 Latin American countries. He is currently the 2018-2020 Chair of the ISPOR Latin America Consortium Executive Committee and Colombia Chapter past president.
13:00 - 17:00
SHORT COURSE AFTERNOON SESSION
¡Nuevo! Introducción Al Aprendizaje De Máquinas
Level: Intermediate
Track: Study Approaches
Presentado e n español / Presented in Spanish El aprendizaje de máquinas (ML, por sus siglas en inglés) comprende representaciones y algoritmos que permiten predecir el comportamiento de un fenómeno de interés, usando observaciones de situaciones previas. ML se concentra en encontrar patrones en los datos que permitan a las computadoras resolver problemas complejos de manera automática. Para desarrollar algoritmos de ML es necesario resolver una pregunta difícil: cómo generalizar el comportamiento de un fenómeno más allá de los ejemplos particulares que componen el conjunto de entrenamiento. Este curso busca explicar los principios fundamentales de ML y cómo estos procesos de generalización pueden ser formulados e implementados. El problema se estudiará desde diferentes perspectivas, ilustrando los conceptos básicos en el área de economía de la salud.
El curso cubre conceptos fundamentales de ML, además de algunas metodologías y algoritmos particulares. Dentro de los temas a tratar estas: principio de sesgo/varianza, calibración de modelos, árboles de decisión, máquinas de aprendizaje vectorial (SVM, por sus siglas en inglés), redes neuronales, y algoritmos de ensamblaje. Se requiere un conocimiento básico de la regresión lineal. Los participantes que deseen participar en los ejercicios prácticos durante el curso deben asegurarse de traer una computadora portátil personal con el software R and R-Studio instalado y funcionando. Las instrucciones de instalación estarán suministradas a los inscritos.
Faculty Member
Dr. Rafael Alfonso-Cristancho, PhD, MSc
GlaxoSmithKline R&D, Collegeville, PA, USA
Rafael Alfonso es un investigador enérgetico que motiva la controversia y el debate científico. Es médico cirujano de la Universidad del Rosario en Colombia y consiguió un máster en Ciencias en Farmacoepidemiología de la Universidad Autónoma de Barcelona en España y un PhD del Programa de Investigación y Política de Resultados Farmacéuticos de la Universidad de Washington, donde mantiene su afiliación como profesor en el Departamento de Cirugía en la facultad de Medicina. Cuenta con una amplia experiencia trabajando en industria, academia y consultoría durante los últimos 19 años. En la industria, comenzó trabajando en el Departamento Médico para compañías farmacéuticas en América Latina (Merck y Sanofi), y se unió a GSK en junio de 2014, teniendo diferentes roles en I+D global. Antes de unirse a GSK, fue profesor y director científico del Centro de Investigación de Resultados Quirúrgicos, Comparative Effectiveness Research and Translation Network, y Collaborative for Healthcare research in behaviOral economIcs and deCision sciEnceS (CHOICES) en la Universidad de Washington en Seattle. En 2007, cofundó y dirigió una organización científica sin fines de lucro en América Latina (Fundación RANDOM) para educar, promover, e implementar actividades de investigación de economía y resultados de la salud en la región. Actualmente, Rafael se desempeña como asesor en las opciones de prevención, diagnóstico, y tratamiento para el Instituto de Investigación de Resultados Centrados en el Paciente, y anteriormente se desempeñó como asesor de la Organización Panamericana de la Salud para la Regulación de Biológicos y Biosimilares. También es miembro activo de ISPOR donde ha ocupado diferentes cargos de liderazgo.
Carlos Felipe Valencia, PhD
Universidad de los Andes, Bogotá, Colombia
Carlos Felipe Valencia Arboledo es profesor del Departamento de Ingeniería Industrial de la Universidad de Los Andes en Bogotá, Colombia. En 2013, recibió su título de doctorado en Ingeniería Industrial con especialización en Estadística de la facultad H. Milton Stewart y de sistemas en el Instituto Tecnológico de Georgia (Gatech, Atlanta, Georgia, EUA). Además, tiene una maestría en estadística de la misma universidad y otra maestría en ingeniería de la Universidad de los Andes. Su interés académico se enfoca en el análisis estadístico de datos complejos que requieren mecanismos de regularización para realizar estimación e inferencia. Estos incluyen estimación funcional, análisis de datos en grandes dimensiones, y estadística no-paramétrica. La mayor parte de su trabajo se enfoca en la teoría y aplicación de algoritmos de aprendizaje (machine learning) a diferentes estructuras de datos. Algunos proyectos específicos incluyen aplicaciones en datos de salud y ambientales, regularización en espacios de Hilbert, medición de eficiencia, y desarrollo de modelos econométricos para negocios y finanzas.
Budget Impact Analysis for Health Decision Making in Latin America / Análisis Del Impacto Presupuestal Para La Toma De Decisión En América Latina
Level: Intermediate
Track: Economic Evaluation
Presented in English and Spanish with simultaneous English / Spanish interpretation The purpose of this course is to present the main concepts, elements and discussions on budget impact analysis (BIA) for health decision making in the context of Latin American countries. Conceptual aspects of the BIA of a new healthcare technology are reviewed, its relevance for decision making in coverage policies in the regional context is examined, and the recommendations of the BIA inclusion and methods of the economic evaluation guides of Latin American countries as well as the ISPOR Good Practice Guide for the realization of the BIA are presented. These concepts and discussions are illustrated through an application exercise with an interactive BIA model. This course is designed for those with some experience with pharmacoeconomic analysis. All participants must bring a laptop with Internet browser. You will be given instructions when you pre-register for the course.
Presentado en inglés y español con interpretación simultánea al español / inglés
El propósito de este curso es de presentar los conceptos principales, elementos y discusiones sobre el análisis del impacto presupuestal (BIA, por sus siglas en inglés) para la toma de decisiones en salud en el contexto de los países en América Latina. Los aspectos conceptuales de la BIA de una tecnología nueva en los cuidados de la salud estarán considerados, su relevancia en la toma de decisión sobre la política de la cobertura en un contexto regional estará examinado, y las recomendaciones de una inclusión BIA y la metodología de las guías de una evaluación económica en los países de América Latina además de Principios ISPOR de buenas prácticas para la realización de una BIA se presentarán. Estos conceptos y discusiones se ilustran a través de un ejercicio de aplicación con un modelo interactivo de BIA. Este curso está diseñado para participantes con alguna experiencia con el análisis farmacoeconómica. Todos los participantes deben traer una computadora portátil con navegador de Internet. Se le darán instrucciones cuando se preinscriba en el curso.
Faculty Member
C. Daniel Mullins, PhD
University of Maryland School of Pharmacy, Baltimore, MD, USA
C. Daniel Mullins, PhD, is a professor and chair of the Pharmaceutical Health Services Research Department at the University of Maryland School of Pharmacy. He received his BS in Economics from M.I.T. and his PhD in Economics from Duke University. His research and teaching focus on comparative effectiveness research (CER), patient-centered outcomes research (PCOR), pharmacoeconomics, and health disparities research. He directs the University of Maryland PATient-centered Involvement in Evaluating effectiveNess of TreatmentS (PATIENTS) Program, which received a University of Maryland Baltimore Champion of Excellence Award. He has received funding as a Principal Investigator from the NIH/NIA, NIH/NHLBI, AHRQ, and the Patient-Centered Outcomes Research Institute (PCORI) and was the Shared Resources Core Director for the NIH-sponsored University of Maryland Center for Health Disparities Research, Training, and Outreach. He previously served as a Regular Member of the AHRQ HSR and the NCI-J Study Sections and currently serves as a Regular Member for the AHRQ HCRT Study Section. He also has chaired PCORI Study Sections. In addition to his work on federal grants, Professor Mullins is co-Editor-in-Chief for Value in Health and is author/co-author of approximately 200 peer-reviewed articles and book chapters on pharmacoeconomics, outcomes research, and pharmaceutical policy and health disparities research in journals such as The American Journal of Managed Care, The American Journal of Public Health, Cancer, Chest, Health Affairs, Health Services Research, JAMA, Journal of Clinical Oncology, Pharmacoeconomics, and Social Science & Medicine. He has received an Outstanding Service Award from the Drug Information Association (DIA) and two Service Awards from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). In 2007, he received the Dr. Patricia Sokolove Outstanding Mentor Award from the University of Maryland, Baltimore campus-wide Graduate Student Association. In 2013, he was the recipient of the Dr. Daniel D. Savage Memorial Science Award, the Association of Black Cardiologists’ most prestigious annual award. Also in 2013, he was awarded a University System of Maryland Wilson H. Elkins Professorship. In 2014, he and Robin Newhouse were named co-researchers of the year for the University of Maryland Baltimore campus.
Alfredo Palacios, MSc
Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
Alfredo Palacios holds a bachelor's degree in economics from the National University of Río Cuarto (UNRC) and a master's degree in economics from the National University of La Plata (UNLP), Argentina. He has also carried out postgraduate studies in the Evaluation of Health Programs at the National Institute of Public Health of Mexico (INSP). His research interests are focused on health economics, applied microeconometrics, and impact evaluation of public policies.
He is currently coordinator of the Health Economics Unit of the Institute of Clinical Effectiveness and Health Policy (IECS), and he is a professor of Economics and a master’s in Clinical Effectiveness and Health Policy at the University of Buenos Aires (UBA).
He has been a consultant on research projects and provided technical assistance for international organizations and local government agencies such as the World Bank, Inter-American Development Bank, International Development Research Center (IDRC), Gates Foundation, World Health Organization, among others.
He has obtained awards, distinctions, and research grants from organizations such as IDRC, Health Systems Global (HSG), Centers for Learning on Evaluation and Results (CLEAR), Research Institute Development, Growth and Economics (RIDGE), Latin American Association of Economic Theory (ALTE), and the Ministry of Health of Argentina, among others.
Modelización Avanzada- Cómo Crear Modelos Flexibles y Naturales Con DICE
Level: Intermediate
Track: Methodological & Statistical Research
Presentado en español / Presented in Spanish El método de simulación DICE ha emergido como una técnica estándar para el diseño y construcción de modelos en evaluación de tecnologías de salud porque es muy transparente y fácil de utilizar y a la vez suficientemente flexible como para implementar modelos de todo tipo desde Markov de cohorte hasta simulación por eventos discretos, todos en simple MS Excel® . Este curso suministrará un entendimiento detallado de los conceptos de DICE, sus componentes, y cómo funciona. Ejemplos de varios tipos serán construidos durante la clase para ilustrar lo fácil y rápido que es crear un modelo DICE y destacar sus ventajas y desventajas. El uso de una computadora personal portátil con Windows Microsoft Excel® instalado es opcional.
Faculty Member
J. Jaime Caro, MDCM, FRCPC
Evidera, Waltham, MA, USA and Adjunct Professor of Medicine, Adjunct Professor of Epidemiology and Biostatistics, Waltham, MA, USA
J. Jaime Caro es el jefe científico de Evidera y profesor de epidemiología y medicina en la Universidad McGill y profesor de la Escuela de Economía de Londres. Él fue pionero en el uso de SED, desarrolló el método de comparación de tratamientos por vía de simulación y propuso la frontera de eficiencia como una alternativa viable al uso de costo por AVAC. Recientemente, ha desarrollado un nuevo método para modelos, la simulación DICE, apto para los problemas de evaluación de las tecnologías en salud.
17:30 - 18:30
EDUCATIONAL SYMPOSIUM
APPRAISAL AND ASSESSMENT WITH AN EMPHASIS ON PATIENT INVOLVEMENT
There is increasing recognition that HTAs involving evaluation of clinical and cost effectiveness are an incomplete assessment of value and that a broader evaluation is needed including patient and social aspects. Patients have unique knowledge about living with a disease and taking treatments that can help resolve uncertainties in HTA. Patients can be involved in HTA through rigorous forms of research to understand patients’ perspectives and experiences and via participation in the HTA process. It is challenging for patients to access clinical trials and they face delays in access to new medicines, new HTA processes could mean further delays. There are a range of ways in which healthcare stakeholders could engage with patients and patient groups. Multi-stakeholder forums could be particularly valuable and lead to development of joint solutions that could improve drug development and reduce time to access of patients.
Sponsor
Eli Lilly
Moderators
Manny Papadimitropoulos, MScPhm, PhD
Eli Lilly and Company, Pickering, ON, Canada
Speakers
Jaime Calderon Herera
Fundación Cardiovascular de Colombia, Bucaramanga, Santander, Colombia
Martin Petrocco
Asociación Civil para el Enfermo de Psoriasis (AEPSO), Buenos Aires, Argentina
Stephen Stefani, MD
Hospital do Câncer Mãe de Deus, Porto Alegre, Brazil
18:45 - 19:45
ACCESS TO ORPHAN DRUGS IN LATIN AMERICA- OPPORTUNITIES AND CHALLENGES
The purpose of this educational symposium is to discuss the challenges faced by health technology assessment (HTA) agencies and health care decision makers in Latin America in evaluating novel therapies for rare/orphan diseases and best practices in assessing the value of these treatments. The symposium will present the orphan drug policies that exist in Latin American countries today, with a focus on the impact of these policies on time to access and reimbursement relative to other markets. In addition, the symposium will highlight several methodologies that have been developed for the assessment of rare disease products that have been used in other regions and will present spinal muscular atrophy (SMA) as a case study. The panelists will share the importance of implementing a robust evidence package and holistic assessment framework (including a multi-stakeholder view and multi-criteria analysis) for addressing uncertainties in clinical and economic outcomes in order to ensure successful access and reimbursement of novel rare/orphan disease therapies.
Sponsor
Biogen
Moderators
Dennis Meletiche, PharmD
Maple Health Group, LLC, Cambridge, MA, USA
Speakers
Maria Isabel Acevedo, BA, MEd
FAME Colombia & Active Member, FECOER, Bogota, Colombia
Rosa Maria Galindo Suarez, MHA
PERMA Consultores, Mexico City, Mexico
Andre Liamas, BA, MSc
Biogen Idec, São Paulo, Brazil
Diego Rosselli, MD, MEd, MHP
Pontificia Universidad Javeriana, Medical School, Bogota, Colombia
Diego Rosselli is a Colombian neurologist trained at the London Institute of Psychiatry. He began his academic career as a neuroscience teacher. After obtaining his Master’s degree in Education in Harvard in 1993, he joined the Colombian Ministry of Health as Director for Scientific and Technological Development in charge of performing health technology assessments. He then obtained a second master's degree in Health Policy at the London School of Economics. Since then (1997), he has been teaching Health Economics at the Universidad Javeriana, in Bogotá. Rosselli has authored 7 books and more than 100 scientific articles in many aspects of clinical epidemiology, real-world evidence and health economics. He has lectured in pharmacoeconomics in 17 Latin American countries. He is currently the 2018-2020 Chair of the ISPOR Latin America Consortium Executive Committee and Colombia Chapter past president.
20:00 - 21:00
GENOMIC PROFILING IN CANCER- POLICIES AND REGULATORY LANDSCAPE FOR LATIN AMERICAN COUNTRIES
Genomic profiling is a technology based on next generation sequencing and big data to provide genomic and treatment information in cancer to improve healthcare outcomes through innovation and it is oriented to get access to personalized medicine with sustainable healthcare models. Is genomic profiling a reality in Latin -America? Roche Foundation Medicine presents its findings from the policies and regulation landscape related to comprehensive genomic profiling for cancer derived from critical and comparative research conducted by The Economist Intelligence Unit among different Latin American Countries. Comprehensive Genomic profiling is a technology based on next generation sequencing and big data to provide genomic and treatment information in cancer to improve healthcare outcomes through innovation and oriented to get access to personalized medicine with sustainable healthcare models.
Sponsor
Roche
Moderators
Andrés Felipe Cardona, MD
Clinica del Country, Bogota, DF, Colombia
Speakers
Alan Lovell, MA
The Economist Intelligence Unit (The EIU), London, United Kingdom
Fri 13 Sep
8:30 - 10:30
WELCOME AND FIRST PLENARY SESSION
FIRST PLENARY SESSION- THE ROLE OF DATA SUPPORTING AN EFFECTIVE DECISION-MAKING PROCESS
Many of the processes of everyday life have become increasingly automated. The sheer volume and diversity of data that are currently applied to healthcare have grown exponentially as medical technology and integrated solutions have made this information increasingly accessible and useful for healthcare decision makers.
Real-world data extends the usefulness of randomized controlled trials by its ability to include timely data, large sample sizes that enable analysis of subpopulations and less common effects, and real-world practice and behaviors in applied research studies. Research that uses real-world data and real-world evidence are becoming increasingly important to decision makers, and through careful analysis and interpretation, this type of evidence will play an increasing role in informing healthcare decisions.
In the session entitled “The Role of Data Supporting Effective Decision-Making Processes,” different stakeholders will explore how the management of these “data” impact real-life healthcare decisions and resource allocation in Latin America.
Moderators
Manuel Antonio Espinoza, MD MSc PhD
Pontificia Universidad Católica, Santiago, Chile
Manuel Espinoza is Associate Professor in the Department of Public Health and Chief of the Health Technology Assessment Unit, both at Pontificia Universidad Católica de Chile. He is also Visiting Honorary Fellow in the Centre for Health Economics at University of York and Consultant for the Interamerican Bank of Development. He has served as advisor and consultant for several public entities in Latin America as well as institutions such as the World Bank and World Health Organization. Manuel holds a medical doctor degree and Master in Epidemiology both from Pontificia Universidad Católica de Chile; a Master in Biostatistics from Universidad de Chile, and Master and PhD in Health Economics, both from University of York in the UK. Manuel´s work has been focused on the development of methods and processes for prioritization in health care as well as applied research in health economic evaluation.
Speakers
Rafael Alfonso-Cristancho, MD, PhD, MSc
GlaxoSmithKline, Collegeville, PA, USA
Edson Amaro, MD, PhD
Hospital Israelita Albert Einstein, São Paulo, Brazil
Prof. Dr. Edson Amaro is a practicing neuroradiologist and Head of the Big Data Initiative based at the Albert Einstein Hospital, São Paulo. He graduated in Medicine from University of São Paulo in 1993. In 2000, he became the University of São Paulo’s first PhD in functional Magnetic Resonance Imaging (fMRI) whilst also guiding Radiology residents through their medical training as a Chief Resident in 1997. In 2002 he finished a 2 year Wellcome Trust Visiting Fellowship at the Institute of Psychiatry and Maudsley Hospital, King’s College London for a post-doc in fMRI. In 2002, he set up a functional neuroimaging group at University of São Paulo working with network analytics to understand brain function and joined the Department of Radiology at Albert Einstein Hospital establishing a program for clinical use of brain function MRI. He also conducted neuroimaging studies in CNS disorders and in 2003 he was appointed head of the Brain Institute from 2008 to 2012 at Albert Einstein Hospital. More recently, in 2015 he was appointed the head of the Big Data Initiative at Albert Einstein, and is leading this journey aimed at getting value out of data for health care. The projects are driven both by daily clinical (bed side and primary care) and management questions (cost/efficacy and resource optimization) as well as helping to lead the Institutional pathway to a Data Driven Health Care Organization. And since 2018 he is coordinating a Big Data and Innovation Project for the Ministry of Health (PROADI Big Data and Innovation) involving various University and groups to provide database and analytics pipelines to help and support decision making in public health system. Edson has co-authored over 200 papers in leading scientific journals in his research area.
William H Crown, PhD
OptumLabs, UAE, Cambridge, MA, USA
William H. Crown, Ph.D., is Chief Scientific Officer of OptumLabs. In this role, he is responsible for research activities of the Labs. From 2004-2013, Dr. Crown was President of the health economics, late phase research, data products, and epidemiology business units at Optum Life Sciences. He was Vice President of Outcomes Research and Econometrics at Thomson Reuters Medstat from 1994-2004. From 1982-1995, Dr. Crown was a faculty member of the Florence Heller Graduate School, Brandeis University, where he taught graduate courses in statistics and conducted research on the economics of aging and long-term care policy. He received his doctorate degree in urban and regional studies from the Massachusetts Institute of Technology, and a master of arts in economics from Boston University. The author of two books and co-author of two others, Dr. Crown has published over 175 peer-reviewed journal articles, book chapters, and other scholarly papers. Known for his early application of econometric methods in the pharmaceutical outcomes research literature, he is a frequent speaker on statistical methods for the analysis of observational data at professional meetings and conferences. His current interests are in the areas of causal modeling and machine learning, and bias reduction through data linkage. In addition to his CSO role within Optum Labs, Dr. Crown is Affiliate Faculty, Mongon Institute for Health Policy, Harvard University. He was also 2013-14 President of the International Society of Pharmacoeconomics and Outcomes Research.
Oscar Espinosa, MSc
Institute of Technology Assessment in Health, Bogota, Colombia
Economist Graduated with distinction and Magister in Statistical Sciences graduated with distinction of the Universidad Nacional de Colombia. Citizen Data Scientist certified by CAOBA. Scholar of the Doctoral School 2019 in Neurosciences of the Pontificia Universidad Católica de Chile. Currently, he is the Coordinator of the Analytical Unit of the Technological Health Assessment Institute. Founder and Director of the Research Group on Economic Models and Quantitative Methods (IMEMC), recognized by Colciencias. With articles published in national and international indexed journals. Advisor of Master Thesis in Quantitative Finance, Epidemiology and Economic Sciences.
His areas of work and research interest are focused on the topics of quantitative management of health risks, actuarial sciences of social security, statistical modeling of non-linear multivariate time series, financial and Bayesian econometrics, corporate governance and economy of the innovation.
Lucinda Orsini, DPM, MPH
ISPOR, Lawrenceville, NJ, USA
Lucinda Orsini is currently Associate Chief Science Officer at ISPOR, the leading society for health economics and outcome research. The science office at ISPOR develops, leads, and supports strategic initiatives related to research, scientific, and content priorities. While Lucinda holds a professional medical degree, she has spent most of her ~20-year career in health economics and outcomes research. Starting at The Medstat Group (Truven Health Analytics) Lucinda managed projects using health care claims data for external clients. She has worked in the pharmaceutical industry at Bristol-Myers Squibb and subsidiaries in Global HEOR focused on oncology and immunotherapy leading and publishing on patient reported outcomes, health economic modeling and real-world evidence studies – both prospective and retrospective in many different tumor types. Lucinda has recently led HEOR efforts at PAREXEL a full-service contract research group prior to coming to ISPOR.
WELCOME FROM ISPOR CEO/EXECUTIVE DIRECTOR
Speaker
Nancy S. Berg
ISPOR, Lawrenceville, NJ, USA
Nancy S. Berg is chief executive officer (CEO) and executive director of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), the leading global scientific and educational organization for health economics and outcomes research. Ms. Berg has over 30 years of experience in health care and scientific/technical association leadership, and has been an entrepreneur and business consultant to both commercial and nonprofit organizations. At ISPOR, Ms. Berg is responsible for the Society’s global strategic direction and leadership of the association. She has led the organization, in concert with the Board of Directors, to design and implement a new strategic plan, mission, and vision to guide the Society into the future.
Previously, Ms. Berg led the International Society for Pharmaceutical Engineering (ISPE) as president and CEO. ISPE is the world's largest professional society fostering dialogue and education on technical, scientific, and regulatory best practices in the pharmaceutical and biotech industries. During her tenure with ISPE, Ms. Berg was the architect of the Society's Strategic Plan, focusing ISPE's energies and expertise on high-value initiatives related to drug shortages, quality metrics, global manufacturing quality, facility and supply chain issues, and patient experiences in clinical trials. Prior to her role at ISPE, Ms. Berg served as executive director and CEO of the Society of Manufacturing Engineers (SME). She also previously founded a strategic and business development consultancy company.
Ms. Berg has been engaged in education and business issues at national and international levels. She has served on many government initiatives involving business, community, development, growth, revitalization, and labor issues. She is a supporter of the Leukemia and Lymphoma Society’s Team in Training Program cycling events and a patron of many other charities. Ms. Berg is a graduate of the University of Michigan-Flint and is married to Timothy Jackson.
WELCOME FROM ISPOR PAST-PRESIDENT
Speaker
Federico Augustovski, MSc, PhD
Institute for Clinical Effectiveness and Health Policy, Buenos Aires, B, Argentina
Federico Augustovski es médico de la Universidad de Buenos Aires (UBA) galardonado con un diploma de honor. Se graduó de Máster en Ciencias en Epidemiología en la Harvard School of Public Health y es doctor en Medicina con orientación en Salud Pública (UBA). Realizó cursos de posgrado y experiencias de formación e investigación en evaluaciones económicas y ciencias de la decisión en distintos centros internacionales como la Universidad de York, la Universidad de Texas, y el Baylor College de Medicina de Houston, Estados Unidos. Actualmente, se desempeña como director del Departamento de Evaluación de Tecnologías Sanitarias y Economía de la Salud del Instituto de Efectividad Clínica y Sanitaria, y como profesor adjunto de Salud Pública de la Facultad de Medicina de la UBA. Es investigador del Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina.
En 2017, fue elegido presidente de la Sociedad Internacional de Farmacoeconomía e Investigación de Resultados (ISPOR), el primero en no proceder de Norteamérica o Europa. Es el director del Centro Colaborador OMS/OPS de Evaluación de Tecnologías Sanitarias, y del Centro PROVAC de Argentina para la excelencia en evaluaciones económicas y la toma de decisiones en inmunizaciones. También es médico de familia (se desempeñó como médico de planta de la Unidad de Medicina Familiar y Preventiva del Hospital Italiano de Buenos Aires durante algo más de 20 años) y es director de los cursos de Análisis de Decisiones Sanitarias, de Desarrollo de Cuestionarios en Salud, Evaluaciones Económicas y Sanitarias, Evaluaciones de Tecnologías Sanitarias, y Modelos de Decisión I y II de la Maestría en Efectividad Clínica de la UBA. Fue el primer editor en jefe de la revista Value in Health Regional Issues (hasta diciembre de 2017), publicación con revisión de pares de economía de la salud e investigación de resultados indizada en MEDLINE, y es uno de los fundadores del Consorcio ISPOR para América Latina.
Ha coordinado diversos proyectos académicos y de investigación en el área de la evaluación de tecnologías sanitarias y las evaluaciones económicas en Argentina, Bolivia, Brasil, Chile, Colombia, México, Perú, y Uruguay. Cuenta actualmente con más de 80 publicaciones indizadas en MedLine.
CONFERENCE PROGRAM OVERVIEW FROM PROGRAM COMMITTEE CO-CHAIRS
Speaker
Yajaira Bastardo, PhD
Universidad Central de Venezuela, Caracas, Venezuela (Bolivarian Republic of)
Yajaira Bastardo es profesora y jefe de la Catedra de Farmacoeconomía y Administración de Farmacia de la Universidad Central de Venezuela. Ella también imparte cursos de postgrado en farmacoeconomía en el Postgrado de Vigilancia Sanitaria de Medicamentos del Instituto Nacional de Salud "Rafael Rangel" en Caracas, Venezuela. Ella recibió su título de farmacéutico de la Universidad Central de Venezuela y, en 2010, completó un doctorado en Administración de Atención Farmacéutica en la Universidad de Florida.
La Dra. Bastardo ha ocupado varios cargos en la Facultad de Farmacia de la Universidad Central de Venezuela incluyendo director administrativo (2010-2011), director del Departamento Administrativo y Legal, coordinadora de la Mención Sanitario Asistencial y de la Mención de Microbiología Aplicada, jefe de la Cátedra de Microbiología Aplicada, y jefe de la Sección de Medios de Cultivo. Ella ha realizado investigaciones y publicado en la investigación de resultados de salud. Sus principales intereses de investigación incluyen la calidad de vida, la toma de decisión en salud, y la adherencia a la terapia.
Ella es miembro fundador del Consorcio ISPOR para América Latina y presidente fundador del capítulo regional ISPOR Venezuela. Ha servido ISPOR en varias funciones: copresidente del Subcomité de cursos cortos de conferencias ISPOR para América Latina durante del 2010-2012, copresidente del Subcomité de Investigación durante la 3ª Conferencia ISPOR para América Latina, miembro del grupo de trabajo para la implementación de la Visión ISPOR 2020, editor en jefe del boletín electrónico News Across Latin America. Actualmente, es presidente electa del capítulo regional ISPOR Venezuela y presidente electa del Consorcio ISPOR para América Latina para 2018-2020.
Jaime Calderón, MD
Fundación Colombiana del Corazón, Bogotá, Colombia
Diego Rosselli, MD, MEd, MHP
Pontificia Universidad Javeriana, Medical School, Bogota, Colombia
Diego Rosselli is a Colombian neurologist trained at the London Institute of Psychiatry. He began his academic career as a neuroscience teacher. After obtaining his Master’s degree in Education in Harvard in 1993, he joined the Colombian Ministry of Health as Director for Scientific and Technological Development in charge of performing health technology assessments. He then obtained a second master's degree in Health Policy at the London School of Economics. Since then (1997), he has been teaching Health Economics at the Universidad Javeriana, in Bogotá. Rosselli has authored 7 books and more than 100 scientific articles in many aspects of clinical epidemiology, real-world evidence and health economics. He has lectured in pharmacoeconomics in 17 Latin American countries. He is currently the 2018-2020 Chair of the ISPOR Latin America Consortium Executive Committee and Colombia Chapter past president.
10:30 - 11:00
BREAK, EXHIBITS AND RESEARCH POSTER PRESENTATIONS VIEWING - SESSION I
10:30 - 19:30
POSTER & EXHIBIT HALL HOURS
RESEARCH POSTER PRESENTATIONS – SESSION 1
11:00 - 12:00
BREAKOUT SESSION 1
(SI) PATIENT-CENTERED HEALTHCARE SYSTEMS - DO THEY FIT IN LATIN AMERICA?--SISTEMAS DE SALUD CENTRADOS EN EL PACIENTE- ¿SE AJUSTAN EN LATINOAMERICA?
ISSUE:
Over the last decade, a substantial movement across the globe to systematically involve patients in identifying preferences regarding their own treatment, along with their participation in drug development, outcomes research, and regulatory and reimbursement decision making has led to including the patient voice in these processes where they had been previously excluded. Is it possible to move forward with a patient-centered healthcare system in Latin America?
OVERVIEW:
Is there a need to rethink healthcare systems within the region, making them more patient-centered and outcomes oriented? This might involve changes in the model for care delivery as well as changes in the outcome measurement, such as: overall patient experience, value-based measures, new market access models for innovative technology, human resource satisfaction and reliable key performance indicators. Are health systems prepared for that change? Does the current healthcare governance scheme provide a platform to move in that direction? This issue panel aims to discuss the divergent points of view surrounding the actions set forth to transform current health systems in an effort to become more patient oriented. This multi-stakeholder discussion is aimed at providing insight on the role of patient involvement in research and decision making and identifying the key opportunities for future efforts in the region.
ARGUMENTO : Durante la última década, un movimiento sustancial en todo el mundo para involucrar sistemáticamente a los pacientes en sus preferencias de tratamiento, junto con su participación en el desarrollo de medicamentos, la investigación de resultados y la toma de decisiones regulatorias y de reembolsos ha llevado a incluir la voz de los mismos en estos procesos los cuales habían sido excluidos previamente. ¿Es posible avanzar con un sistema de atención médica centrado en el paciente en Latinoamérica?
DESCRIPCIÓN GENERAL : ¿Es necesario reconsiderar los sistemas de salud dentro de la región, haciéndolos más centrados en el paciente y orientados a los resultados? Esto podría implicar cambios en el modelo para la prestación de atención, así como cambios en la medición de esos resultados, tales como: experiencia general del paciente, medidas basadas en el valor, nuevos modelos de acceso para tecnología innovadora, satisfacción de los recursos humanos e indicadores rendimiento confiables. Debieramos preguntarnos: ¿Están los sistemas de salud preparados para ese cambio? ¿El esquema de gobernanza de la atención medica actual proporciona una plataforma para avanzar en esa dirección? Este panel discutirá los puntos de vista, algunos de ellos divergentes, que rodean las acciones para transformar los sistemas de salud actuales para orientarse más hacia el paciente. Asimismo, pretende identificar las oportunidades clave para futuros esfuerzos en la región tal como el papel de la participación del paciente en la toma de decisiones.
Moderators
Clarissa Cooblall, MPH
ISPOR, Lawrenceville, NJ, USA
Panelists
Angela Chavez, BSc(IM), DSD
Biogen, Bogota, Colombia
Migdalia Denis, MA
Sociedad Latina de Hipertensión Pulmonar, Plantation, FL, USA
Maria Isabella Grueso
Pfizer, Bogota, Colombia
Adriana Torres Navas, MD
Los Cobos Medical Center, Bogota, Colombia
DIAGNOSTIC TESTS VALUE FRAMEWORKS IN LATIN AMERICA. IS IT TIME FOR A CONSENSUS?
ISSUE
: Value frameworks specifically tailored for diagnostic technologies are scarce. There is no specific value framework commonly used in Latin America. This issue panel will describe a value framework currently “in the making” in Latin America and present different stakeholders’ perspectives.
OVERVIEW
: Value frameworks are being increasingly used by different stakeholder all over the world, from Health Technology Assessment Agencies such as NICE or ICER, to Professional Societies (ASCO; AHA-ACC), other scientific societies (ISPOR, HTAi policy forums) and also patient societies (FasterCures). Though they are oriented to different health technologies, their main focus is usually on therapeutic interventions and not specifically oriented to diagnostic tests. In this issue panel we will present a specific pilot value framework designed for assessing diagnostic tests technologies, including in vitro diagnostic tests or IVDs. The moderator (Federico Augustovski) will briefly present the project and the current pilot value framework (12 minutes); Vania Canuto Santos from the Brazilian HTA agency (CONITEC) and Carlos Eduardo Pinzón Flórez from the Colombian HTA agency (IETS) will present their impressions (in 12 minutes each) and how is their current -implicit or explicit- value framework in the case of diagnostic tests; including which stakeholders are involved -and how do they participate in the process. An industry representative, Karine Ferreira (Roche Diagnostics LATAM) will give her impressions of the pilot value framework and react to the previous presentations. The remaining time will be devoted to address the audience with open discussion and debate. This issue panel is well suited for different stakeholders working in health technology assessment, access, who want to better understand values considered for diagnostic technologies.
Moderators
Federico Augustovski, MD, MSc, PhD
Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
Federico Augustovski is the current director of Health Economic Evaluations and Technology Assessment at the Institute for Clinical Effectiveness and Health Policy—an independent non-profit organization affiliated with the University of Buenos Aires, a National Scientific and Technical Research Council center and one of the few INAHTA Health Technology Assessments agencies in Latin America. He is the director of the WHO Collaborating Centre in HTA and Economic Evaluations at IECS. He is also the founding editor-in-chief for Value in Health Regional Issues, the ISPOR peer-reviewed journal for Latin America, Asia, Central and Eastern Europe, and Africa. He was elected president of ISPOR from 2018-2019.
Federico is director of the PAHO-affiliated PROVAC Center of Excellence for decision making in vaccines. He leads a multidisciplinary team devoted to clinical and economic evaluations of new and existing preventive, diagnostic, and therapeutic technologies that works doing research, education, and technical support with public and private health decision makers in Latin America. He is a professor of Public Health at the School of Public Health of the University of Buenos Aires where he teaches courses for graduate and postgraduate students in Decision Sciences, Patient Reported Outcomes (PRO) development in health and health economic evaluations.
He received his Medical Degree with honors at the University of Buenos Aires (1986-1991) and is a specialist in family medicine. He practiced family medicine and was a staff physician for more than 20 years at the Family and Community Medicine Division of the Hospital Italiano de Buenos Aires, the leading academic, non-profit hospital in Argentina. He got his MSc in Epidemiology at the Harvard School of Public Health, (1997-1999). He was an Alban Scholar of the European Union in Health Economics (2003-2004), getting research and training experience at the Centre for Health Economics at York University at the UK. His research production and publication in international peer-reviewed journals (with more than 80 PubMed indexed papers) concentrates on HTA, Health Economic Evaluations (ie, multi-country studies in Latin America, model-based or individual patient level studies), PRO, and preference status measures and validation (ie, derivation of Argentine and Uruguayan weights for the EQ-5D, Argentine SF-36 validation, discrete choice experiments). He has published more than 60 PubMed indexed papers.
Panelists
Vania Cristina Canuto Santos, MSc
Brazilian Ministry of Health, Brasília, Brazil
Karine A Ferreira, PhD
Roche Diagnostics LATAM, Sao Paulo, Brazil
Adriana Robayo García, MD, FETP
Institute of Technological Evaluation in Health- IETS, Bogota, Colombia
COST-EFFECTIVENESS ANALYSIS STUDIES
CE1: COSTO-EFECTIVIDAD DE UNA INTERVENCIÃN ECO-SISTÃMICA PARA EL CONTROL DEL DENGUE EN GIRARDOT-COLOMBIA DESDE LA PERSPECTIVA DE LA SOCIEDAD
11:00AM - 11:15AM
Taborda A 1 , Carrasquilla G2 , Quintero J1 , Chamorro C1 , Londoño D1 1 Fundación Santa Fé de Bogotá, Bogotá, Colombia, 2 Fundación Santa Fe de Bogotá, Bogotá, Colombia
OBJECTIVES Evaluar la costo-efectividad de una intervención en salud pública con enfoque ecosistémico versus el programa convencional para la prevención y control de casos de dengue en un municipio endémico (Girardot-Colombia). METHODS Desde la perspectiva de la sociedad, y con un horizonte temporal a un año. La efectividad de la intervención se midió por medio de un ensayo comunitario; los costos directos se tomaron de registros clínicos y validación con expertos. Los costos indirectos se midieron por medio de encuestas con enfoque de capital humano. Se estimó la razón de costo-efectividad incremental por desenlace evitado y se hicieron análisis de sensibilidad RESULTS Como resultado de costo incremental se tiene USD 35.543 y una efectividad incremental de 0.26. La razón de costo efectividad es USD 137.817, lo que significa que para disminuir la probabilidad de ocurrencia del 1% de los casos de dengue, se debe invertir dicha cantidad. CONCLUSIONS A precios actuales y con una disponibilidad a pagar por desenlace evitado de USD 80.000, la intervención eco-sistémica no es una estrategia costo-efectiva para Colombia, la discusión del valor generado por la intervención puede cambiar si los costos operacionales de la intervención ecosistémica se reducen en 44%.
CE4: TRATAMIENTOS PARA LOS PACIENTES CON ESCLEROSIS MULTIPLE REMITENTE RECURRENTE CON ALTA ACTIVIDAD DE LA ENFERMEDAD- ANALISIS COSTO EFECTIVIDAD EN MEXICO
11:30AM - 11:45AM
Rubio Ponce R 1 , Díaz O2 , Soto Molina H1 1 HS Estudios Farmacoeconómicos S.A. de C.V., Mexico City, Mexico, 2 HS Estudios Farmacoeconómicos S.A. de C.V., Mexico, Mexico
OBJECTIVES: Comparar el perfil costo efectividad de Cladribina oral contra cuatro opciones terapéuticas disponibles en México para el tratamiento de la esclerosis múltiple remitente recurrente, desde el punto de vista del sector público. METHODS: Se empleó un modelo de Markov validado que consta de 11 Estados de salud (1 muerte y 10 por EDSS) validado por NICE, con la finalidad de comparar a los comprimidos de Cladribina contra natalizumab, fingolimod, alemtuzumab y ocrelizumab. La población objetivo considerada son los pacientes con Esclerosis Múltiple Remitente Recurrente con alta actividad de la enfermedad (HDA-RRMS) de 18 años en adelante. El costo de cada uno de los tratamientos considerados, así como los años de vida ajustados por calidad fueron evaluados a través de ciclos anuales que conducen a la recaída, muerte, interrupción o progresión de la enfermedad durante un horizonte de 50 años. Las estimaciones de riesgo y las utilidades se obtuvieron a partir de un metaanálisis en red, donde se incluyeron todos los comparadores. Los datos sobre los costos directos del tratamiento (adquisición, administración, monitorización, eventos adversos, recaídas) por estado de EDSS se obtuvieron de fuentes institucionales y expertos locales. Se consideró una tasa de descuento para los costos y los resultados del 5%. Con el fin de permear la incertidumbre estructural y paramétrica del modelo se llevó a cabo un análisis de sensibilidad determinístico y probabilístico. RESULTS: Los resultados muestran que Cladribina es una opción dominante contra natalizumab, alemtuzumab y ocrelizumab, y costo efectivo contra fingolimod a 1 PIB per cápita para 2018 ($ 187.905 MXN). El perfil costo efectividad de cladribina se mantuvo en el análisis de sensibilidad determinístico y probabilístico. CONCLUSIONS: Cladribina es una opción costo efectiva para el tratamiento de pacientes con HDA-RRMS, en comparación con fingolimod, natalizumab alemtuzumab, ocrelizumab, desde el punto de vista del sector público mexicano.
CE3: ECONOMIC EVALUATION OF THE USE OF PRE-FILLED SYRINGE VERSUS MANUALLY FILLED SYRINGE PARAFLUSHING IN PATIENTS WITH CENTRAL VENOUS CATHETER IN THE PERSPECTIVE OF HEALTH CAREERS
11:15AM - 11:30AM
Gomes M 1 , Romcy MH2 1 Celler Faculdades, Porto Alegre/RS, RS, Brazil, 2 Associação Brasileira dos Enfermeiros Auditores, Fortaleza, Brazil
OBJECTIVES The advancement of technology in the health sector has brought, mainly to the Health Insurances, a discussion on what is the best path for the incorporation of new medical and hospital products. The objective of this study is to do a cost analysis comparing a new technology (pre-filled syringe) with a usual technology (manually filled syringe) in patients in use of central venous catheter (CVC). METHODS An economic assessment based on a Decision Tree model was developed to evaluate the commercially pre-filled syringe in comparison to the manually filled syringe with saline solution for flushing in patients with CVC, considering the perspective of private health care providers. The time horizon considered was 1 year. As clinical outcomes, the occurrence of Central line-associatedblood stream (CLABSI) and occlusions were adopted. For economic outcomes, we considered flush costs, reduction of CLABSI and occlusion. All costs were extracted from local cost database for Brazil. RESULTS The economic evaluation indicated that the use of the pre-filled syringe presented a reduction of 77% (1.17 vs 5.10) and 62% (3.26 vs 8.57)in the occurrences of CLABSI and occlusion, respectively, compared to the manually filled syringe. The cost per flushing is R$32.88 and R$98.48 for pre-filled syringe and manually filled syringe, respectively, representing an absolute reduction of R$65.60 and percentual of 67%. Univariate sensitivity analysis showed that the parameters with the greatest influence on results were: % of ICSAC (manually filled syringe), flushing number per day, ICSAC odds ratio and ICSAC cost. However, However, for all altered parameters the result continued to show an economy with the use of flushing with pre-filled syringe. CONCLUSIONS The use of the commercially pre-filled syringe has been shown to be an economically and clinically dominant option for flushing in patients with CVC when compared to the manually filled syringe.
CANCER STUDIES
CN2: EVALUACIÓN DE COSTO-EFECTIVIDAD DE LA ENZALUTAMIDA (ENZA) FRENTE A LA ABIRATERONA (ABI) PARA EL TRATAMIENTO DE PACIENTES CON CÁNCER DE PRÓSTATA RESISTENTE A LA CASTRACIÓN METASTÁSICO (CPRCM) ANTES DEL USO DE DOCETAXEL EN EL INSTITUTO MEXICA ...
11:15AM - 11:30AM
Gay JG 1 , Toro W2 , Braun S3 1 T.I. Salud, Mexico D.F., Mexico, 2 Astellas Pharma Inc., Lake Forest, IL, USA, 3 Astellas Pharma Inc., Northbrook, IL, USA
BACKGROUND: ENZA y ABI son tratamientos aprobados orales del CPRCm en México. Se evalúa el reembolso de ambas opciones en el IMSS. OBJECTIVES: METHODS: RESULTS: CONCLUSIONS: FUNDING: Astellas Pharma Inc. y Medivation LLC, una empresa de Pfizer. EDITORIAL: Complete HealthVizion.
CN1: CALIDAD DE VIDA RELACIONADA A LA SALUD Y COSTOS DEL SISTEMA DE SALUD, POR PÉRDIDA DE PRODUCTIVIDAD Y OTROS DE PACIENTES CON DIAGNOSTICO DE CÁNCER DE MAMA EN AMÉRICA LATINA Y EL CARIBE- REVISIÓN SISTEMÁTICA Y META-ANALISIS
11:00AM - 11:15AM
Augustovski F, Gonzalez LA
OBJECTIVES: METHODS RESULTS CONCLUSIONS:
CN4: ANÁLISIS DE COSTO-UTILIDAD E IMPACTO PRESUPUESTARIO DE LA ENZALUTAMIDA PARA EL TRATAMIENTO DEL CÁNCER DE PRÓSTATA RESISTENTE A LA CASTRACIÓN NO METASTÁSICO (CPRCNM) EN ARGENTINA
11:45AM - 12:00PM
Toro W1 , Braun S2 , Sanchez LA3 , Anaya P 3 1 Astellas Pharma Inc., Lake Forest, IL, USA, 2 Astellas Pharma Inc., Northbrook, IL, USA, 3 IQVIA, Mexico City, DF, Mexico
OBJECTIVES: METHODS: RESULTS: CONCLUSIONS: FUNDING: Astellas Pharma Inc. y Medivation LLC, una empresa de Pfizer. EDITORIAL: Complete HealthVizion.
EVOLUCIÓN DE LAS HERRAMIENTAS DE ASESORAMIENTO DE TECNOLOGÍAS SANITARIAS EN LATINOAMÉRICA- ¿CÓMO PUEDE PREPARARSE LA INDUSTRIA PARA OPTIMIZAR LA GENERACIÓN DE EVIDENCIAS Y DEMOSTRAR EL VALOR DE LA INNOVACIÓN?
PURPOSE
: Este taller proporcionará una vista general de las herramientas de asesoramiento del valor de tecnologías sanitarias (por ejemplo, precios de referencia, compras centralizadas, evaluación de tecnologías de salud (HTA por sus siglas en inglés), análisis de decisiones de criterios múltiples (MCDA por sus siglas en inglés), etc.) que han sido implementados a través de Latinoamérica, y discutir las implicaciones para las empresas biofarmacéuticas que buscan demostrar el valor de la innovación y diseñar estrategias exitosas para cumplir con los crecientes requisitos de evidencia.
DESCRIPTION
: En un contexto de presupuestos para la salud limitados y una creciente presión pública para dar acceso a terapias innovadoras, los gobiernos de Latinoamérica han implementado diferentes herramientas de asesoramiento del valor de tecnologías sanitarias para comunicar decisiones de precios y financiación. Al inicio de la sesión, los ponentes proporcionarán un resumen de las herramientas de evaluación de valor que han sido aplicadas en ARG, BRA, COL, CHL y MEX, y cómo están siendo utilizadas para informar de decisiones de acceso. Luego, los ponentes valorarán de forma crítica los beneficios y limitaciones potenciales de las herramientas de asesoramiento del valor de tecnologías sanitarias existentes, comparando los resultados en cuanto a precios y financiación de casos de estudio seleccionados de terapias innovadoras en áreas terapéuticas diferentes (por ejemplo, oncología, enfermedades huérfanas y enfermedades inflamatorias) que ya hayan sido evaluados localmente. Los ponentes también presentarán las expectativas para el futuro y las tendencias regionales de las políticas (por ejemplo, bancos de precios netos / transparencia de precios, armonización de métodos HTA, aumento del número de HTA vinculantes, incorporación de MCDA en HTA, compra conjunta, etc.) que podrían influenciar como las herramientas de asesoramiento del valor de tecnologías sanitarias existentes son utilizadas, y comentarán sobre impacto potencial que podrían tener estas políticas en decisiones futuras sobre precios y financiación. Los ponentes cerrarán la sesión proporcionando recomendaciones sobre como empresas biofarmacéuticas planeando la presentación de sus dossiers en la región pueden optimizar el valor de su innovación y estar preparadas para crecientes demanda de evidencia (por ejemplo, desarrollo de modelos con parámetros / comparadores relevantes, secuencia de lanzamientos, investigaciones exhaustivas de precios, etc.).
Discussion Leader
Rafael Alfonso-Cristancho, MD, PhD, MSc
GlaxoSmithKline, Collegeville, PA, USA
J. Jaime Caro, MDCM, FRCPC
Evidera, Waltham, MA, USA and Adjunct Professor of Medicine, Adjunct Professor of Epidemiology and Biostatistics, Waltham, MA, USA
J. Jaime Caro es el jefe científico de Evidera y profesor de epidemiología y medicina en la Universidad McGill y profesor de la Escuela de Economía de Londres. Él fue pionero en el uso de SED, desarrolló el método de comparación de tratamientos por vía de simulación y propuso la frontera de eficiencia como una alternativa viable al uso de costo por AVAC. Recientemente, ha desarrollado un nuevo método para modelos, la simulación DICE, apto para los problemas de evaluación de las tecnologías en salud.
Diego F Guarin, MD, MPH, MA
EMD Serono, Miami, FL, USA
Miguel Martin De Bustamante, BA
CBPartners, San Francisco, CA, USA
12:00 - 13:30
LUNCH, EXHIBITS AND RESEARCH POSTER PRESENTATIONS VIEWING
12:30 - 13:30
EDUCATIONAL SYMPOSIUM
IS LATIN AMERICA READY FOR BIOSIMILARS?
A panel of regional and international experts will share their perspective on the challenges and opportunities of biosimilar adoption in Latin America, leveraging the learnings from biosimilars introduction in Europe and taking into consideration the current regulatory and access landscape. The symposium will start with an introduction on basic concepts on biosimilars, what they are but also what they are not (biobetters, non-comparable…). After this introduction, the learnings from the recent biosimilars introduction in Europe will be presented, focusing on the challenges/pitfalls to avoid and best practices to ensure the right biosimilars are adopted (quality, reputable, supply assurance, healthcare system sustainability, etc). Finally, the current regulatory/policy landscape for biosimilars in various Latin America countries will be presented, highlighting the potential improvement needs for successful biosimilars adoption.
Sponsor
Amgen
Moderators
Juan Pablo Mac Donald
Amgen Inc., Thousand Oaks, CA, USA
Speakers
Stephen Doral Stefani, MD
UNIMED, Porto Alegre, Brazil
Carlo Vinicio Caballero Uribe, MD, PhD
Universidad del Norte Uninorte, Barranquilla, Colombia
Arnold Vulto, PhD, PharmD
The Erasmus University Medical Center, Rotterdam, Netherlands
13:30 - 14:30
ISPOR FORUMS
MEJORES RESULTADOS EN SALUD A PARTIR DE LA GESTIÓN DE DATOS Y EL USO DE LA INFORMACIÓN- UNA NECESIDAD DE LOS SISTEMAS DE SALUD
La gestión eficaz de los datos, su transformación en información valiosa y su uso apropiado por parte de los actores estratégicos de los sistemas sanitarios, impacta directamente en los resultados en salud. En este foro se compartirán las experiencias de aseguradores, prestadores y organizaciones sanitarias relacionadas con la gestión de información, con el propósito de transferir conocimiento para su aplicabilidad en la región y contribuir a la eficiencia y sostenibilidad de los sistemas de salud.
ISPOR CAREER ADVICE ACROSS THE GLOBE- HOW TO ADVANCE IN YOUR CHOSEN CAREER PATH
Join us for the first ever student and new professional event to be hosted at an ISPOR Latin America Conference. Attend the ISPOR Career Advice Across the Globe event, which aims to provide a global perspective for those who are graduating soon or new to the field of HEOR. For each ISPOR conference, Career Advice Across the Globe touches on a different career-related topic. For ISPOR Latin America the topic will be “How to Advance in Your Chosen Career Path.” After the session Students & New Professionals will be encouraged to join us for a Networking Reception to connect with their peers and also have an opportunity to ask questions of the speakers.
Speaker
Arturo Figueroa, MIM
Pharmamanagement EAS, Cuidad de México, Mexico
Rosa Maria Galindo Suarez, MHA
PERMA Consultores, Mexico City, Mexico
Diego Rosselli, MD, MEd, MHP
Pontificia Universidad Javeriana, Medical School, Bogota, Colombia
Diego Rosselli is a Colombian neurologist trained at the London Institute of Psychiatry. He began his academic career as a neuroscience teacher. After obtaining his Master’s degree in Education in Harvard in 1993, he joined the Colombian Ministry of Health as Director for Scientific and Technological Development in charge of performing health technology assessments. He then obtained a second master's degree in Health Policy at the London School of Economics. Since then (1997), he has been teaching Health Economics at the Universidad Javeriana, in Bogotá. Rosselli has authored 7 books and more than 100 scientific articles in many aspects of clinical epidemiology, real-world evidence and health economics. He has lectured in pharmacoeconomics in 17 Latin American countries. He is currently the 2018-2020 Chair of the ISPOR Latin America Consortium Executive Committee and Colombia Chapter past president.
13:45 - 14:45
EDUCATIONAL SYMPOSIUM
BIOSIMILARS IN LATIN AMERICA- CHALLENGES AND OPPORTUNITIES
Limited healthcare resources across many Latin American countries mean that important biologics for conditions such as oncology and orphan drugs are being underutilized, due largely to healthcare system development, economic constraints and limited access to these therapies. These factors contribute to restricted patients access and inequality of healthcare across the region. Payers are increasingly looking for new solutions to help curb healthcare expenditure and broaden patient access. The use of biosimilars has resolved many of these problems in many countries (mainly European and other developed countries) through biosimilars access. The panel will present the understanding of biosimilars, overview of biosimilars reimbursement globally and overview of biosimilars challenges and opportunities in Latin America. Furthermore, they also will discuss how the healthcare system can best adopt the reimbursement policies in Latin America.
Sponsor
Abbott
Moderators
Alan Vivas
Abbott LATAM, Bogotá, FL, Colombia
Speakers
Fabio Aristizábal, PhD
National University of Colombia, Bogotá,DC, Colombia
Zoltán Kaló, PhD
Semmelweis University and Syreon Research Institute, Budapest, Hungary
14:30 - 15:00
ISPOR FORUMS
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15:00 - 16:00
SPOTLIGHT SESSION
MARCOS DE EVALUACIÓN DE VALOR EN AMÉRICA LATINA - ¿ESTAMOS AHÍ?
ISSUE:
Los marcos de evaluación de valor han sido desarrollados en América Latina por entidades nacionales y regionales para medir el valor de las tecnologías en salud como un medio para respaldar las decisiones de fijación de precios y reembolsos. Sin embargo, el enfoque utilizado por cada entidad difiere en cuanto al alcance de las tecnologías en salud, el establecimiento de prioridades, la evaluación y la implementación que finalmente afectan el acceso del paciente.
OVERVIEW:
En América Latina, los Marcos de Evaluación de Valor han sido producidos principalmente por agencias financiadas por el gobierno o entidades sin fines de lucro con objetivos y métodos mixtos. Si bien estos marcos pueden proporcionar una mayor transparencia en la toma de decisiones de atención médica, plantean preguntas importantes y preocupaciones. Este panel, moderado por un líder del Consorcio ISPOR para América Latina, revisará y debatirá el estado y el futuro de los marcos de evaluación de valor en América Latina desde diferentes perspectivas: Tomador de decisiones, Experto académico, Representante de pacientes, e Industria.
Claudia Brabata moderará y abrirá la discusión con una revisión de marcos de valor en América Latina utilizando una taxonomía publicada.
Aurelio Mejía discutirá los desafíos en el diseño y la aplicación de marcos de valor, incluido el resolver tensiones entre los intereses de la sociedad, el pagador y el paciente, desde la perspectiva de una organización tomadora de decisiones en atención médica.
Jaime Caro abordará su experiencia relacionada con los fundamentos de los marcos de valor, y la necesidad de un conjunto de criterios metodológicamente sólidos que todos los marcos deben cumplir.
Eva Maria Ruiz presentará la perspectiva del paciente, ofreciendo información sobre las experiencias de los pacientes y las posibles consecuencias de las evaluaciones de valor en el acceso de los pacientes a productos sanitarios innovadores. Cada panelista tendrá 10 minutos para presentar, seguidos de una sesión de discusión y preguntas de la audiencia.
Moderators
Claudia Brabata, MBA, MSc
Baxter Healthcare Corporation, Miami, FL, USA
Panelists
J. Jaime Caro, MDCM, FRCPC
Evidera, Waltham, MA, USA and Adjunct Professor of Medicine, Adjunct Professor of Epidemiology and Biostatistics, Waltham, MA, USA
J. Jaime Caro es el jefe científico de Evidera y profesor de epidemiología y medicina en la Universidad McGill y profesor de la Escuela de Economía de Londres. Él fue pionero en el uso de SED, desarrolló el método de comparación de tratamientos por vía de simulación y propuso la frontera de eficiencia como una alternativa viable al uso de costo por AVAC. Recientemente, ha desarrollado un nuevo método para modelos, la simulación DICE, apto para los problemas de evaluación de las tecnologías en salud.
Aurelio Mejia, MSc
Colombian Ministry of Health, Bogotá, Colombia
Eva Maria Ruiz de Castilla, PhD
Global Alliance for Patient Access (GAfPA), Miami , FL, USA
ESTUDIOS RECIENTES DE PREFERENCIAS SOCIALES EN LATIONOAMÉRICA- MÉTODOS, RESULTADOS, LECCIONES APRENDIDAS
ISSUE
: Los estudios de preferencias sociales tienen diferentes métodos, con mayor o menos complejidad, costos, y aproximaciones analíticas. La familia de instrumentos EuroQOL (EQ-5D 3L o 5L) es la más utilizada a nivel mundial para derivar valores sociales. En este panel se presentarán y discutirán las experiencias recientes de tres países de la región.
OVERVIEW
: Los años de vida ajustados por calidad (AVACs-QALYs) son una medida cada vez más usada en las evaluaciones económicas en América Latina. Para poder usar preferencias locales, muchos países han llevado a cabo y publicado estudios de valoración social, por ejemplo, Argentina, Chile, Brasil, Uruguay, y Trinidad & Tobago. En años recientes, Colombia y Ecuador han desarrollado valoraciones sociales basados en el EQ-5D-3L; y Perú acaba de terminar su estudio de valoración usando el EQ-5D-5L. En este panel presentaremos una visión general y metodología de los estudios de valoración social. El moderador (Federico Augustovski) presentará brevemente un resumen de los estudios de valoración; Maria Ximena Rojas Reyes presentará el estudio de Colombia (basado en 10.863 entrevistas a adultos que valoraron su estado de salud usando el cuestionario EQ-5D-3L y la escala visual análoga, y una submuestra de 3.489 individuos que completaron las entrevistas Time Trade Off [TTO]); Ruth Lucio presentará el estudio de Ecuador (basado en 2.310 entrevistas TTO con el cuestionario EQ-5D-3L; usando para el modelamiento Mínimos Cuadrados Generalizado con modelo de efectos aleatorios); Romina Tejada Caminiti presentará por primera vez los resultados del estudio de valoración de Perú con el cuestionario EQ-5D-5L (1.000 sujetos de una muestra poblacional; entrevistas mediante TTO y Discrete Choice Experiment; modelo híbrido). Las presentaciones durarán 12 minutos. El tiempo restante será empleado para la discusión y debate con la audiencia. Este panel es adecuado para diferentes partes interesadas, incluyendo investigadores y tomadores de decisiones, quienes trabajan o usan estudios de valoración y están interesados en los años de vida ajustados por calidad como una medida de beneficio en evaluaciones económicas.
Moderators
Federico Augustovski, MD, MSc, PhD
Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
Federico Augustovski is the current director of Health Economic Evaluations and Technology Assessment at the Institute for Clinical Effectiveness and Health Policy—an independent non-profit organization affiliated with the University of Buenos Aires, a National Scientific and Technical Research Council center and one of the few INAHTA Health Technology Assessments agencies in Latin America. He is the director of the WHO Collaborating Centre in HTA and Economic Evaluations at IECS. He is also the founding editor-in-chief for Value in Health Regional Issues, the ISPOR peer-reviewed journal for Latin America, Asia, Central and Eastern Europe, and Africa. He was elected president of ISPOR from 2018-2019.
Federico is director of the PAHO-affiliated PROVAC Center of Excellence for decision making in vaccines. He leads a multidisciplinary team devoted to clinical and economic evaluations of new and existing preventive, diagnostic, and therapeutic technologies that works doing research, education, and technical support with public and private health decision makers in Latin America. He is a professor of Public Health at the School of Public Health of the University of Buenos Aires where he teaches courses for graduate and postgraduate students in Decision Sciences, Patient Reported Outcomes (PRO) development in health and health economic evaluations.
He received his Medical Degree with honors at the University of Buenos Aires (1986-1991) and is a specialist in family medicine. He practiced family medicine and was a staff physician for more than 20 years at the Family and Community Medicine Division of the Hospital Italiano de Buenos Aires, the leading academic, non-profit hospital in Argentina. He got his MSc in Epidemiology at the Harvard School of Public Health, (1997-1999). He was an Alban Scholar of the European Union in Health Economics (2003-2004), getting research and training experience at the Centre for Health Economics at York University at the UK. His research production and publication in international peer-reviewed journals (with more than 80 PubMed indexed papers) concentrates on HTA, Health Economic Evaluations (ie, multi-country studies in Latin America, model-based or individual patient level studies), PRO, and preference status measures and validation (ie, derivation of Argentine and Uruguayan weights for the EQ-5D, Argentine SF-36 validation, discrete choice experiments). He has published more than 60 PubMed indexed papers.
Panelists
Ruth Alicia Lucio-Romero, Econ, MSc
Instituto Nacional de Salud, Quito, Ecuador
Maria Ximena Rojas Reyes, Prof
Universidad Javeriana, Bogota, Colombia
Romina Tejada, MD, MSc
Instituto Nacional de Salud, Lima, Peru
(SI) DEFINING VALUE IN MEDICAL DEVICE – “THE STAKEHOLDER MATTERS”
ISSUE: The medical device market is growing faster than the pharmaceutical one. A large and growing middle class in Latin American has been identified as a key emerging market. Ensuring access to medical technology associated with the highest value for money however is a priority for a broad range of stakeholders (e.g. regulators, HTA assessors, healthcare providers, payers and patients) across the healthcare ecosystem.
OVERVIEW: During the session a group of stakeholders will reflect on what makes a medical valuable for them. Panelist will describe their definition of value for medical devices, their views on what drives or should drive the adoption of innovative medical devices, and how these technologies should be assessed.
Moderators
Cynthia P. Iglesias, MSc, PhD
University of York, Heslington, York, United Kingdom
Cynthia is a health economist and health services researcher with a 20-year experience in applied health research (AHR) working at the crossroad between various disciplines in health services research (eg, nursing, midwifery, medicine, epidemiology, sociology, and health economics). She has a first degree as an Actuary (Mexico), an MSc in Health Economics (York), and a PhD in Health Sciences (York).
Her research focuses on the role of health technology assessment (HTA) for decision making and the contribution that quantitative and, more recently, mixed methods can make to address core challenges associated with the use of existing evidence to determine the value for money of complex interventions (eg, medical devices, self-management of chronic conditions, and global health interventions). Most of her methodological work (innovative epidemiological study design; Bayesian methods such as value of information, elicitation, evidence synthesis, bias adjustment, and complementary use of RCT and observational data) has been embedded as part of AHR using and extending existing research methods to accommodate key characteristics of the available data and contextual factors, when necessary.
She has an established national and international reputation in HTA and medical devices evaluation. Since 2012, Cynthia has been serving on the National Institute for Health and Care Excellence (NICE) Medical Technologies Advisory Committee (MTAC). This group of experts is responsible for producing guidance and making recommendations on the introduction and use of medical devices in the NHS in England and Wales. She is one of only two health economists serving on this Committee.
Panelists
Jaime Calderón, MD
Fundación Colombiana del Corazón, Bogotá, Colombia
Maria Gabriela Fernandez, PharmD
Juan Garrahan Pediatric Hospital, Buenos Aires, Argentina
Gabriela Prada, MD, MHA
Medtronic, Ontario, ON, Canada
Robbert Zusterzeel, MD, PhD, MPH
National Evaluation System for Health Technology Coordinating Center (NESTcc), Arlington, VA, USA
Robbert Zusterzeel, MD, PhD, MPH, is the Data Network Director for the NEST Coordinating Center. He joins from the U.S. Food and Drug Administration (FDA) where he led multiple groups conducting translational regulatory research. Dr. Zusterzeel earned his MD and PhD from Maastricht University, The Netherlands, as well as a Master of Public Health (MPH) in epidemiology from Harvard University. He has published numerous peer-reviewed journal articles related to the safety and effectiveness of medical devices and drugs and predicting individualized response to therapies using and creating study data across the full product life cycle.
16:00 - 16:15
BREAK, EXHIBITS AND RESEARCH POSTER PRESENTATIONS VIEWING - SESSION I
16:15 - 17:15
BREAKOUT SESSION 2
COST & RESOURCE USE STUDIES
CR1: LOS COSTOS INDIRECTOS DE LA MORTALIDAD MATERNA EN BRASIL- UN ESTUDIO DE COSTOS DE ENFERMEDADES
4:15PM - 4:30PM
Lynn F 1 , Spence D1 , de Souza MDL2 1 Queen's University Belfast, Belfast, ANT, UK, 2 Universidade Federal de Santa Carolina, Florianópolis, Brazil
OBJECTIVES: Estimar el costo indirecto de la mortalidad materna en Brasil en términos de producción económica perdida como consecuencia de la muerte materna durante el embarazo, parto o durante las primeras seis semanas posparto.METHODS: Se realizó un estudio de costo de la enfermedad, siendo 2015 el año de referencia. Los datos secundarios que se recolectaron de las participantes fueron la expectativa de vida al nacer, la proporción de muertes maternas entre edades de 15-49 años, el total de muertes maternas, el producto interior bruto (PIB) per cápita y el gasto en salud total per cápita. Las fuentes de datos fueron la Organización Mundial de la Salud (OMS), UNICEF, UNFPA, el Banco Mundial y el Sistema de Información de Nacimientos Vivos de Brasil (SINASC). Los costos indirectos se calcularon como la pérdida en el PIB (excluyendo el gasto en salud) atribuido a las muertes maternas. Las estimaciones del PIB perdido en el futuro se descontaron a una tasa del 3,5%. Se realizó un análisis de sensibilidad para recalcular los costos indirectos a unas tasas de descuento del 5% y 10%.RESULTS: Las 1.300 muertes maternas ocurridas en Brasil en 2015 produjeron una pérdida total del PIB (excluyendo el gasto en salud) de US $ 268.830.673, lo que equivale a US $ 206.793 por cada muerte materna. El análisis de sensibilidad con tasas de descuento del 5% y 10% dio como resultado pérdidas totales en el PIB de US $ 196.917.206 y US $ 113.428.082 respectivamente. Los costos indirectos de las muertes maternas representan una pérdida sustancial para el PIB no relacionado con salud. Estos hallazgos son similares a investigaciones previas realizadas en África y en América Latina, donde las pérdidas en el PIB (excluyendo el gasto en salud) para los países de ingresos medio-altos se estimaron en US $ 283.355 (convertidos al nivel de vida de 2015) por muerte materna.CONCLUSIONS: Las estimaciones del costo indirecto se pueden utilizar en actividades de promoción para aumentar la inversión en servicios de maternidad y realizar estrategias de prevención para abordar las tasas de mortalidad materna. Se deberían realizar investigaciones adicionales que estimaran los costos directos que supone para la sociedad la mortalidad materna.
CR2: IMPACTO ECONOMICO DE CANCER DE MAMA Y SU TENDENCIA AL 2030 EN EL SISTEMA DE SALUD PUBLICO DEL PERU
4:30PM - 4:45PM
Gutierrez-Aguado A 1 , Escobedo-Palza S2 , De La Cruz-Vargas J3 , Espinoza Rojas R4 1 Universidad Continental, LIMA, LIM, Peru, 2 SPEAS, Lima, Peru, 3 Universidad Ricardo Palma, Lima, Peru, 4 Universidad Continental, LIMA-PERU, Peru
OBJECTIVES Estimar los costos, gasto público y la tendencia de tamizaje contra Cáncer de mama (CM) en Sistema de Salud Público del Perú METHODS Se realizó una evaluación económica parcial de tipo costo de enfermedad (CE). Los costos se estimaron desde la perspectiva del financiador tomados para el año 2018. La definición de los esquemas de manejo clínico (procedimientos médicos y medicamentos para el diagnóstico, tratamiento y seguimiento de la enfermedad) provienen de las Condiciones Asegurables. Cada esquema de manejo clínico se ha estimado con la metodología de costeo estándar. El costo total fue ajustado por factores de oferta, demanda y adherencia. Gasto público se obtuvo del Ministerio de Economía y el dato de examen clínico de cáncer de mama de la Encuesta de Salud Familiar RESULTS La cohorte hipotética de CM es de 206,719 mujeres para el año 2018 (Incidencia de CM en Perú: 51.4 x 100,000). El costo total para CM es de 514,272.41 soles correspondiendo al Cáncer de mama temprano Quimioterapia Paclitaxel+Anastrazol-Triptolerina -Biopsia con RadioTx Axila. Traztusumab: 346,633.00 soles y Cáncer de mama localmente avanzado con Cirugia con RadioTx Axila con Quimio Adyuvante + Triptolerina--Biopsia: 167,639.41 soles. El costo total correspondiente a prevención y diagnóstico es 1,372.12 soles (0.27%), tratamiento 511,996.73 soles (99.56%) y para seguimiento 903.56 soles (0.18%). El costo fijo correspondió a 70,306.65 soles (13.8%) y el costo variable a 440,907.13 soles (86.2%). En relación a la tendencia de examen clínico de mama 2020 a 2030 sería 24.1% y 30.1%. CONCLUSIONS El costo anual total para Cáncer de mama se estimó en S/. 106,309,878,516.40. Este monto representa más del 100% del presupuesto anual en el programa presupuestal de prevención y control del cáncer del país. Si no se toma acciones al respecto la cobertura de examen clínico de mama no llegaría a lo esperado
CR3: COSTOS DIRECTOS Y CUMPLIMIENTO DE INDICADORES DE CONTROL METABOLICO EN PACIENTES CON DIABETES MELLITUS TIPO 2 EN UN HOSPITAL PUBLICO DE COLOMBIA
4:45PM - 5:00PM
Manrique Torres GA
OBJECTIVES: Determinar los costos directos de atención de pacientes con diabetes mellitus tipo 2, establecer la variación del costo con las comorbilidades-complicaciones y medir el cumplimiento de 4 indicadores de control metabólico de un hospital público. METHODS: Estudio de costos directos desde la perspectiva del sistema de salud, de las atenciones promedio anuales por paciente durante el año 2017. Los costos se dividieron en: atención médica, exámenes de laboratorio-clínicos, medicamentos hipoglicemiantes y para comorbilidades-complicaciones; se emplearon como referencia manual tarifario SOAT y SISMED año 2017. Para establecer la variación de costos totales se realizaron regresiones lineales múltiples y correlación. Los indicadores metabólicos fueron: glicemia basal, hemoglobina glicosilada, microalbuminuria e índice de masa corporal. La información de costos se recopiló y calculó en pesos colombianos, y luego se convirtieron a dólares americanos USD al valor de la tasa representativa al día 30 de diciembre de 2017 (1 USD = $2.984). RESULTS: El costo directo promedio anual por paciente para el sistema de salud fue 1.133 USD, dividido en: medicamentos hipoglucemiantes 933 USD (82%), medicamentos para comorbilidades-complicaciones: 98 USD, atención médica 45 USD, laboratorios clínicos 51 USD. La hipertensión arterial, la obesidad y la gastritis incrementan el costo total y en hombres se disminuye en 32 USD. El costo marginal incremental por cada año de edad del paciente es de 1 USD. Solo el 3% de los pacientes cumplen los 4 indicadores de control metabólico y el 24% no cumplen ninguno. CONCLUSIONS: La diabetes mellitus tipo 2 genera elevados gastos para el sistema de salud, principalmente relacionada con el tratamiento farmacológico con medicamentos como las insulinas y se incrementa con la presencia de comorbilidades-complicaciones.
REIMBURSEMENT & ACCESS POLICY STUDIES
RE3: RELAPSING-REMITTING MULTIPLE SCLEROSIS- COSTS & BENEFITS OF EXPANDING COVERAGE FROM A PUBLIC PAYER PERSPECTIVE
4:15PM - 5:15PM
OBJECTIVES 80% of Relapsing-Remitting Multiple Sclerosis cases in Chile utilizes outdated treatments, without access to other drugs unless their condition exacerbates, and disability appears; Despite evidence, the public payer has been rejecting coverage for cases dealing with contraindication of current therapies, and life-threating conditions have arisen. Patient-organizations and Specialists criticize lack of prevention of exacerbations and outdated local recommendation and coverage. We conducted a Cost-Study to identify direct costs of re-organizing the dispensation of current treatments and providing new drugs. METHODS We conducted a Cost-Study from the perspective of the public payer. Variables of Price, Quantity, and Expenditure were identified conducting: A literature review, Expert Validation Process, Clinical Pathways, and Pricing. After such, data for sub-groups, medical guidelines, case-mix, eligibility, costs-drivers and effective access to first (80%), second (20%) and third-line drugs (0%) was revealed. An evidence-based scenario analyzed the effect of changing those proportions to 0%, 72%, and 28% respectively, gaining early access to innovation-drugs, considering clinical features and coverage of alternatives for patients at death-risk. RESULTS According to specific disease-profile and equitable access to advanced medicines, a potential cost increase of 2.21 times compared to current scenario considering diagnosis, treatments, physical-therapy, and exacerbations, was estimated. Current cost in drugs is U$D6,897 per-case versus U$D19,769 in the simulation. For physical-therapy, current annual-cost is U$D599 versus U$D1,542 as expected (38,8% increase). The present cost of exacerbations is U$D1,893 compared to U$D312 in simulation. This is an 83,5% reduction attributable to early-access and reductions in hospital-based care. CONCLUSIONS Through a new reorganization of resources, the decrease of episodes of exacerbation, and availability of treatments for patients at death-risk can be projected. Chile is in urgent need to provide access in the public sector and at death-risk. By including innovative therapies earlier, exacerbations are diminished, cases are better managed, and resources can be better reallocated.
RE4: PROPOSED SOLUTIONS TO ACHIEVING HEALTHCARE SUSTAINABILITY IN LATIN AMERICA
5:00PM - 5:15PM
Guarin DF1 , Matus A2 , Toro W3 , Trujillo de Hart JC4 , Boers Trilles V5 , McGahan S6 , Graham N6 , Martin De Bustamante M 5 1 EMD Serono, Miami, FL, USA, 2 Roche, Mexico City, DF, Mexico, 3 Astellas Pharma Inc., Lake Forest, IL, USA, 4 FIFARMA, Bogota, Colombia, 5 CBPartners, San Francisco, CA, USA, 6 CBPartners, New York, NY, USA
OBJECTIVES Outline Latin America (LA)’s hurdles to healthcare sustainability, review the current approaches taken by LA Ministries of Health (MoHs) to control pharmaceutical spending, and propose a set of solutions that benefit both LA MoHs and the pharmaceutical industry. METHODS Global benchmarks for healthcare sustainability, LA-specific hurdles that challenge the achievement of those targets and approaches to attain sustainability implemented globally were identified through review of 43 articles published by regional and international organizations (e.g., OECD, WHO / PAHO, United Nations, IFPMA, PhRMA, FIFARMA etc.). Identified global solutions were prioritized based on the feasibility (availability of resources / capabilities) and economic impact in the LA region. RESULTS Despite the significant strides made to attain universal health coverage (UHC), LA’s four largest markets based on 2018 GDP - Argentina, Brazil, Colombia, and Mexico - remain below the OECD and PAHO/WHO benchmarks for healthcare sustainability. Increase in the % of the population covered to meet UHC goals, aging population, and increase in the prevalence of non-communicable disease with an unfinished infectious disease agenda, coupled with constrained budgets and inadequate use of resources have led to a situation where LA healthcare systems cannot provide the services required to meet the needs of the population. To date, the LA MoH’s approach to attain healthcare sustainability has focused on reducing the cost of pharmaceuticals, rather than addressing healthcare system inefficiencies holistically. Alternative mechanisms, such as managed entry agreements, value added services, multi-stakeholder coalitions, incorporation of MCDA within HTA, integrated health models, and local evidence generation should be explored by LA MoHs as they can lead to long-term sustainability. CONCLUSIONS Across LA the demand for health services has outpaced supply. LA MoHs have responded by implementing measures that control the cost pharmaceuticals. Instead, LA MoHs should explore solutions focused on addressing healthcare inefficiencies holistically.
RE2: Definiendo “Valor” en Latinoamérica- Lo bueno, lo malo y lo feo
4:30PM - 4:45PM
Alfonso-Cristancho R 1 , Brabata C2 , Gilardino R3 , Guarin DF4 , Monsanto H5 , Díaz Toro YR6 , Gonzalez L7 , Alandete Manotas JC8 , Ariza JG9 , Bustos Márquez M10 , Caceres H11 , Guirant L12 , Matus A13 , Morán Gortaire MB14 , Pozo L15 , Sanchez D16 1 GlaxoSmithKline plc., Collegeville, PA, USA, 2 Baxter Healthcare Corporation, Miami, FL, USA, 3 ISPOR, Lawrenceville, NJ, USA, 4 EMD Serono, Miami, FL, USA, 5 Merck Sharp & Dohme IA LLC, Carolina, PR, USA, 6 Productos Roche S.A. Colombia, Bogotá, DC, Colombia, 7 Astellas Pharma US,Inc, Northbrook, IL, USA, 8 Bayer LATAM, Randolph, NJ, USA, 9 BAXTER, BOGOTA, Colombia, 10 Amgen, Bogota, Colombia, 11 AMGEN, Newbury Park, CA, USA, 12 Janssen Mexico, Mexico, DF, Mexico, 13 Roche, Mexico City, DF, Mexico, 14 Boehringer Ingelheim, Buenos Aires, P, Argentina, 15 Grupo Farmacos, Mexico City, Mexico, 16 Johnson & Johnson Medical, Mexico City, Mexico
OBJECTIVES: Tomadores de decisiones en Latinoamérica han establecido diferentes marcos para evaluar y comparar el valor relativo de tecnologías de salud respecto a eficacia, seguridad y calidad de vida, entre otros. Utilizando la taxonomía desarrollada por un grupo de académicos, evaluamos las fortalezas y limitaciones de cada uno. METHODS: Realizamos una revisión sistemática de la literatura, examinamos sitios web de Ministerios de Salud y agencias de Evaluación de Tecnología (HTA), y encuestamos los miembros del Comité de Industria de Latinoamérica-ISPOR para identificar y seleccionar los marcos de valor disponibles. Una vez seleccionados, 16 revisores evaluaron el propósito, metodología y resultados de cada marco. Para garantizar la coherencia entre los revisores, para cada dominio desarrollamos una definición operativa. RESULTS: Evaluamos 7/9 marcos de valor identificados en la región. Excluimos 2 que no estaban en uso. Uno desarrollado por el Banco Interamericano de Desarrollo; y seis de países individuales para la evaluación de precios (CMED-Brasil; IETS-Colombia), o para informar reembolso (CONITEC-Brasil; EtD-Chile; IETS-Colombia; CSG-México). La mayoría de estos marcos tienen propósito definido (6/7), pero pueden proporcionar más detalles del enfoque conceptual, las perspectivas, los métodos para obtener preferencias y la capacidad de incorporar múltiples dimensiones de valor (2/7). La mayoría carece de información sobre inclusiones/exclusiones de elementos incluidos en el marco, y si asumen un comparador de base y cómo se selecciona. La descripción de la evaluación de fuentes de datos y su validez científica fue inconsistente (3/7). Algunos incluyeron una evaluación del efecto de la intervención en los costos totales del tratamiento de una población definida (2/7), o describieron cómo podría incorporarse incertidumbre (3/7). Por último, los posibles conflictos de intereses de los creadores del marco no se mencionan (0/7). CONCLUSIONS: Pocos países de América Latina han documentado marcos de valor para la toma de decisiones políticas y clínicas. De los disponibles, existen oportunidades para mejorar las dimensiones, los métodos y el alcance a la hora de evaluar las tecnologías sanitarias.
RE1: THE IMPACT OF REAL-WORLD EVIDENCE ON REIMBURSEMENT SUBMISSIONS- ARE WE CLEAR ON CURRENT PRACTICES?
4:15PM - 4:30PM
Barinova A 1 , Fevre R2 , Brooks Rooney C2 , Pearce D3 1 Takeda, Singapore, Singapore, 2 Costello Medical Singapore Pte Ltd, Singapore, Singapore, 3 Takeda, London, UK
OBJECTIVES Real-world evidence (RWE) complements safety and efficacy data generated from randomized controlled trials and reflects real-life use of health technologies in clinical practice. In developed markets, regulators are accelerating access to new interventions, and payers can utilise RWE to manage uncertainty around the value of new products. However, the use of RWE in emerging markets is less clear. We investigated current practices for RWE use and its impact on reimbursement processes for pharmaceutical products. METHODS Targeted searches of grey literature and websites of health-technology assessment (HTA)/reimbursement agencies in England (National Institute of Health and Care Excellence; NICE), Australia (Pharmaceutical Benefits Advisory Committee; PBAC) and Canada (Canadian Agency for Drugs and Technologies in Health; CADTH) were conducted to identify policies for RWE use in HTA and reimbursement processes. Evidence exemplifying the impact of RWE on reimbursement processes was also extracted. RESULTS Formal policies for RWE use in reimbursement decision-making were identified in three areas: scoping before assessment (NICE, CADTH), during HTA assessment to address clinical and cost effectiveness and manage uncertainty through conditional reimbursement (NICE, PBAC, CADTH), and after technology assessment to inform reassessments and confirm value (NICE, PBAC, CADTH). Examples, predominantly from developed markets, of the direct impact of RWE on reimbursement processes were identified during reimbursement decision-making - including in pharmacoeconomic analysis, conditional reimbursement and to support the release of full payment - and after reimbursement, to counter formulary exclusion and to provide evidence for disinvestment. Initiatives for RWE generation and use, and challenges and potential solutions for use of RWE in reimbursement processes were also identified. CONCLUSIONS In developed markets, RWE influences all stages of the reimbursement decision-making process, however policies for RWE use differ between HTA/reimbursement agencies in different countries. A more consistent policy approach could be valuable and could inform development of procedures for RWE use in emerging markets.
(SI) HOW TO ENHANCE EVIDENCE-INFORMED DELIBERATIVE PROCESSES IN HEALTH TECHNOLOGY ASSESSMENT PRACTICES?--¿CÓMO MEJORAR LOS PROCESOS DELIBERATIVOS INFORMADOS POR LA EVIDENCIA DE LAS AGENCIAS DE EVALUACIÓN DE TECNOLOGÍAS SANITARIAS (ETESA)?
ISSUE
: The ISPOR HTA Council Working Group Report on Good Practices in HTA (2019) shows that guidance is needed regarding the use of deliberative processes in HTA. The evidence-informed deliberative processes (EDPs) framework, based on rational decision-making (using MCDA) as well as the accountability for reasonableness approach, is intended to support HTA agencies in this process. As such, it is important to identify the current level of use of EDPs, the need for guidance, and to learn about best practices as some HTA agencies have already certain elements in place that could serve as inspiration for others.
OVERVIEW
: We will present the level of use of EDPs by HTA agencies and discuss the potential of enhancing its use in Latin America. This is especially challenging as the need for transparency in HTA, involvement of relevant stakeholders, explicit priority-setting processes, and clearly linking HTA and decision making in this Region have been emphasized as important. Wija Oortwijn will moderate the panel; she presents the results of a survey among members of the International Network of Agencies for HTA and will pose key questions to the panellists: What are the current challenges for introducing EDPs? How to (further) enhance the use of EDPs? Is there any lesson to be learned from certain HTA practices? Andrés Pichon will discuss the challenges and opportunities for stakeholder involvement in Latin America based on the work from the HTAi Latam Policy Forum. Thereafter, Ana Pérez will discuss the experiences of developing an explicit priority-setting process in Uruguay, including the views from patient organizations. Vania Canuto will present the development of introducing deliberative processes in the Brazilian HTA context, which is seen as a best practice for the Region. Finally, an interactive discussion will be organized with the audience on how to further enhance the use of EDPs. El Grupo de Trabajo del Consejo de ISPOR ETESA sobre Buenas Prácticas en ETESA (2019) observa que se necesita guiar con respecto al uso de procesos deliberativos en ETESA. El marco de los procesos deliberativos informados por la evidencia (EDPs), basado en la toma de decisiones racional (utilizando MCDA), así como el enfoque de responsabilidad de rendición de cuentas, tiene la intención de apoyar a las agencias de ETESA en este proceso. En este sentido, es importante identificar el nivel actual de uso de los EDPs, la necesidad de orientación y de aprender acerca de las mejores prácticas, ya que algunas agencias de ETESA cuentan con ciertos elementos que podrían servir de inspiración para otras. Presentaremos el nivel de uso de los EDPs por parte de las agencias de ETESA y discutiremos el potencial de mejorar su uso en América Latina. Esto es especialmente desafiante ya que la necesidad de transparencia, la participación de distintos actores, los procesos explícitos de establecimiento de prioridades y la vinculación clara de la ETESA y la toma de decisiones han sido identificados como importantes en esta Región. Wija Oortwijn (Países Bajos) será la moderadora del panel; presentará los resultados de una encuesta entre los miembros de la Red Internacional de Agencias para ETESA (INAHTA) y planteará preguntas clave a los panelistas: ¿Cuáles son los desafíos actuales para la introducción de los EDPs? ¿Cómo mejorar el uso de los EDPs? ¿Cuáles son las lecciones aprendidas de algunas prácticas de ETESA? Andrés Pichon (Argentina) discutirá los desafíos y oportunidades para la participación de distinctos actores en América Latina en base de los resultados del Foro Latino Americano de Políticas en ETESA de la Health Technology Assessment International (HTAi). Ana Pérez discutirá las experiencias de desarrollo de un proceso explícito de establecimiento de prioridades en Uruguay, incluidas las opiniones de las organizaciones de pacientes. Vania Canuto presentará el desarrollo de la introducción de procesos deliberativos en Brasil, que es considerada una de las experiencias de buenas prácticas de ETESA de la Región. Finalmente, se organizará una discusión interactiva con la audiencia.
Moderators
Wija Oortwijn, MSc PhD
Radboud university medical centre, Nijmegen, GE, Netherlands
Panelists
Vania Cristina Canuto Santos, MSc
Brazilian Ministry of Health, Brasília, Brazil
Ana Pérez-Galán, MD MSc
Ministry of Public Health, Montevideo, Uruguay
Andres Pichon-Riviere, MD, MSc, PhD
Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
THE USAGE OF REAL-WORLD EVIDENCE (RWE) IN MONITORING AND MANAGING HEALTH TECHNOLOGIES IN LATIN AMERICA - WHERE WE ARE AND WHERE WE ARE HEADING
PURPOSE
: Demographic trends together with new health technologies generate a move towards the increase of healthcare spending worldwide. Latin American (Latam) healthcare systems present an important pressure to decrease expenditures, mainly due to limited budgets and potential inefficiencies. Therefore, once there is a limited budget for healthcare management, a rational budget allocation for the incorporation of novel technologies and use of established ones is crucial. In this scenario, real world evidence (RWE) plays an important role, especially for effectiveness evaluation, safety and economic analysis. Nevertheless, RWE studies in Latam are still scarce, with important barriers in usage, interpretation, methodology and data availability. In this context, RWE usage in Latam will be addressed in the workshop using different perspectives (policy, manufacturer/consultant and technical).
DESCRIPTION
: In this workshop, we will hold a holistic discussion regarding the usage of RWE in Latam in regards to new and established health technologies (burden of disease and priority setting, health technology assessment [HTA], effectiveness and safety measurement, innovative access models), from the health policy, industry/data consultancy and research/technical perspectives. The focus will be on health technologies broadly but with special emphasis on medicines. The use of RWE in HTA and/or in post launch phases from the perspective of health systems, with applied examples around the world (from Latam or applicable to Latam) will be presented. ISPOR role and perspectives in regards to RWE will be highlighted. RWE challenges and opportunities for technology producers, data holders and consultants will be provided by a regional life science consultant. A technical overview about current technical challenges for RWE worldwide and in Latam and suggestions for technical enablers will be provided by an experienced pharmacoecopidemiologist working in the region. At the end of the workshop, participants will be encouraged to share relevant experiences and suggestions in regards to the topics presented.
Discussion Leader
Ramiro Gilardino, MD, MSc
ISPOR, Lawrenceville, NJ, USA
Guilherme Julian, BPharm, MsC
IQVIA, São Paulo, Brazil
Gerardo Machnicki, MSc, PhD
Janssen LATAM, Buenos Aires, Argentina
Gerardo is director, Real World Evidence at Janssen Latin America. He has spent 18 years in the pharmaceutical industry (country, region, and global levels) in roles involving health economics, outcomes research and analytics across different therapeutic areas (cardiovascular, diabetes, hematology, immunology, neurology, oncology, and respiratory). He has an international education in economics (Universidad Católica Argentina), health economics (University of York, UK), and epidemiology/public health/biostatistics (Saint Louis University, USA).
Gerardo has been an invited lecturer for several health economics/health management programs (Universidad Isalud, Universidad de San Andres, Universidad de Buenos Aires, and Universidad Maimónides). He has been co-instructor for economic analysis short courses presented by ISPOR and also serves as the chair of the 2018-2019 ISPOR Research Methods Awards Committee. Additionally, he has authored 20 peer reviewed journals and has developed other forms of communication which includes participating as author in scientific books, editorials, oral and poster presentations at international scientific meetings.
His skills include the design and analysis of epidemiological studies, economic evaluation of healthcare technologies, health technology assessment, health outcomes research with large databases, patient-reported outcomes, and resource allocation in healthcare and statistical modeling. Gerardo is also interested in big data in healthcare, creating impactful real-world evidence (RWE) strategies, and innovative epidemiologic and statistical methods.
Claudia S Soares, MD, MPH, PhD
GlaxoSmithKline, Rio de Janeiro, Brazil
LOS CENTROS DE EXCELENCIA- PRESENTE Y FUTURO EN EL MANEJO DE LAS ENFERMEDADES CRÓNICAS NO TRANSMISIBLES - EL CASO DE LA ARTRITIS REUMATOIDE
PURPOSE:
Discutir el potencial de los Centros de Excelencia (CdE) como estrategia de manejo de enfermedades crónicas no transmisibles (ECNT), a través del análisis del caso de la artritis reumatoide (AR).
DESCRIPTION
: El manejo de las ECNT, especialmente los trastornos musculoesqueléticos , se ven afectados por la fragmentación y la escasez de atención médica en los sistemas de salud de algunos países latinoamericanos. Esta fragmentación en la prestación de servicios de salud resulta en una baja adherencia a los programas de atención de enfermedades crónicas, pocos resultados de salud y costos evitables para los sistemas de salud, las familias y las sociedad en general. Los CdE para el manejo de ECNT, como la AR, son una estrategia que optimiza el manejo de la enfermedad y aumenta la efectividad de las intervenciones con costos racionales para los sistemas de salud, las familias y las sociedades. En el presente Workshop, primero se conceptualizará el modelo de CoE para el manejo de las ECNT, y se informarán los resultados de un caso de éxito basado en el manejo de la AR. Se mostrarán resultados respecto a la efectividad y el ahorro de costos de la gestión de la AR bajo un CoE basado en un modelo de atención centrado en el tratamiento y en el paciente. Finalmente, discutiremos la posibilidad de generalización de la aplicación de esta estrategia para los sistemas de salud de América Latina.
Discussion Leader
Nelson Alvis-Guzman, MD. MPH. PhD.
ALZAK Group, Cartagena, BOL, Colombia
Nelson J. Alvis-Zakzuk, Eco, MSc
Universidad de la Costa-CUC, Barranquilla, Colombia
Fernando De La Hoz, MD MSc PhD
Universidad Nacional de Colombia, Bogota, Colombia
Pedro Santos-Moreno, MD, MSc, MBA
Biomab, bogota, Colombia
17:30 - 18:30
BREAKOUT SESSION 3
MEDICAL TECHNOLOGIES STUDIES
MT3: ICD THERAPY FOR SUDDEN CARDIAC ARREST PREVENTION IS POTENTIALLY COST-EFFECTIVE IN THE 1.5 PRIMARY PREVENTION POPULATION IN COLOMBIA- AN ECONOMIC EVALUATION OF THE IMPROVED SCA STUDY
6:00PM - 6:15PM
Higuera L 1 , Holbrook R1 , Wherry K1 , Valencia JE2 , Van Dorn B3 , Arcos J4 , Lopez Gomez A5 1 Medtronic, Inc, Mounds View, MN, USA, 2 Medtronic Latin America, Miami, FL, USA, 3 Medtronic, Inc, Minneapolis, MN, USA, 4 Medtronic Colombia, Bogota, Colombia, 5 Medtronic Colombia, Bogota, CUN, Colombia
OBJECTIVES: Implantable cardiac defibrillators (ICDs) for primary prevention (PP) of sudden cardiac arrest (SCA) is well-established but underutilized globally. The IMPROVE SCA study has identified a cohort of patients called 1.5 primary prevention (1.5PP) based on PP patients with the presence of documented risk factors: non-sustained ventricular tachycardia, frequent premature ventricular contractions, left ventricular ejection fraction < 25%, and pre-syncope or syncope. This cohort could be used to prioritize health care resources in geographies where resources are scarce. We evaluated the cost-effectiveness of ICD therapy compared to no ICD among 1.5PP patients in Colombia. METHODS: We modified inputs to a published Markov model to compare costs and outcomes of ICD therapy to no ICD. The model was run over a lifetime time horizon from the Colombian payer perspective. Mortality and utility estimates were obtained from the IMPROVE SCA study. Additional effectiveness inputs were sourced from the literature. Cost inputs were obtained from the Colombian authorities' price list, adjusted as suggested by local guidelines. Costs and quality-adjusted life years (QALYs) were discounted at 5.0%. We used a willingness-to-pay (WTP) value of between one (cost-effective) and three times (potentially cost-effective) Colombian GDP per capita in 2017. RESULTS: The total discounted lifetime costs for ICD therapy were COP$ 132,937,748 (Colombian Peso) compared to COP$ 79,017,109 for no ICD therapy. Total discounted QALYs for ICD therapy and no ICD therapy were 6.20 and 5.04, respectively. The incremental cost effectiveness ratio was COP$ 46,729,029; therefore, ICD therapy should be considered potentially cost effective at a COP$ 56,484,299 WTP threshold. CONCLUSIONS: ICD therapy compared to no ICD therapy is potentially cost-effective in the 1.5PP population in Colombia. A combination of global trial results and localized cost inputs provide a robust economic evaluation of this therapy in the Colombian health care system. These results may not be generalizable to other geographies.
MT1: ANÁLISIS COSTO-EFECTIVIDAD DE UN SISTEMA DE TROMBECTOMÍA REOLÍTICA PARA EL TRATAMIENTO DE LA ISQUEMIA AGUDA DE MIEMBROS INFERIORES EN ADULTOS MEXICANOS
5:30PM - 5:45PM
Cerecero-García D1 , Celis-Luvian L2 , Acevedo-Parra G2 , Toral-Cruz M3 , Figueroa-Lara A 4 1 Instituto Nacional de Salud Pública, Cuernavaca, MR, Mexico, 2 Evisys Consulting, Ciudad de México, Mexico, 3 Boston Scientific de México, Ciudad de México, Mexico, 4 Boston Scientific Mexico, Mexico City, Mexico
OBJECTIVES: METHODS: RESULTS: CONCLUSIONS:
MT4: ANALISIS DE IMPACTO PRESUPUESTARIO SOBRE LA INCORPORACION DEL COCIENTE SFLT-1/PLGF PARA PREDECIR EL RIESGO DE PREECLAMPSIA EN LA COBERTURA DE LAS OBRAS SOCIALES NACIONALES DE ARGENTINA
6:15PM - 6:30PM
Garay U
OBJECTIVES : METHODS RESULTS CONCLUSIONS
MT2: REMOTE MONITORING COMPARED TO CONVENTIONAL FOLLOW-UP FOR PATIENTS WITH HEART FAILURE USING IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR- A BUDGET IMPACT ANALYSIS
5:45PM - 6:00PM
Lucchetta RC 1 , Rosim MP1 , Okumura L1 , Pedro GO1 , Nita ME2 , Riveros BS1 1 MAPESolutions, Sao Paulo, Brazil, 2 MAPESolutions, Sao Paulo, SP, Brazil
OBJECTIVES METHODS RESULTS CONCLUSIONS
CLINICAL OUTCOMES ASSESSMENT STUDIES
CL2: EFFECTIVENESS OF TREATMENT WITH DIRECT-ACTING ANTIVIRALS IN THE COLOMBIAN POPULATION WITH CHRONIC HEPATITIS C
5:45PM - 6:00PM
Acuña Merchan L 1 , Moreno LA2 , Contreras YA3 1 Fondo Colombiano de Enfermedades de Alto Costo, Bogotá, Colombia, 2 Cuenta de Alto Costo, Bogotá, Colombia, 3 Cuenta Alto Costo, Bogotá, Colombia
OBJECTIVES: to characterize the population with chronic hepatitis c and to evaluate the effectiveness of direct-action antivirals. METHODS: a descriptive observational study was conducted with the information of each patient who received treatment for chronic hepatitis C from August 1, 2017 to December 31, 2017. The data were audited and validated with the clinical history. Adherence to treatment was monitored. Sociodemographic, administrative and clinical variables of the disease were determined that allowed to monitor patients and evaluate their results. Measures of central tendency were calculated according to the nature and distribution of the variables. The Stata v.12 program was used. RESULTS: 1.136 patients with chronic hepatitis C infection were followed. 51.7% men. The average age was 49 (SD=16) years in men and 63 (SD=12) years in women. Co-infection with HIV occurred in 23.8% of cases. The most frequent genotype was 1b with 592 cases (52%, (49.1%-54.9% CI)), followed by type 4 with 198 cases (17.3%, (15.1%-19.5% CI)) and 1a with 150 cases (13.1%, (11.1%-15.1% CI)). The most frequent mechanism of transmission was blood transfusion (n = 376, 34.2%, (31.6%-37.2% CI)), followed by sexual transmission (n = 120, 10.9%, (9.6%-13.2% CI)). The prevalence of fibrosis was 45.7% (42.8%-48.6% CI). An effectiveness of 96.1% (95.3%-97.5% IC) was identified in all patients who received treatment with direct-acting antivirals. CONCLUSIONS: the direct-acting antivirals have met the effectiveness expected in the treatment for chronic hepatitis c. The strategy of centralized purchase of high-cost medicines has improved access to treatment and the consequent cure of patients with hepatitis c and allows a contribution to the sustainability of the health system.
CL3: ESTUDIO DE EVALUACIÃN ECONÃMICA DEL APÃSITO TRANSPARENTE IMPREGNADO CON CLORHEXIDINA, PARA LA FIJACIÃN DE CATÃTERES CENTRALES BAJO EL CONTEXTO DE LOS HOSPITALES PÃBLICOS DE REPáBLICA DOMINICANA- CASO HOSPITAL DOCENTE PADRE BILLINI, AÃO 201 ...
6:00PM - 6:15PM
Carvajal Nunez AD
OBJECTIVES: METHODS: RESULTS: CONCLUSIONS:
CL1: PATIENT ACTIVATION MEASURE IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ITS IMPORTANCE REGARDING EMPOWERMENT
5:30PM - 5:45PM
Arrighi E1 , Rodríguez F2 , Buitrago-Garcia D3 , Osorio P4 , Santos-Moreno P 5 1 Universidad Austral, Buenos Aires, Argentina, 2 Biomab, center for rheumatoid arthritis, Bogotá, CUN, Colombia, 3 Fundación Universitaria de Ciencias de la Salud-FUCS, BOGOTA, Colombia, 4 Biomab - Center for Rheumatoid Arthritis, Bogota, Colombia, 5 Biomab, Center for Rheumatoid Arthritis, Bogota, CUN, Colombia
OBJECTIVES: The Patient Activation Measure (PAM) is a 13-item scale that assesses patient knowledge, skills, and confidence for self-management. This measure is important for the education and empowerment of patients with their disease. The objective of the study is to determine the level of activation of patients with rheumatoid arthritis (RA). METHODS: We performed a quantitative, observational, cross-sectional, and questionnaire-based study; participants were recruited in a specialized RA center. We applied the PAM-13 scale validated in Spanish. The scale has a score from 1 to 4 divided in four levels, where level 1 represents a disengaged patient and suggests that the doctor is in charge of their health; level 2: the patient becomes aware but struggling; level 3: The patient is taking action and considers himself as apart of the healthcare team, and level 4 represents a patient that maintains behaviors and pushes forward. RESULTS: 322 patients participated, 23 patients generated incomplete PAM-13 scores (response rate 92%) and were excluded from study; 93% of patients were women. Mean age was 60 years ±10; mean PAM-13 was 19.83 ±6.16. In our study 68% of patients were in level 2 according to PAM-13 scale which means that they are becoming aware of their knowledge, skills and self-management but are still struggling. In average, 87% of patients answered each question to be in level 1 or 2 that means many patients do not have the knowledge and skills to better cope with the disease; only a 12% was in level 3 and 4. CONCLUSIONS: This is the first study in our country where the PAM-13 is applied in patients with rheumatoid arthritis. Thus, it might be useful to implement patient activation monitoring, since the level of activation is low in patients with RA could be cost-effective to empower patients to obtain better results.
(SI) REGULATORY APPROVAL VS ACCESS IN RARE CANCERS- ARE THE LATIN AMERICAN HEALTHCARE SYSTEMS PREPARED TO FOLLOW FAST TRACK APPROVALS AND ENSURE ADEQUATE ACCESS FOR HIGH UN-MET NEED POPULATIONS?
ISSUE
: Rare cancers are a heterogeneous group of conditions with highly unmet medical needs. Although infrequent, rare cancers affect millions of people who deserve effective treatments. Novel treatments are urgently needed because unspecific therapies such as cytotoxic drugs or radiotherapy are limited by adverse events and variable treatment success. In recent years, the rise of precision medicine is allowing significant improvements in patient outcomes due to individualized treatments. To ensure availability of new treatment options for this high unmet need population, the regulatory agencies worldwide created specific pathways for registration that resulted in higher number of fast-track approvals for certain niches and/or rare diseases, with reduced clinical development programs. Regarding the HTA process, some agencies, such as NICE, also developed specific approaches for value assessment of products for rare diseases, such as the inadequacy of the use of cost-effectiveness analysis. In Latin America, the advances in the regulatory pathway have not been matched by improvements in the reimbursement process, since in most of the countries all approved products must follow the classic reimbursement pathway. In some cases, such as in the Brazilian private healthcare system, the HTA decision-making process takes two to three years, negatively impacting the possibility of patients to received innovative treatments considering their high unmet need condition.
OVERVIEW
: In this panel, we suggest a holistic discussion regarding HTA landscape for rare conditions in Latin America, especially rare cancers, covering the perspectives of industry, payers and patient’s association. We intend to facilitate an open dialogue about challenges and opportunities in reimbursement decisions through an open discussion between these stakeholders with distinct backgrounds, identify key barriers and possible actions to ensure timely treatment access for high unmet need populations, considering the limitation of resources in the Latin American setting. The topic will benefit payers, patient’s association and industry attendees. ACCESO A TRATAMIENTO DE CÁNCERES RAROS: ¿ESTÁN LOS SISTEMAS DE SALUD LATINOAMERICANOS PREPARADOS PARA LLEVAR A CABO APROBACIONES REGULATORIAS ACELERADAS Y ASEGURAR UN ACCESO ADECUADO PARA POBLACIONES CON UNA ALTA NECESIDAD NO ATENDIDA?
PROBLEMA: Los cánceres raros son un grupo heterogéneo de afecciones con necesidades médicas altamente insatisfechas. Aunque son poco frecuentes, los cánceres raros afectan a millones de personas que merecen tratamientos efectivos. Se necesitan urgentemente tratamientos innovadores porque las terapias inespecíficas, como los fármacos citotóxicos o la radioterapia, están limitadas por los eventos adversos y el éxito variable del tratamiento. En los últimos años, el aumento de la medicina de precisión está permitiendo mejoras significativas en los resultados de los pacientes debido a los tratamientos individualizados. Para garantizar la disponibilidad de nuevas opciones de tratamiento para esta población con necesidades no atendidas, las agencias regulatorias de todo el mundo crearon rutas específicas para el registro de medicamentos, que dieron como resultado un mayor número de aprobaciones aceleradas para ciertos nichos y/o enfermedades raras, con programas de desarrollo clínico reducidos. Con respecto al proceso Evaluación de Tecnologías en Salud, algunas agencias como NICE, también desarrollaron procesos específicos para la evaluación del valor de los medicamentos para enfermedades raras, como lo inadecuado del uso de análisis de costo-efectividad. En América Latina, los avances en los procesos regulatorios no han sido acompañados por mejoras en el proceso de reembolso, ya que, en la mayoría de los países, todos los productos aprobados deben seguir el proceso clásico de reembolso. En algunos casos, como en el sistema de salud privado de Brasil, el proceso de toma de decisiones de la Agencia Evaluadora de Tecnologías en Salud demora entre dos y tres años, lo que afecta negativamente la posibilidad de que los pacientes reciban tratamientos innovadores considerando su condición de alta necesidad no atendida.
SINOPSIS: En este panel, sugerimos una discusión holística sobre el panorama de la Evaluación de Tecnologías en Salud para enfermedades raras en América Latina, especialmente cánceres raros, incluyendo las perspectivas de la industria, los pagadores y las organizaciones de pacientes. Tenemos la intención de facilitar un diálogo abierto sobre los desafíos y oportunidades en las decisiones de reembolso a través de una discusión abierta entre todas los participantes con distintos antecedentes, identificar barreras clave y posibles acciones para garantizar el acceso oportuno al tratamiento para las poblaciones con necesidades más altas, teniendo en cuenta la limitación de recursos en América Latina. El tema beneficiará a los pagadores, las organizaciones de pacientes y los asistentes de la industria.
Moderators
Melina Calderon, Director
Janssen, Mexico, Mexico
Panelists
David E. Debrott Sánchez, Director
Instituto de Análisis de Políticas Públicas y Gestión, Santiago, Chile
Tiago Farina Matos, PHD
Oncoguia - Patient Association, São Paulo, Brazil
Zoltan Kalo, PhD
1) Semmelweis University; 2) Syreon Research Institute, Budapest, PE, Hungary
HACIA UNA AGENCIA NACIONAL DE EVALUACIÓN DE TECNOLOGÍAS DE SALUD EN ARGENTINA- LOGROS Y DESAFÍOS
ISSUE
: Recientemente, la CONETEC (Comisión Nacional de Evaluación de Tecnologías de Salud) ha sido creada dentro del alcance de la Secretaría de Salud de Argentina. Está conformada por un comité técnico, un comité de pacientes y un comité de decisiones. Aunque las decisiones tomadas por este comité no serán vinculantes en el nivel subnacional (como las provincias, que son autónomas), constituirán un sólido precedente para las decisiones de cobertura de las nuevas tecnologías que evalúa. La comprensión de sus mecanismos de acción, y la identificación de barreras y facilitadores para su implementación, serán los primeros pasos para la conformación de la primera AGENCIA NACIONAL, sobre la que se está trabajando en un proyecto de ley. OVERVIEW
: Las Agencias Nacionales de evaluación de tecnologías de salud se han expandido a lo largo del tiempo, permitiendo un acceso más equitativo y homogéneo a las nuevas tecnologías. Sin embargo, en América Latina el proceso de creación ha sido más lento, así como en aquellos países con sistemas de salud altamente fragmentados, como Argentina. La cobertura de las nuevas tecnologías en salud es altamente heterogénea en estos contextos. Comprender las diferentes perspectivas de las partes interesadas en este tipo de sistemas de salud, así como identificar barreras y facilitadores, podría ayudar a la creación de una Agencia Nacional que permita una incorporación equitativa de las nuevas tecnologías. Luego de presentar a los participantes del panel, el representante de CONETEC presentará la forma de funcionamiento de la comisión. A continuación, el moderador dirigirá una serie de preguntas al resto de los panelistas, buscando obtener una pluralidad de voces sobre las ventajas y los desafíos que enfrenta la comisión. Se harán las mismas preguntas a todos los panelistas, quienes responderán desde diferentes perspectivas: 1) ¿Cómo lo favorece la existencia de CONETEC?, 2) ¿Cuál es el perjuicio?, 3) ¿Cuáles son los resultados esperados?, y 4 ) ¿Se podría evitar o potenciar la judicialización?.
Moderators
Jorge Elgart, BEc, MSc
CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET), La Plata, B, Argentina
Panelists
Natalia Jorgensen, Economista
CAEME. Cámara Argentina de Especialidades Medicinales, Buenos Aires, Argentina
Analia Lopez, MD
Ministry of Health and Social Development, Argentina, Buenos Aires, Argentina
Andres Pichon-Riviere, MD, MSc, PhD
Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
ADAPTACIÓN DE MODELOS GLOBALES DE COSTO-EFECTIVIDAD A LOS REQUERIMIENTOS LOCALES EN PAISES DE LATINOAMERICA- ESTUDIOS DE CASO
PURPOSE:
ilustrar retos reales en los países al adaptar modelos globales de costo-efectividad y un marco conceptual para atender estos retos a través de un análisis comparativo de dos estudios de caso con adaptaciones en 4 a 5 países Latinoamericanos: Argentina, Brasil, Chile, Colombia y Mexico. DESCRIPTION:
Discussion Leader
Pablo Anaya, BSc, MPH
IQVIA, Mexico City, DF, Mexico
Maria Camila Bustos Márquez, MD MPH
AMGEN, Bogota, CUN, Colombia
Diego F Guarin, MD, MPH, MA
EMD Serono, Miami, FL, USA
Alfredo Palacios, BEcon, MEcon
Instituto de Efectividad Clínica Sanitaria (IECS), Buenos Aires, Argentina
18:30 - 19:30
RESEARCH POSTER AUTHOR DISCUSSION HOUR - SESSION I
18:30 - 20:00
NETWORKING RECEPTION IN THE POSTER/EXHIBIT HALL
18:45 - 19:45
EDUCATIONAL SYMPOSIUM
ACCURATE DIAGNOSIS ENABLES VALUE-BASED CARE- IMPROVING THE CARE & AVOIDING UNNECESSARY COSTS
Among the variables that influence clinical decisions, laboratory tests are considered to be among the most important and frequently used. The influence of laboratory tests on clinical decisions varies from 56% to 98% for inpatient, emergency department, and outpatient populations. In this scenario, the decision to use one diagnostic test or another may impact directly clinical and economic outcomes. Accurate lab results also have other important implications on, such as frequency of hospitalizations, length of stay, time to discharge, hospital admissions, expenses with pharmaceutical or non-pharmaceutical therapies (e.g. surgical, physical, etc.), further diagnostic procedures, among others. In the current context with significant economic challenges, the rising cost of health care is a major issue for patients, employers, providers and payers. The desire to reduce costs, optimize resources allocation, and increase quality of care is a motivating force forcing to move health care from a fee-for-service to a more value-based outcome model.
Disease Management Programs and Value-based health Care Models aims mainly to improve quality of care and increase efficiency for healthcare systems. Adoption of in-vitro Diagnostic tests (IVD) in the Delivery Care Chain based on the their clinical and economic benefits - and not only on their accuracy (named specificity and sensitivity) - may bring significant value to the whole health care ecosystem. The question is how to design, implement, and track the performance of a Diagnostic Value-Based health care model (VBHC). The clinical and scientific communities have larger experience on treatment Value-Based Health Care models than on diagnostic VBHC. Thus, the Symposium “Accurate Diagnosis enables Value-based Care: improving care & avoiding unnecessary costs” aims to share two real-life experiences where Diagnostic Value-Based health care models were designed, implemented and evaluated. The first experience is a Heart Failure Program from Spain and the second one, a Cervical Cancer Screening Program from Brazil.
The adoption of an IVD test into clinical practice based primarily on added value – as determined by the test´s clinical and economic impacts - are necessary to ensure the quality of patient care, to achieve specific goals and better manage potential downstream costs.
Sponsor
Roche Diagnostics LATAM
Speaker
Karine A Ferreira, PhD
Roche Diagnostics LATAM, Sao Paulo, Brazil
Antonio Leon, PhD
Macarena University Hospital, Sevilla, Spain
Julio Teixeira, PhD
University of Campinas (UNICAMP), CAISM, São Paulo, Brazil
19:30 - 20:30
ARTIFICIAL INTELLIGENCE AND INNOVATION ON HEALTH. WHAT IS THEIR INFLUENCE ON LATIN AMERICAN HTAs
The symposium will describe the integration of artificial intelligence in health, how new technology implementations could impact health care and the way in which HTA systems should analyze innovation using big data in LATAM.
Sponsor
Astellas
Moderators
David Bardey, PhD
University of Los Andes, Bogotá, Colombia
Speakers
Oscar Bustos, PhD
Aval Digital Labs / Pontifical Xaverian University, Bogotá, Colombia
Stephen Stefani, MBA
CAPESESP, Rio de Janeiro, Brazil
Sat 14 Sep
7:15 - 8:15
ARE HEALTH SYSTEMS IN LATIN AMERICA EFFECTIVELY COPING WITH CURRENT AND UPCOMING INNOVATIVE MEDICAL TECHNOLOGIES?
HTA has become instrumental to support access to novel medical technologies. In Latin America, there is an increasing trend towards its use, with different levels of adoption and implementation, as a mechanism to support resource allocation in health care. Several challenges have been raised, mostly related to the limited availability of technical and financial resources, local data, institutional infrastructure and political will, to guarantee on time and systematic use of evaluation methods and decision making. Increasing demand from healthcare professionals, patients and caregivers to be part of the process is also a reality, even though the pathways are not always clearly defined. Dilemma for decision makers in Latin America still remains in how to balance the need to adopt more efficient mechanisms to broaden access for patients to value-added medicines, while maintaining financial sustainability. As research and development efforts are rapidly transitioning towards “potentially curative” technologies and “disruptive innovators” but budget-constraints are expected to remain constant, coverage and financing of novel treatments by decision makers in the region will require a combination of improved methods for HTA and expanded dimensions to be considered, added to collaborative efforts among health care system stakeholders, in order to make them accessible for patients. In this symposium, advances, evolving trends and challenges for inclusion and coverage of novel technologies in Latin America will be discussed.
Sponsor
Novartis
Speaker
Hector Castro, MD, MSc, PhD
Management sciences for Health, Washington, DC, USA
Doctor in Medicine and Surgery, MSc in Health Policy, Planning and Financing from the London School of Hygiene & Tropical Medicine (LSHTM) joint degree with the London School of Economics & Political Science (LSE), Specialized in Health Management and previous MSc in Occupational Health (Public Health Branch). Doctor in Public Health & Policy/Health Economics from the University of London (LSHTM). Former Takemi Postdoctoral Fellow at the T.H. Chan Harvard School of Public Health.
Broad professional experience (20 years) as Chief Officer, Technical Advisor, Director and Manager in Strategic Planning, Quality Assurance, Health, Safety and Environment for Pharmaceutical and Health Insurance and Non-Governmental Organizations. Main focus of work has been on health systems` strengthening in areas such as quality assurance, assessment, strategic purchasing and provision of healthcare technologies (including medicines, devices and procedures).
More than ten years as international consultant in health care access, health economics, health policy, priority setting, health technology assessment (HTA) and health systems´ reform, familiar with and relevant experience in health systems and markets in Low and Middle Income Countries- LMICs. Previous working experience includes: the US, United Kingdom, Colombia, Ecuador, Ukraine, Belarus, Thailand, Kenya, Peru, Costa Rica, Brazil, Mexico, United Arab Emirates, Uganda, Chile, Turkey and Tunisia. Experience also as a researcher and lecturer for undergraduate and post graduate students in ivy league institutions in Latin America, the US and United Kingdom.
Former funding Chief Executive Director of the HTA Institute of Colombia (IETS) and Director of Medicines & Technologies at the Ministry of Health and Social Protection of Colombia. Currently is Global Leader of Health Financing, Technologies, Data and Impact at Management Sciences for Health (MSH) in Washington D.C area. Starting June 2018 and until 2021, Doctor Castro serves at the board of directors of the Health Technology Assessment International- HTAi one of the most prominent international networks in the field of HTA.
Dávid Dankó, PhD, MSc
Ideas & Solutions (I&S), Budapest, Hungary
8:30 - 9:30
BREAKOUT SESSION 4
PARTICIPACION DE PACIENTES EN PROCESOS DE DECISION SOBRE COBERTURA EN SALUD- LECCIONES INICIALES DE LA LEY RICARTE SOTO EN CHILE Y SUS IMPLICANCIAS PARA LATINOAMERICA
PURPOSE
: La participación de pacientes en los procesos de decisiones sobre cobertura en salud ha pasado de ser una demanda de las agrupaciones de pacientes a su realización práctica. Este es el caso de Chile que incluyó representantes de pacientes en su proceso de decisiones para coberturas de alto costo (Ley Ricarte Soto). El propósito del presente workshop es revisar las lecciones iniciales que deja el proceso chileno y sus implicancias para otras jurisdicciones en Latinoamérica.
DESCRIPTION
: Manuel Espinoza presentará resultados de una investigación que ha revisado el proceso de participación de pacientes en Chile, a partir del cual se han caracterizado sus desafíos y han emanado recomendaciones para la autoridad sanitaria y para las propias agrupaciones de pacientes. Cecilia Rodriguez, comentará los desafíos prácticos de avanzar en Chile implementando estas recomendaciones, en base a la experiencia como representante de agrupaciones de pacientes que debe lidiar con la burocracia del sistema de salud. Migdalia Denis, comentará el caso chileno, destacando aquellos elementos que resultan transferibles a otras jurisdicciones, ejemplificando esta transferabilidad con casos reales. Además, propondrá la generación de un decálogo de recomendaciones para la participación de pacientes en proceso de cobertura para Latinoamércia y Caribe.
Discussion Leader
Migdalia Denis, MA
Sociedad Latina de Hipertensión Pulmonar, Plantation, FL, USA
Manuel Antonio Espinoza, MD MSc PhD
Pontificia Universidad Católica, Santiago, Chile
Manuel Espinoza is Associate Professor in the Department of Public Health and Chief of the Health Technology Assessment Unit, both at Pontificia Universidad Católica de Chile. He is also Visiting Honorary Fellow in the Centre for Health Economics at University of York and Consultant for the Interamerican Bank of Development. He has served as advisor and consultant for several public entities in Latin America as well as institutions such as the World Bank and World Health Organization. Manuel holds a medical doctor degree and Master in Epidemiology both from Pontificia Universidad Católica de Chile; a Master in Biostatistics from Universidad de Chile, and Master and PhD in Health Economics, both from University of York in the UK. Manuel´s work has been focused on the development of methods and processes for prioritization in health care as well as applied research in health economic evaluation.
Cecilia Rodriguez, MPH
Fundación Me Muevo, Santiago, Chile
HEALTH TECHNOLOGY ASSESSMENT STUDIES
HT3: BASE DE COSTOS UNITARIOS EN SALUD EN ARGENTINA- UNA FUENTE DE INFORMACIÓN CONTINUAMENTE ACTUALIZADA PARA EVALUACIONES ECONOMICAS Y ANALISIS DE IMPACTO PRESUPUESTARIO EN UN SISTEMA DE SALUD FRAGMENTADO
9:00AM - 9:15AM
Palacios A1 , Balan D 2 , Garay OU1 , Mena M1 , Souto A1 , Augustovski F1 , Pichon-Riviere A1 1 Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina, 2 Institute for Clinical Effectiveness and Health Policy (IECS), CABA, Argentina
OBJECTIVES METHODS RESULTS CONCLUSIONS
HT1: TRANSFERIBILIDAD DE LAS EVALUACIONES ECONOMICAS PARA LA TOMA DE DECISIONES- UNA REVISION DE REVISIONES SISTEMATICAS
8:30AM - 8:45AM
Mezones-Holguin E 1 , Helguero-Santin LM2 , Cordova-Agurto J2 , Burela-Prado PA3 , Peralta-Aguilar V3 , Fiestas F3 1 Universidad San Ignacio de Loyola, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, LIM, Peru, 2 Universidad Nacional de Piura, Facultad de Ciencias de la Salud, Piura, Peru, 3 Seguro Social en Salud (EsSalud), Instituto de Evaluación de Tecnologías Sanitarias e Investigación (IETSI), Lima, Peru
OBJECTIVES: Revisar los posicionamientos, aproximaciones y herramientas para valorar la transferibilidad de los resultados de evaluaciones económicas en salud (EE) en el marco de la evaluación de tecnologías sanitarias (ETS). METHODS: Llevamos a cabo una revisión de revisiones sistemáticas (RS). Incluimos RS que evaluaron artículos primarios acerca de metodologías, herramientas o guías para realizar trasferencia de EE. Realizamos una búsqueda sin restricción de idioma hasta diciembre del año 2018 en PubMed-MEDLINE, EMBASE, WOS y EconLit. Asimismo, identificamos otras RS potencialmente elegibles a través de la revisión del listado de referencias de las RS seleccionadas para lectura a texto completo. La valoración de la calidad la realizamos con R-AMSTAR. La selección, evaluación de calidad y extracción fueron dobles ciegas e independientes con participación dirimente. RESULTS: Identificamos 819 registros en la búsqueda primaria, removimos 101 duplicados. A partir de 718 resúmenes tamizamos 40 artículos evaluación a texto completo, tras ello incluimos cuatro RS: Goeree et al., (2011), Drummond et al., (2009), Goeree et al., (2007) y Sculpher et al. (2004). La RS obtuvieron entre 25 y 34 puntos en el R-AMSTAR. Las RS reportaron diferentes herramientas para evaluar la transferibilidad de una EE a un contexto particular. No obstante, identificamos un patrón de evaluación secuencial en dos secciones: primero, la selección de los estudios transferibles sustentado en la validez y confiabilidad; y segundo, la evaluación de la variabilidad de los elementos de las EE entre la jurisdicción original y la receptora. Finalmente se define si una determinada EE se puede transferir, adaptar o no aplicar para un contexto específico. CONCLUSIONS: La valoración de la transferibilidad de las EE en la ETS requiere la implementación de procesos con participación multidisciplinaria que incorporen la apreciación crítica de la calidad y la evaluación de la variabilidad entre el contexto original y el receptor.
HT2: DISEÑO E IMPLEMENTACIÓN DE UN PROCESO DE INVOLUCRAMIENTO ACTIVO DE ACTORES RELEVANTES EN UNA AGENCIA DE EVALUACIÓN DE TECNOLOGÍAS SANITARIAS DE ARGENTINA
8:45AM - 9:00AM
Klappenbach R 1 , Pichon-Riviere A2 , Garcia Marti S2 , Augustovski F3 , Alcaraz OA4 1 Institute for Clinical Effectiveness and Health Policy (IECS), Ciudad Autónoma de Buenos Aires, B, Argentina, 2 Institute for Clinical Effectiveness and Health Policy (IECS), Ciudad Autonoma de Buenos Aires, B, Argentina, 3 Institute for Clinical Effectiveness and Health Policy, Buenos Aires, B, Argentina, 4 Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
OBJECTIVES: METHODS: RESULTS: CONCLUSIONS:
HT4: EXPERIENCIAS INTERNACIONALES ACERCA DE LOS CRITERIOS DE DECISIÓN USADOS EN LA PRIORIZACIÓN DE LAS TECNOLOGÍAS DE SALUD
9:15AM - 9:30AM
Moreno-Calderón A 1 , Buitrago-Díaz C2 , Eslava-Schmalbach J2 , Díaz Rojas JA2 1 Universidad Nacional de Colombia, Bogotá, CUN, Colombia, 2 Universidad Nacional de Colombia, Bogotá, Colombia
OBJECTIVES: Los sistemas de salud enfrentan la necesidad de implementar estrategias racionales, eficientes y transparentes para la priorización de los recursos escasos, basadas en criterios relevantes a las necesidades de la población. Este estudio identifica los criterios y su importancia relativa utilizados en procesos de priorización para la inclusión de nuevas tecnologías de salud en planes de beneficios. METHODS: Se realizó una revisión sistemática de la literatura en Embase, Medline, WebOfScience, Econlit y Cochrane. Se seleccionaron artículos relacionados con procesos de priorización que involucraban múltiples criterios relacionados con la decisión de incluir tecnologías en planes de beneficios, desde 2008 hasta 2018. La selección de los artículos y la extracción de los datos fueron realizadas por los revisores de forma independiente, siguiendo la metodología Cochrane. Los criterios encontrados se agruparon usando el marco de EVIDEM (10 edición), se midió la frecuencia de su aparición y, además, se estableció un ranking de criterios a partir de los estudios que evaluaron la importancia relativa. RESULTS: Se identificaron 1776 artículos, de los cuales 49 fueron seleccionados para su evaluación. Se observó una amplia heterogeneidad en la definición de los criterios, se identificaron 382 términos diferentes. Mediante el marco EVIDEM los criterios se clasificaron en 21 categorías, siendo las más frecuentes las siguientes: prioridades de población y acceso 13,0% (61), eficacia comparativa 12,8% (60), capacidad del sistema y uso apropiado de la intervención 11,3% (53), gravedad de la enfermedad 8,5% (40), costo de la intervención 7,0% (33) y calidad de la evidencia 6,8% (32). De acuerdo a su nivel de importancia en los estudios, el ranking de las categorías fue: 1) efectividad comparativa, 2) prioridades y acceso de la población, 3) gravedad de la enfermedad, 4) tamaño de la población afectada y 5) capacidad del sistema y uso apropiado de la intervención. CONCLUSIONS: Este estudio proporciona una visión general tanto de los criterios utilizados como de su importancia relativa para priorizar tecnologías de salud; además, apoya la toma de decisiones, el establecimiento de prioridades y la asignación de recursos.
CARDIOVASCULAR & DIABETES STUDIES
CV2: MODELO PREDICTIVO DEL RIESGO DE MUERTE EN PACIENTES DIABETICOS APLICADO EN UNA COMPAÑIA DE ASEGURAMIENTO EN SALUD DE COLOMBIA
8:45AM - 9:00AM
Garcia Rojas D 1 , Morales Florez J1 , Montoya Jaramillo YM2 , Estrada Acevedo F3 , Diazgranados Ojeda DI4 1 EPS y Medicina Prepagada Suramericana S.A., Medellin, ANT, Colombia, 2 EPS y Medicina Prepagada Suramericana S.A., Medellín, Colombia, 3 Seguros de Vida Suramericana S.A., Medellin, Colombia, 4 Consultoría en Gestión de Riesgos Suramericana S.A.S, Medellín, Colombia
OBJECTIVES Según la Organización Mundial de la Salud, la diabetes fue responsable de 1.600.000 muertes en 2015. Asimismo, la prevalencia mundial de diabetes en personas mayores de 18 años ha aumentado, especialmente en países de ingresos medianos y bajos. Este estudio implementó un modelo predictivo aplicado a pacientes diabéticos, identificando el riesgo de muerte. METHODS Se realizó un estudio transversal con información retrospectiva (enero 2012 a junio 2017) con variables medidas en el último año de exposición. Para estimar el riesgo de muerte se desarrolló un modelo de regresión logística seleccionando las variables candidatas a ingresar mediante un análisis bivariado (p<0.05) y plausibilidad biológica. El entrenamiento se hizo con información administrativa y clínica de 57.261 diabéticos. Se validó el modelo con datos fuera de muestra de 69.671 pacientes diabéticos a junio 2017. RESULTS El modelo de regresión logística obtuvo un pseudo R2 de 36.2%. Con valores de OR entre 1.05 y 2.49, las categorías que aumentan el riesgo de muerte fueron: presión sistólica <120mmHg, creatinina alta, número de hospitalizaciones, presión sistólica fluctuante, sedentarismo, enfermedad cerebrovascular, EPOC, fluctuaciones del índice de masa corporal (IMC) (<18.5 y >24.9), no tener registro de hemoglobina, ser insulino-dependiente, número de urgencias, número de días en UCI, hemoglobina alta, edad, no tener registro de creatinina. Por su parte, con valores de OR entre 0.53 y 0.96, las categorías que disminuyen el riesgo de muerte fueron: cumplir consultas anuales de nutrición, cumplir consultas odontológicas anuales, pertenecer al Programa de Protección Renal, citas con endocrinólogo, cumplimiento consultas médicas de riesgo cardiovascular, IMC >=25, cumplimiento consultas de medicina interna, citas con médico general. CONCLUSIONS La capacidad del modelo para predecir las muertes en diabéticos es del 63.6% (sensibilidad). Además, tiene una capacidad de detectar individuos vivos del 85.8% (especificidad). Estos resultados son importantes para la gestión del riesgo en salud.
CV1: CARDIOVASCULAR RISK IN DIABETES PATIENTS MONITORED BY A MOBILE--PHONE APP HEALTH CARE PROGRAM IN BRAZIL
8:30AM - 8:45AM
Picoli R 1 , Braga C2 , Costa AL1 1 University of São Paulo, Ribeirão Preto, Brazil, 2 University of São Paulo, Ribeirão Preto, SP, Brazil
OBJECTIVES Diabetes requires a variety of strategies to promote glycemic control and avoid complications. Recently, apps are being used to promote, manage and provide medical and healthcare education. By the way, the mobile phone is used to support healthcare and public health interventions, also are a useful and easy method for collection of data for healthcare research. In addition, apps have shown successful use of support telemedicine and remote healthcare in developing nations. This study aims to assess the prevalence of the cardiovascular risk factors in a group of diabetic patients monitored by a mobile phone app health care program. METHODS The mobile phone app health care program is available for Android and IOS system, patients followed up is done through a specialized telephone monitoring center, made up of a physician, nurses, nutritionists, and psychologists, which provide constant monitoring and guidance health actions. A cross-sectional descriptive study was conducted in 63,955 patients monitored by mobile phone app health care program. The number of patients with diabetes totalized 6,983 (10,92%), then data were collected considering patients with 45 years or older. The cardiovascular risk factors analyzed was smoking, cholesterol and systolic and diastolic blood pressure. RESULTS The majority of the patients (52.94%) were female, average patient age was 55.40 years for female and 54.67 for male. The overall prevalence for uncontrolled cholesterol (more than 180 mg/dl) was 27,45% (female) and 17,65%. In addition, the average systolic/diastolic blood pressure (mmHg) was 129,33/84,29 (female) and 123,17/77,58 (male). The cardiovascular risk factor smoking was 3,11% (female) and 2,97% (male). CONCLUSIONS The results of this study, considering the useful and easy method (mobile phone app health care program) for collection data can facilitate and improve the way of chronic diseases management. For that reason, it could be used to support healthcare and public health interventions.
CV4: EVALUACION DE LOS MOTIVOS DE LA OMISION DE RETIROS DE MEDICAMENTOS PENDIENTES EN LA OFICINA DE FARMACIA. POSIBLES SOLUCIONES
9:15AM - 9:30AM
Lalin M 1 , Nogués S2 1 Universidad J.F.Kennedy, Boedo, Argentina, 2 Universidad John F Kennedy, CABA, B, Argentina
OBJECTIVES Evaluar los motivos de la omisión de retiro de medicamentos en farmacias argentinas y posibles soluciones a la problematica para reducir costos. METHODS Se realizó una encuesta piloto en 100 pacientes de dos farmacias de Argentina ubicadas en la Provincia de Buenos Aires, la misma fundamentalmente busco las causas de la problemática del incumplimiento no intencionado secuencial ( INIS ), y simultaneamente se realizó un sondeo, determinando posibles acciones de reducción. RESULTS De la encuesta surge hasta un 22% (± 3%),al olvido por parte del paciente, la espera y falta de los medicamentos en la farmacia. Se notó una disminución del INIS con la intervención farmacéutica por medio de llamados, utilización de aplicaciones y/o mail, con una aceptación del 91%, 70 % y 36 %. CONCLUSIONS Notamos que la disminución del INIS es el resultado positivo por la utilización de llamados, APPs, mails, la reformulación de la atención y dispensa de las farmacias. Esto además traería con el tiempo la reducción de comorbilidades y gastos generalmente sub valuados asociadas al INIS.
CV3: COST-EFFECTIVENESS OF A COMPREHENSIVE INTERVENTION FOR HYPERTENSION CONTROL IN LOW-INCOME SETTINGS IN ARGENTINA- A MARKOV MODEL
9:00AM - 9:15AM
Shi L 1 , Yin L2 1 Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA, 2 Tulane University School of Public Health and Tropical Medicine, Pasadena, CA, USA
OBJECTIVES: METHODS: RESULTS: CONCLUSIONS:
8:30 - 14:00
POSTER & EXHIBIT HALL HOURS
RESEARCH POSTER PRESENTATIONS – SESSION 2
9:30 - 10:00
BREAK, EXHIBITS AND RESEARCH POSTER PRESENTATIONS VIEWING - SESSION 2
10:00 - 11:45
WELCOME AND SECOND PLENARY SESSION
WELCOME, ISPOR SERVICE AWARDS, AND RECOGNITION OF ISPOR COLOMBIA CHAPTER
Speaker
Federico Augustovski, MSc, PhD
Institute for Clinical Effectiveness and Health Policy, Buenos Aires, B, Argentina
Federico Augustovski es médico de la Universidad de Buenos Aires (UBA) galardonado con un diploma de honor. Se graduó de Máster en Ciencias en Epidemiología en la Harvard School of Public Health y es doctor en Medicina con orientación en Salud Pública (UBA). Realizó cursos de posgrado y experiencias de formación e investigación en evaluaciones económicas y ciencias de la decisión en distintos centros internacionales como la Universidad de York, la Universidad de Texas, y el Baylor College de Medicina de Houston, Estados Unidos. Actualmente, se desempeña como director del Departamento de Evaluación de Tecnologías Sanitarias y Economía de la Salud del Instituto de Efectividad Clínica y Sanitaria, y como profesor adjunto de Salud Pública de la Facultad de Medicina de la UBA. Es investigador del Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina.
En 2017, fue elegido presidente de la Sociedad Internacional de Farmacoeconomía e Investigación de Resultados (ISPOR), el primero en no proceder de Norteamérica o Europa. Es el director del Centro Colaborador OMS/OPS de Evaluación de Tecnologías Sanitarias, y del Centro PROVAC de Argentina para la excelencia en evaluaciones económicas y la toma de decisiones en inmunizaciones. También es médico de familia (se desempeñó como médico de planta de la Unidad de Medicina Familiar y Preventiva del Hospital Italiano de Buenos Aires durante algo más de 20 años) y es director de los cursos de Análisis de Decisiones Sanitarias, de Desarrollo de Cuestionarios en Salud, Evaluaciones Económicas y Sanitarias, Evaluaciones de Tecnologías Sanitarias, y Modelos de Decisión I y II de la Maestría en Efectividad Clínica de la UBA. Fue el primer editor en jefe de la revista Value in Health Regional Issues (hasta diciembre de 2017), publicación con revisión de pares de economía de la salud e investigación de resultados indizada en MEDLINE, y es uno de los fundadores del Consorcio ISPOR para América Latina.
Ha coordinado diversos proyectos académicos y de investigación en el área de la evaluación de tecnologías sanitarias y las evaluaciones económicas en Argentina, Bolivia, Brasil, Chile, Colombia, México, Perú, y Uruguay. Cuenta actualmente con más de 80 publicaciones indizadas en MedLine.
SECOND PLENARY SESSION- VALUE MEASUREMENT IN 2020- MOVING FORWARD IN LOW- TO MIDDLE-INCOME COUNTRIES
Based on the delivery model of value-based healthcare, “value” is determined by measuring health outcomes against the cost of delivering the outcomes. However, value measurement in health involves some important decisions about what to measure and how. Which key outcomes determine how the efficiency of a health system should be measured? How can the perspectives of all stakeholders be incorporated, thus making patients and providers partners in healthcare decisions? And, how can patients’ access to innovation be effectively managed so that it adds value and improves health system efficiency?
In the session entitled “Value Measurement in 2020: Moving Forward in Low- to Middle-Income Countries,” panelists will present different approaches to increase efficiency in health systems and improve access to patients.
Moderators
Mariana Barraza Llorens, MSc
Blutitude Healthcare Intelligency, Mexico City, Mexico
Since 2015, she has been engaged in consulting projects. She is founding partner of Blutitude, providing consulting services specialized in health policy, planning and strategy, priority-setting and health technology assessment.
She holds a degree in Economics from the Instituto Tecnológico Autónomo de México (ITAM) and a Master of Science in Health Economics from the University of York, United Kingdom. From 2014 to 2015, she was Policy Advisor to the Deputy Minister of Health in Mexico. Prior to this position, she was Coordinator of the Pharmaceutical Policy Studies Center at the Mexican Health Foundation (Funsalud).
She has also worked as Advisor to the Director of Finance of the Mexican Institute of Social Security and has collaborated with the Mexican Ministry of Health for almost ten years in different areas, including her position as Deputy Director General of Financing Policies in the Economic Analysis Unit. She has been involved in several projects related to the health system, including the 2003 reform of the General Health Law that created the System of Social Protection in Health (Seguro Popular), and the development of pharmaceutical policy proposals.
She has also worked as Research Fellow at the York Health Economics Consortium (University of York), and as a consultant for the Inter-American Development Bank, the World Bank, the Pan American Health Organization and Funsalud.
Speakers
Hector Castro, MD, MSc, PhD
Management sciences for Health, Washington, DC, USA
Doctor in Medicine and Surgery, MSc in Health Policy, Planning and Financing from the London School of Hygiene & Tropical Medicine (LSHTM) joint degree with the London School of Economics & Political Science (LSE), Specialized in Health Management and previous MSc in Occupational Health (Public Health Branch). Doctor in Public Health & Policy/Health Economics from the University of London (LSHTM). Former Takemi Postdoctoral Fellow at the T.H. Chan Harvard School of Public Health.
Broad professional experience (20 years) as Chief Officer, Technical Advisor, Director and Manager in Strategic Planning, Quality Assurance, Health, Safety and Environment for Pharmaceutical and Health Insurance and Non-Governmental Organizations. Main focus of work has been on health systems` strengthening in areas such as quality assurance, assessment, strategic purchasing and provision of healthcare technologies (including medicines, devices and procedures).
More than ten years as international consultant in health care access, health economics, health policy, priority setting, health technology assessment (HTA) and health systems´ reform, familiar with and relevant experience in health systems and markets in Low and Middle Income Countries- LMICs. Previous working experience includes: the US, United Kingdom, Colombia, Ecuador, Ukraine, Belarus, Thailand, Kenya, Peru, Costa Rica, Brazil, Mexico, United Arab Emirates, Uganda, Chile, Turkey and Tunisia. Experience also as a researcher and lecturer for undergraduate and post graduate students in ivy league institutions in Latin America, the US and United Kingdom.
Former funding Chief Executive Director of the HTA Institute of Colombia (IETS) and Director of Medicines & Technologies at the Ministry of Health and Social Protection of Colombia. Currently is Global Leader of Health Financing, Technologies, Data and Impact at Management Sciences for Health (MSH) in Washington D.C area. Starting June 2018 and until 2021, Doctor Castro serves at the board of directors of the Health Technology Assessment International- HTAi one of the most prominent international networks in the field of HTA.
Cristina Gutierrez Delgado, PhD
Economic Analysis Unit, Mexican Ministry of Health, Mexico City, Mexico
Cristina is an actuary specialized in health and disability insurance. She obtained her PhD in disability insurance from Heriot-Watt University in Edinburgh, Scotland. Cristina has developed work in different topics of the health sector since 1993.She has work at the Mexican Ministry of Health, the Mexican Institute of Social Security, the Genetics and Insurance Research Centre in Edinburgh Scotland, El Colegio de Mexico and the National University of Mexico.
Her professional interests are centered in the role of the actuarial, economic and financial modeling in the provision of health services and in the development of public health insurance schemes. Cristina develops and directs projects under interdisciplinary environments and also collaborates in projects for providing technical evidence for diverse aspects of the health services provision.
She is adviser in health economics and strategic planning for the Mexican Minister of Health, the Mexican Institute of Social Security, the General Health Council, the National Immunization Council, the National Centre for the Prevention and Control of HIV/AIDS, the National Transplant Centre and the National Commission of Social Protection in Health (Seguro Popular de Salud) among other public institutions of the health sector in Mexico.
Cristina has published over 20 works in actuarial, economic, medical and public health journals and has supervised over 30 thesis specialized in health issues for first degree on Actuarial Sciences. At present Cristina is Principal Researcher of the National Project to Estimate Social Values for the Mexican Population under the EuroQol Protocol. She is member of the following organizations: the International Society for Pharmaco-economics and Outcome Research (ISPOR), chapter México and the International Health Economics Association (iHEA).
Analia Lopez, MD, MSc
Ministry of Health and Social Development, Argentina, Buenos Aires, Argentina
WELCOME FROM ISPOR LATIN AMERICA CONSORTIUM EXECUTIVE COMMITTEE CHAIR
Speaker
Diego Rosselli, MD, MEd, MHP
Pontificia Universidad Javeriana, Medical School, Bogota, Colombia
Diego Rosselli is a Colombian neurologist trained at the London Institute of Psychiatry. He began his academic career as a neuroscience teacher. After obtaining his Master’s degree in Education in Harvard in 1993, he joined the Colombian Ministry of Health as Director for Scientific and Technological Development in charge of performing health technology assessments. He then obtained a second master's degree in Health Policy at the London School of Economics. Since then (1997), he has been teaching Health Economics at the Universidad Javeriana, in Bogotá. Rosselli has authored 7 books and more than 100 scientific articles in many aspects of clinical epidemiology, real-world evidence and health economics. He has lectured in pharmacoeconomics in 17 Latin American countries. He is currently the 2018-2020 Chair of the ISPOR Latin America Consortium Executive Committee and Colombia Chapter past president.
2021 LATIN AMERICA CONFERENCE ANNOUNCEMENT
Speaker
Ramiro Gilardino, MD
ISPOR, Lawrenceville, NJ, USA
Cesar Alberto Cruz Santiago, MD MSC PHD
National Health Council, mexico, DF, Mexico
11:45 - 13:15
LUNCH, EXHIBITS AND RESEARCH POSTER PRESENTATIONS VIEWING - SESSION 2
12:15 - 13:15
EDUCATIONAL SYMPOSIUM
THE CLINICAL AND ECONOMIC VALUE OF EMERGING GENE THERAPY FOR SPINAL MUSCULAR ATROPHY
Spinal Muscular Atrophy (SMA) is a progressive monogenic neurologic disease caused by bi-allelic deletion or mutation in the survival motor neuron 1 (SMN1) gene, resulting in the irreversible loss of motor neurons. Patients with SMA develop motor neuron loss, muscle weakness, respiratory failure, and are frequently hospitalized early in life. Furthermore, SMA is associated with a poor quality of life, significant caregiver burden, and early mortality. Novel gene therapies for ultra-rare diseases such as SMA attempt to address the genetic root cause of the disease. Gene therapy (GT) for SMA is designed for sustained expression of SMN protein allowing for rapid onset and durable therapeutic effect since it targets non-dividing neurons. However, these kinds of therapies require medical and payer education and different evaluation and valuation approaches compared to conventional pharmaceuticals; and new valuation models and philosophies are needed to harness the high pace of innovation. The evaluation and valuation of gene therapy for rare conditions with a large unmet need are probably amongst the most challenging decisions that medical and Health Technology Assessment (HTA) bodies currently face and the lack of standardized evaluation methodologies for GTs provide challenges and require innovative solutions. This panel will address different approaches to clinical and economic data collection and evaluation.
Sponsor
AveXis
Moderators
Omar Dabbous, MD, MPH
AveXis, Inc., Bannockburn, IL, USA
Speakers
Juliana Gurgel-Giannetti, MD, PhD
Hospital das Clínicas da UFMG, Belo Horizonte, Brazil
Sean D. Sullivan, PhD, MSc, RPh
University of Washington, Seattle, WA, USA
13:00 - 14:00
RESEARCH POSTER AUTHOR DISCUSSION HOUR - SESSION 2
13:15 - 14:15
ISPOR FORUMS
ISPOR LATIN AMERICA CONSORTIUM PUBLICATIONS COMMITTEE- MOVING TOWARDS A VALUE BASED HEALTHCARE- FOCUSING ON VALUE VERSUS VOLUME
The increasing costs of the healthcare system are stimulating several initiatives that can bring new innovative management practices for the Latin American (LA) Healthcare Systems. One approach is Value based healthcare where the focus shifts from discussing volume of use and its costs to the value we can bring to the patients. While the concept of value is not agreed by all stakeholders, increasingly, our region is testifying concrete cases of value based care, even as risk sharing agreements for drugs. The goal of this forum is to discuss what are the definitions of value being used in the region, and bring concrete cases being implemented in the LA region.
13:30 - 14:30
EDUCATIONAL SYMPOSIUM
MANAGED ENTRY AGREEMENTS - A HEALTH POLICY MECHANISM TO RECONCILE ACCESS TO INNOVATION WITH HEALTH CARE SYSTEM SUSTAINABILITY
With increasing pressure to reconcile universal coverage with access to innovative therapies, countries are struggling in finding viable policy solutions. Managed Entry Agreements (MEAs) have been implemented in Low and middle income countries in an attempt to address this policy issue. This symposium will provide insights from experts representing 3 different perspectives, Academia : MEAs rationale, taxonomy and success implementation cases in LMIC, Industry: Enabling factors for successful implementation and Multilateral organization – WB : Building trust among private, public and civil society stakeholders to improve access to innovation, healthcare outcomes and financial sustainability. FIFARMA will moderate the session followed by a discussion with the attendees.
Sponsor
Federación Latinoamericana de la Industria Farmacéutica A.C. (FIFARMA)
Moderators
Rafael Diaz-Granados, JD
Federación Latinoamericana de la Industria Farmacéutica A.C. (FIFARMA), CIUDAD DE MEXICO, Mexico
Speakers
Hector Castro, MD, MSc, PhD
Management sciences for Health, Washington, DC, USA
Doctor in Medicine and Surgery, MSc in Health Policy, Planning and Financing from the London School of Hygiene & Tropical Medicine (LSHTM) joint degree with the London School of Economics & Political Science (LSE), Specialized in Health Management and previous MSc in Occupational Health (Public Health Branch). Doctor in Public Health & Policy/Health Economics from the University of London (LSHTM). Former Takemi Postdoctoral Fellow at the T.H. Chan Harvard School of Public Health.
Broad professional experience (20 years) as Chief Officer, Technical Advisor, Director and Manager in Strategic Planning, Quality Assurance, Health, Safety and Environment for Pharmaceutical and Health Insurance and Non-Governmental Organizations. Main focus of work has been on health systems` strengthening in areas such as quality assurance, assessment, strategic purchasing and provision of healthcare technologies (including medicines, devices and procedures).
More than ten years as international consultant in health care access, health economics, health policy, priority setting, health technology assessment (HTA) and health systems´ reform, familiar with and relevant experience in health systems and markets in Low and Middle Income Countries- LMICs. Previous working experience includes: the US, United Kingdom, Colombia, Ecuador, Ukraine, Belarus, Thailand, Kenya, Peru, Costa Rica, Brazil, Mexico, United Arab Emirates, Uganda, Chile, Turkey and Tunisia. Experience also as a researcher and lecturer for undergraduate and post graduate students in ivy league institutions in Latin America, the US and United Kingdom.
Former funding Chief Executive Director of the HTA Institute of Colombia (IETS) and Director of Medicines & Technologies at the Ministry of Health and Social Protection of Colombia. Currently is Global Leader of Health Financing, Technologies, Data and Impact at Management Sciences for Health (MSH) in Washington D.C area. Starting June 2018 and until 2021, Doctor Castro serves at the board of directors of the Health Technology Assessment International- HTAi one of the most prominent international networks in the field of HTA.
Louis P. Garrison, PhD
Consultants in Global Health, Seattle, WA, USA
Jens Grueger, PhD
F. Hoffmann-LaRoche, Division Pharma, Basel, Switzerland
14:45 - 15:45
BREAKOUT SESSION 5
MULTIMORBILIDAD- EL DESAFÍO DE LOS SISTEMAS DE SALUD Y SUS FORMAS DE ENFRENTARLO
ISSUE
: As populations become older, Multimorbidity (MM), the coexistence of 2 or more chronic conditions, has been positioned as one of the main challenges for health systems. However, in LA, MM is yet an unknown phenomenon, due to the lack of measurement as well as the absence of, an effective and value based, care model. In the world, several approaches are being made regarding MM. Thus, multimorbidity itself is being used as a risk stratification measurement to tailor clinical care and, also, to allocate financial resources in a risk adjusted manner. It is urgent for LA health services to get on board with this challenging issue.
OVERVIEW
: This panel will discuss about the state of knowledge of MM in Latin America, as well as its burden in health services. It will focus on value- based care model using population risk stratification. It is addressed to decision makers as well as clinicians. Dr. Espinoza will moderate and expose the prevalence of MM in Chile and will expand on the capacity for the Chilean Health System to cope with this phenomenon. Dr. Anríquez will expose the real burden of MM on health services at all levels and expose new tools for population risk stratification based on MM. Paula Zamorano will focus on value- based care model to manage MM, as she will expose an innovative MM model been carried by her team at the Center of Health Innovation-PUC. Dr. Abel Castaño will address Colombia´s actual state regarding multimorbidity and its financial burden to the system, as well as innovations on health in the Colombian scenario.
Moderators
Manuel A. Espinoza, MD, MSc, PhD
Catholic University of Chile, Santiago, Chile
Manuel Espinoza is associate professor in the Department of Public Health and Chief of the Health Technology Assessment Unit, both at Pontificia Universidad Católica de Chile. He is also visiting honorary fellow in the Centre for Health Economics at University of York and Consultant of the Interamerican Bank of Development.
Manuel holds a medical doctor degree and master in epidemiology both from Pontificia Universidad Católica de Chile, a master in biostatistics from Universidad de Chile, and master and PhD in Health Economics, both from University of York in the UK. Manuel´s work has included the development of methods and processes for prioritization in health care as well as applied research in health economic evaluation of healthcare technologies. After running the first exercise of MCDA to support the update of the health benefit plan in the Dominican Republic, Manuel has run MCDA workshops in Mexico, Ecuador, Colombia, and Argentina to explore the potential use of this type of analysis in health priority settings in the region.
Panelists
Samanta Anriquez, MD MSc Public Health Specialist
Pontificia Universidad Catolica de Chile, SANTIAGO, Chile
Ramon Castaño, MD MSc PhD
Organization for Excellence in Health, Colombia, Bogotá, Colombia
Paula Zamorano, PT MHA
Health Innovation Center, SANTIAGO, Chile
IMPLEMENTAÇÃO DE UMA UNIDADE DE PRÁTICA INTEGRADA (IPU) E MODELO DE PAGAMENTO BASEADO EM VALOR PARA O MANEJO DO CICLO DO CUIDADO ACIDENTE VASCULAR CEREBRAL
ISSUE:
A epidemiologia global de acidente vascular cerebral (AVC) está mudando rapidamente. Se, por um lado, a mortalidade está reduzindo, por outro lado, a prevalência e morbidade estão aumentando, o que faz do AVC a segunda maior causa de perda de qualidade de vida em países em desenvolvimento. A criação de Unidades de Prática Integradas (IPU, Integrated Practice Units) para a gestão de pacientes que apresentaram AVC é capaz de melhorar substancialmente o impacto da morbidade da doença bem como prevenir novos episódios. Além disso, a coleta sistemática dos dados seguida da análise de custos e desfechos, permite aprimoramento da gestão e proposição de modelos inovadores de reembolso. Para esta mesa, e baseado na experiência dos panelistas, foram definidos três tópicos principais para a implementação de IPU no AVC e para modelos de pagamento baseado em valor: 1) Sensibilizando executivos e gerindo suas expectativas quanto aos resultados; 2) Implementando um time exclusivo para coleta e análise dos dados (value measurement team); 3) Informando resultados baseado em valor e lidando com interesses de diferentes stakeholders.
OVERVIEW:
Este painel discutirá um caso bem-sucedido de IPU em acidente vascular cerebral (Hospital São José e Neurológica) no Brasil e trará percepções sobre como replicar este caso nos países da América Latina. Bruno Riveros moderará o painel e trará uma visão geral das IPUs e modelos de pagamento atualmente empregados no Setor de Saúde na América Latina e levantará questões fundamentais para os panelistas: Quais são os benefícios e como superar as dificuldades na implementação de uma IPU para AVC? Quais são os principais custos e resultados do AVC a serem coletados? Quais são os indicadores mais relevantes de valor para executivos e gerentes? Como evoluir para acordos de compartilhamento de risco baseados em desempenho, considerando tecnologias e serviços para o AVC? Quais são os stakeholders mais sensíveis ao tema? (5 min) Pan1 relatará sua experiência na criação e participação de uma IPU de AVC, guiada pelas questões elaboradas nesta forma (15 min); Pan2 oferecerá insights sobre a definição de valor em AVC e quais resultados e custos são relevantes para o processo (15 min); Pan3 discutirá os movimentos estratégicos de prestadores, pagadores e fornecedores em direção aos acordos de compartilhamento de risco em torno do ciclo de atendimento do AVC (15 min). Haverá 10 minutos para discutir os tópicos propostos com o público. Os stakeholders que se beneficiarão do tema discutido nessa mesa são aqueles buscando insights para implementar IPU, acordos de reembolso inovadores ou outras medidas de atividades baseadas em valor.
Moderators
Bruno S Riveros, PhD
MAPESolutions, Sao Paulo, Brazil
Panelists
Pedro Magalhães, MD
Neurologica; Hospital São José, Joinville, Brazil
Marcia Makdisse, MD, PhD, MBA
Hospital Israelita Albert Einstein, SAO PAULO, SP, Brazil
Marcelo Eidi Nita, MD, MSc, PhD
MAPESolutions, São Paulo, Brazil
EPIDEMIOLOGY & PUBLIC HEALTH STUDIES
EP4: HOW IS SELF-PERCEIVED HEALTH STATUS (EQ-5D) ASSOCIATED WITH SOCIOECONOMIC CONDITIONS IN 22 LATIN AMERICAN COUNTRIES?
3:30PM - 3:45PM
Cabieses B 1 , Darrigrandi F2 , Ortiz M3 , Zarate V4 1 Universidad del Desarrollo, Santiago, Chile, 2 Universidad Adolfo Ibañez, Santiago, Chile, 3 Universidad de la Frontera, Temuco, Chile, 4 Universidad de los Andes, Santiago, RM, Chile
OBJECTIVES The measurement and valuation of health-related quality of life is as an integral part of assessment processes of health interventions. EQ-5D 3L is one of the most widely used instrument in the world given its simplicity, high level of validity, low cost and large availability of language translations. Little is known about how self-perceived health status (SPHS) is influenced by socioeconomic factors in Latin America. We aimed to analyse this relationship in 22 countries of the region. METHODS Using the Gallup World Survey dataset 2007-2008 that contained 22 Latin American countries, we analysed the association between SPHS (EQ-5D, dichotomous variable that took value 1 if respondent had at least one health problem in any of the five dimensions) and a number of socioeconomic variables (household income, individuals living on less than $2/day and $1.25/day, perception of the national economy, standard of living, standard of living better, not enough money for food, not enough money for shelter, having a saving account, educational level), adjusted by country-level development indicators clustered into 5 categories (Human Development Index (HDI), Gini coefficient of inequality, percentage of rural population, and average life expectancy). Multivariate regressions were conducted using Stata 12.0. RESULTS We found a significant association between SPHS and most socioeconomic factors, including household income, being dissatisfied with current standard of living (OR=1,5), feelings of not improving the standard of living at present time (the same standard OR=1,2; getting worse OR=1,6), and not having enough money for food (OR=1,4). All categories showed a protective effect for poor quality of life compared to cluster 1, which represents countries low HDI level, high GINI level and medium rural population percentage. CONCLUSIONS Quality of life is intimately related to socioeconomic conditions, both at household and country level independently. Improving countries economic and human development could impact of individual ́s quality of life.
EP1: SCHOOL ENVIRONMENT FACTORS ASSOCIATED WITH ADOLESCENTS BMI IN BRAZIL
2:45PM - 3:00PM
Balbinotto G1 , Menegotto G 1 , Cardoso LB2 1 ufrgs - universidade federal do rio grande do sul (Brazil), porto alegre, Brazil, 2 Universidade Federal de Goiás, Goiânia, Brazil
OBJECTIVES: : An increased number of studies evaluate the association of school environment and overweight in adolescents, contributing to identify the aspects that can be used to elaborate programs to prevent the growth of obesity epidemy. The aim of this study was to evaluate the association between overweight and school environment in adolescent students in Brazil METHODS: : Analysis were based on a representative national sample of 10.592 students of 13 to 17 years old, from the Brazilian National Survey oh School Health (PeNSE). Multilevel linear regression models were used to identify the association between the Body Mass Index (BMI), calculated with measured height and weight, and school environment characteristics (physical activity score, cafeteria environment score, implementation School Health Program (PSE)), adjusted for socio-demographic factors and school status (public or private). RESULTS: The BMI variation between schools, that represented 3,86% of the total BMI variation (within and between schools), dropped to 1,04% after the inclusion of individual control variables, and further to 0,90% in the final model, with school characteristics. Only the implementation of PSE’s actions was statistically associated with BMI (𝛽=-0,24;p=0,03); there was no association with food and physical education environment scores (𝛽=0,05;p=0,08 and 𝛽=-0,07;p=0,27, respectively). The model also included the level 1 controlled variables that were associated with BMI: female sex (𝛽=0,39;p=0,00), age (𝛽=0,44;p=0,00), students with graduated mothers (𝛽=0,48;p=0,00), having a job (𝛽=0,54;p=0,00), not having breakfast (𝛽=1,07;p=0,00) and at least one smoking parent (𝛽=0,21;p=0,03); the BMI was negatively associated with studying in public schools (𝛽=-0,27;p=0,04). CONCLUSIONS: This study identified that the Brazilian adolescents' BMI variation between schools is related to school factors, especially the implementation of PSE’s actions. More instruments should be developed to better capture school environments and its influence on adolescent obesity. In addition, further studies are needed to evaluate the PSE impacts on obesity prevention.
EP2: PUBLIC HEALTH AND ECONOMIC IMPACT OF A QUADRIVALENT HUMAN PAPILLOMAVIRUS VACCINATION PROGRAM FOR FEMALES AGED 9 YEARS IN EL SALVADOR
3:00PM - 3:15PM
Rendon AM 1 , Oranges C1 , Yen G2 , Pavelyev A3 , Monsanto H4 , Parellada C5 1 MSD Central America, Panama city, Panama, 2 Merck & Co., Inc., Kenilworth, NJ, USA, 3 XPE Pharma & Science, Brussels, Belgium, 4 Merck Sharp & Dohme IA LLC, Carolina, PR, USA, 5 MSD Brazil, São Paulo, SP, Brazil
OBJECTIVES METHODS RESULTS CONCLUSIONS
EP3: CARACTERIZACIÓN EPIDEMIOLÓGICA DE PACIENTES CON ARTRITIS REUMATOIDE ATENDIDOS EN SISTEMA GENERAL DE SEGURIDAD SOCIAL EN SALUD DE COLOMBIA.
3:15PM - 3:30PM
Fuentes JC
OBJECTIVES Realizar la caracterización epidemiológica de la población adulta con diagnóstico de artritis reumatoide (AR), afiliada al Sistema General de Seguridad Social en Salud colombiano (SGSSS). METHODS Se realizó un estudio descriptivo retrospectivo sobre los pacientes adultos con AR reportados a la Cuenta de Alto Costo (CAC) del 1º de Julio de 2017 al 30 de Julio de 2018, por parte de las Entidades Administradoras de Planes de Beneficios y demás Entidades Obligadas a Compensar en Colombia, de acuerdo con la Resolución 1393 del 2015. Los análisis se realizaron luego de la auditoría de los datos, mediante el cálculo de indicadores epidemiológicos para los pacientes activos dentro del SGSSS. Los análisis se realizaron en STATA V13 RESULTS Se evidenciaron 79.199 personas con AR, de las cuales 4.738 fueron casos incidentes. La edad media de los pacientes fue de 57,8 años (DE 13,3), con una razón hombre mujer de 1:5. La prevalencia de AR para la población afiliada fue de 0,23%; 0,33% para el régimen contributivo y 0,11% para el subsidiado. Los departamentos con mayor prevalencia fueron Bogotá D.C. (0,38%), Antioquia (0,30%) y Valle del Cauca (0,26%). Se observó una incidencia de 14,29 por 100.000 afiliados: 17,22 para el contributivo y 10,88 para el subsidiado. Los departamentos con mayor incidencia fueron Caquetá (34,21), Nariño (28,75) y Huila (26,69). La mortalidad no específica en esta población fue de 2,59 por 100.000 afiliados; 5,55 para el régimen contributivo y 2,24 para el subsidiado. Huila, Bogotá, D.C. y Risaralda tuvieron la mortalidad más elevada con 6,96, 6,77, y 5,60 casos por 100.000 habitantes, respectivamente. CONCLUSIONS Se evidenció una mayor carga en el régimen contributivo en términos de incidencia, prevalencia y mortalidad, con una concentración más elevada en departamentos de las regiones Pacífica, Central y Bogotá D.C.; las dos últimas con la mayor mortalidad observada.
HEALTH & INSURANCE RECORDS SYSTEMS
HI3: EVIDENCIA DE LA VIDA REAL EN ARGENTINA- TRATAMIENTO DE PACIENTES CON HEPATITIS C EN EL SISTEMA DE TUTELAJE DE TECNOLOGIAS SANITARIAS EMERGENTES (STTSE)
3:15PM - 3:30PM
Denamiel J
OBJECTIVES METHODS RESULTS CONCLUSIONS
HI1: PRELIMINARY COST ANALYSIS OF MISDIAGNOSIS OF RHEUMATOID ARTHRITIS
2:45PM - 3:00PM
Valencia O 1 , Castillo E2 , Villarreal L3 , Alvis-Zakzuk NJ4 , Santos-Moreno P3 1 Universidad de los Andes, Bogota D.C., CUN, Colombia, 2 Biomab, Center for Rheumatoid Arthritis, Bogota, Colombia, 3 Biomab, Center for Rheumatoid Arthritis, Bogota, CUN, Colombia, 4 Universidad de la Costa-CUC, Barranquilla, Colombia
OBJECTIVES: There is a lack of knowledge and training among general practitioners in Latin America for the assertive diagnosis of rheumatoid arthritis (RA), which leads to diagnostic errors with the respective cost overruns for health systems. The objective of the study was to quantify the costs of treatment in patients with a misdiagnosis of RA. METHODS: We analyzed 774 clinical records of patients with presumptive diagnosis of RA referred by insurers to a comprehensive care center in RA to confirm or rule-out the diagnosis. A strict screening protocol-process was applied to the patients that included the use of physical examination by rheumatologist, clinical records, serological markers and imaging (X-Ray, ultrasound and/or magnetic resonance imaging of hands/feet). The cost of treatment of the disease in the first year was based on the treat-to-target strategy; also, the treatment of the most frequent diagnosis found according to the management guideline was estimated. Costs were estimated in american dollars (USD) of 2018, using an exchange rate of 2,951 COP per dollar. RESULTS: After the screening protocol-process, 74.8% (579/774) of the patients were classified as having Osteoarthritis (OA), being the most frequent diagnosis. Only 21.8% (169/774) were confirmed to have RA and 3.3% were classified in other diagnoses. The cost per year of treatment per patient of the RA was $ 4,979.6 USD and for the OA of $ 483.6 USD. The additional cost of the 579 patients who had received treatment for RA if it has not been reclassified would be $ 28,551,879.60 USD per year. CONCLUSIONS: The correct diagnosis of RA performed through a protocol-process supported in a comprehensive evaluation, allows disease management, where patients receive the appropriate treatment for their condition without burdening unnecessary costs to insurers and in general to the health systems.
HI2: EVALUATION OF THE MEDICAL PROCEDURES ON AN ADMINISTRATIVE DATABASE TO IDENTIFY PATIENTS WITH SUSPECTED PRE-ECLAMPSIA IN THE BRAZILIAN PRIVATE HEALTHCARE SYSTEM
3:00PM - 3:15PM
Ho R 1 , Sebastião M2 , Carvalho J2 , D'Innocenzo M2 , Vassalli A2 , Nussbaum M2 1 Roche Diagnostics Brazil, São Paulo, SP, Brazil, 2 Roche Diagnostics Brazil, São Paulo, Brazil
OBJECTIVES: METHODS RESULTS: CONCLUSIONS:
HI4: ADHERENCE TO TREATMENT IS ASSOCIATED WITH GOOD CLINICAL RESULTS IN PATIENTS TREATED WITH BIOLOGICAL THERAPY IN A CENTER OF EXCELLENCE IN RHEUMATOID ARTHRITIS
3:30PM - 3:45PM
Santos-Moreno P 1 , Alvis-Estrada J2 , Alvis-Zakzuk NJ3 , Villarreal Peralta L1 , Buitrago-Garcia D4 , Alvis-Zakzuk NR5 , Carrasquilla-Sotomayor M5 , Alvis Zakzuk J2 , Alvis-Guzman N6 1 Biomab, bogota, Colombia, 2 ALZAK Foundation, Cartagena, Colombia, 3 Instituto Nacional de Salud. Universidad de la Costa-CUC, BOGOTA, Colombia, 4 SIIES- Investigación y educación en salud, BOGOTA, Colombia, 5 ALZAK Group, Cartagena, Colombia, 6 ALZAK Group, Cartagena, BOL, Colombia
OBJECTIVES Rheumatoid arthritis (RA) is a disease associated with high cost therapies. We aimed to describe the disease activity score (DAS28) in patients with RA who received biological therapy (b-DMARDs) in a Center of Excellence (CoE) for RA. METHODS The CoE model proposed is based on treat-to-target and RA clinical recommendations. Under this model, patients are seen by rheumatologist up to 6-12 times per year and by other health professionals >3 times per year. Health status of patients is followed by applying the DAS28. CoE strategy guarantees the adherence of RA patients, ensuring opportunity and accessibility to rheumatologists and allied healthcare services. A study was conducted from a cohort of RA patients who received b-DMARDs and were attended at a CoE during 2018. Using the McNeamar test, we analyzed if the activity levels of the disease (remission, low, moderate and severe) changed during the year of follow-up. RESULTS We studied 974 patients receiving b-DMARDs, 83.5% were women. Mean age was 59 years (SD: ±11 years). The median time at which patients were diagnosed with RA was 9 years (IQR:2-20 years). During the year of follow-up, patients who attended between 4-7 rheumatologist appointments (86.86%), sustained an average measurement of the DAS28 in a range of 2.71 to 3.19 (low disease activity). No statistical difference was found in the evolution of the DAS28 measurement between men and women (p-values> 0.05). There was no significant change in each level of DAS28 between the first and sixth appointment (p-values> 0.05). CONCLUSIONS Patients receiving b-DMARDs and treated with a comprehensive care model showed a high adherence to the healthcare services supplied. Our results depict that, with periodic attention the activity of RA could be controlled at low levels of disease severity.
(SI) EVALUATING HEALTH SYSTEMS CAPACITY FOR TIMELY, QUALITY, AND AFFORDABLE SURGICAL CARE- A LATIN AMERICAN FRAMEWORK FOR SITUATIONAL ANALYSIS THROUGH DATA COLLECTION, ANALYSIS AND INTERPRETATION
PURPOSE
: To equip participants with fundamental approaches to baseline data collection and situational analysis for the interpretation of surgical system preparedness, quality and affordability within the larger health system.
DESCRIPTION
: Many approaches exist towards the collection of health indicators that can be used to inform policymakers’ efforts to strengthen health systems in an outcomes driven manner. Each approach is largely dependent on the various country-specific intricacies of healthcare systems and their components. This panel highlights the work of collaborating global surgeons and partners in assessing surgical systems through the collection, analysis and interpretation of surgical indicator data proposed by the Lancet Commission on Global Surgery and World Bank to achieve timely, quality and affordable universal health coverage. Specifically, they will share their unique experiences with data collection in Latin America, and the analysis and interpretation that informs the development of National Surgical Obstetric and Anesthesia Plans to be integrated into National Health Care Plans. Dr. Gregory Peck will communicate academic structure, content, and process that facilitates sustainable bidirectional partnerships in effective collaboration toward information management via the Latin American Indicator Research Collaboratory. Dr. Mónica Pinilla Roncancio will discuss a top-down approach involving collaborations with the Colombian Ministry of Health to repurpose primary and secondary data within existing health information systems to establish a baseline evaluation of Colombia’s surgical system. Dr. Ramos will discuss a bottom-up hospital and state level approach towards surgical indicator collection with an emphasis on gaining support from hospitals to implement programs that improve information management in Veracruz, Mexico. Dr. Guido Parret will discuss the burgeoning interest in this work in Paraguay and where he sees his country’s efforts going. EVALUANDO LA CAPACIDAD DE SISTEMAS DE SALUD PARA ATENCIÓN QUIRÚRGICA OPORTUNA, DE CALIDAD, Y ASEQUIBLE: UN ESBOZO LATINOAMERICANO PARA EL ANÁLISIS SITUACIONAL A TRAVÉS DE LA RECOLECCIÓN DE DATOS, ANÁLISIS, E INTERPRETACIÓN
PROPÓSITO : Equipar a los participantes con estrategias fundamentales para la recolección de datos de referencia y el análisis situacional para la interpretación de la preparación, la calidad, y la asequibilidad del sistema quirúrgico dentro del sistema de salud en general.
DESCRIPCIÓN : Existen muchas estrategias para la recolección de indicadores en salud que pueden ser utilizadas para informar esfuerzos políticos y fortalecer los sistemas de salud de una manera orientada a los resultados. Cada estrategia depende en gran medida de la complejidad del sistema de atención en salud de un país, y de sus diferentes componentes. Este panel destaca el trabajo de cirujanos y socios colaboradores globales en la evaluación de sistemas quirúrgicos a través de la recolección, análisis e interpretación de datos de los indicadores quirúrgicos propuestos por la Comisión Lancet en Cirugía Global y el Banco Mundial, cuyo fin es lograr que la cobertura universal de salud de servicios quirúrgicos sea oportuna, de alta calidad, y asequible. Específicamente, los panelistas compartirán sus experiencias únicas en la recolección de datos en América Latina y el análisis e interpretación que informan el desarrollo de Planes Nacionales de Anestesia, Cirugía, y Obstetricia para ser integrados en Planes Nacionales de Atención en Salud. El Dr. Gregory Peck comunicará la estructura, el contenido, y el proceso académico que han facilitado la colaboración efectiva, sostenible y bidireccional hacia la gestión de la información a través del “Latin American Indicator Research Collaboratory”. La Dra. Mónica Pinilla-Roncancio discutirá una estrategia de arriba hacia abajo que involucra la colaboración con el Ministerio de Salud de Colombia para reutilizar datos primarios y secundarios existentes dentro de los sistemas de información en salud y establecer una línea de referencia del sistema quirúrgico Colombiano. El Dr. Antonio Ramos discutirá una estrategia de abajo hacia arriba a nivel hospitalario y estatal hacia la recolección de indicadores quirúrgicos con el énfasis de obtener apoyo de hospitales para implementar programas que mejoran la gestión de información en salud en Veracruz, México y el Dr. Guido Parquet discutirá interés creciente en este trabajo en el Paraguay y a donde considera que llevarán los esfuerzos de su país.
Discussion Leader
Guido Parquet, MD
International College of Surgeons: United States Section, Asunción, Paraguay
Gregory Peck, DO, FACS
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
Mónica Pinilla Roncancio, MA, MSc, PhD
Universidad de los Andes Facultad de Medicinandes Facultad de Medicina, Bogotá, Colombia
David Tulloch
Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
15:45 - 16:00
BREAK
16:00 - 17:00
BREAKOUT SESSION 6
TREATMENT PATTERNS AND DISEASE MANAGEMENT STUDIES
TP3: ESTUDIO DE UTILIZACION DE DROGAS- DESCRIPCIÓN DEL USO DE INMUNOGLOBULINA INTRAVENOSA HUMANA EN UN HOSPITAL UNIVERSITARIO DE BOGOTÁ, COLOMBIA
4:30PM - 4:45PM
Correa Gonzalez NF 1 , Diaz Cortes DV2 , Figueras A3 , Muñoz O1 1 Pontificia Universidad Javeriana, Bogota, Colombia, 2 Clinica Palermo, Bogota, Colombia, 3 Universitat Autònoma de Barcelona, Barcelona, B, Spain
OBJECTIVES: METHODS: RESULTS: CONCLUSIONS:
TP2: COSTS AND PRESCRIPTION PATTERN OF PATIENTS WITH PSORIATIC ARTHRITIS AND ITS ASSOCIATED COSTS
4:15PM - 4:30PM
Santos-Moreno P 1 , Villarreal Peralta L2 , Cabrera M1 , Alvis Zakzuk N3 , Buitrago-Garcia D4 1 Biomab, Center for Rheumatoid Arthritis, Bogota, CUN, Colombia, 2 Biomab, bogota, Colombia, 3 ALZAK Foundation, Cartagena, Colombia, 4 Fundación Universitaria de Ciencias de la Salud-FUCS, BOGOTA, Colombia
OBJECTIVES Psoriatic Arthritis (PSO) is a chronic inflammatory disease affecting the skin and joints with a significant impact on quality of life. The prevalence of PSO has been estimated to be among 0.9%–8.5% worldwide. On the other hand,the introduction biologics for the treatment of psoriatic arthritis, have increased the economic burden of these disease. We aimed to compare medication resource utilization and costs in patients with Psoriatic Arthritis. METHODS We conducted a retrospective cohort analysis using our patient registry. We followed patients under T2T standards and a multidisciplinary approach. Patients entered into a multidisciplinary program of care with periodic consultations. We describe demographic characteristics and disease activity according to DAS28. Descriptive epidemiology was done, we calculated means, and standard deviations for continuous variables and categorical variables were presented as rates. We calculated the costs for therapy, these are presented in US dollars at the official average rate of exchange for 2018. RESULTS We included 219 patients, 55% were female and 45% were male. Mean age was 56 years ± 13.05. Mean DAS28 was 2.43 ± 0.84. Regarding pharmacological therapy 50% of patients were treated with Biological DMARDs, 40% with conventional DMARDs and 10% were receiving other medications such as pain medications, calcium, vitamins, dermatologic compounds among others. When we calculated the average costs for biological therapy they were $9.906 USD per patient/year, for the conventional therapy $358 USD per patient/year and for other medications $200 USD per patient/year. CONCLUSIONS The consumption of resources in PSO are mostly related to biological therapies. Further investigation should be focused on prescription scheme and economic burden in order to find strategies and treatment options that optimize healthcare resources and potentiate services for patients.
TP1: TRATAMIENTO DEL CANCER DE MAMA ESTADIO IV, ANÃLISIS DE LOS DATOS REPORTADOS A LA CUENTA DE ALTO COSTO. COLOMBIA 2017.
4:00PM - 4:15PM
Choconta-Piraquive LA
OBJECTIVES: METHODS: RESULTS: CONCLUSIONS:
TP4: REAL-WORLD PATIENT CHARACTERISTICS AND OUTCOMES OF RESECTED STAGE III MELANOMA PATIENTS IN ARGENTINA AND BRAZIL
4:45PM - 5:00PM
Villarroel R1 , Chacon M2 , Cuadros MF3 , Maestre K4 , Amaral S5 , Burne R6 , Ionescu-Ittu R7 , Guerin A6 , Munhoz R 8 1 Hospital São Vicente de Paulo, Passo Fundo, Brazil, 2 Fleming Institute, Buenos Aires, Argentina, 3 Instituto de Oncología de Rosario, Santa Fe, Argentina, 4 Novartis Pharmaceuticals, Bogotá, Colombia, 5 Novartis Corporation, east hanover, NJ, USA, 6 Analysis Group, Inc., Montreal, QC, Canada, 7 Analysis Group, Inc., Montréal, QC, Canada, 8 Hospital Sirio Libânes, São Paulo, Brazil
OBJECTIVES: Upon resection, stage III melanoma patients have high risk of relapse. This study described real-world patient characteristics, treatment patterns, and outcomes of this patient population in Argentina and Brazil during years 2011-2016. METHODS: Physicians from 4 melanoma centers (2 in Argentina; 2 in Brazil) extracted de-identified patient-level information, including disease characteristics, treatments, and relapse-free survival (RFS), as part of a global multi-country retrospective chart review study. All patients had >24 months follow-up post-surgical resection (index date). RESULTS: The study included 42 patients (mean age: 55 years; females 52%; private healthcare insurance: 79%). Most patients were first diagnosed with stage III (81%; AJCC7). At index date, 33% had stage IIIB and 17% IIIC, 50% had tumor ulceration/mitosis, and 41% had tumor thickness >4mm. Overall, 33% received adjuvant therapy (interferon alfa-2b: 43%; peginterferon alfa-2b: 43%), while 67% were observed for recurrence. Primary reasons for observation were “limited efficacy of approved therapies” (46%) and “poor tolerability profile” (21%). Relapse rates over an average follow-up of 3.5 years post-index date were high in both the adjuvant (64%) and observation (68%) cohorts. While 62% were tested for BRAFV600 mutation (69% positive), most were tested after first relapse (58% among tested). Compared to observation, the adjuvant treatment cohort tended to be younger (mean age: 52 vs. 57 years), had shorter time from stage III diagnosis to surgery (median: 15.5 vs. 26 days) and higher risk melanoma (tumors >2mm: 86% vs. 63%; ulcerations/mitosis: 71% vs. 44%). At 2 years post-index, RFS rate was 45.9%. CONCLUSIONS: For patients with resected stage III melanoma, use of adjuvant systemic therapies was low, mainly due to the limited efficacy and poor tolerability of interferon. Relapse rates were high both among treated and observation cohorts. There is a need for more efficacious adjuvant therapies to prevent melanoma relapse and reduce associated patient and economic burden.
COMPARATIVE EFFECTIVENESS STUDIES
CM2: REMOTE MONITORING AFTER THE IMPLANTATION OF A CARDIOVERTER-DEFIBRILLATOR- A SYSTEMATIC REVIEW AND META-ANALYSIS
4:15PM - 4:30PM
Lucchetta RC
OBJECTIVES METHODS RESULTS CONCLUSIONS
CM1: EFECTIVIDAD Y SEGURIDAD DE LA RESECCIÃN MUCOSA ENDOSCÃPICA FRENTE A LA DISECCIÃN SUBMUCOSA EN PACIENTES CON CÃNCER GÃSTRICO TEMPRANO- REVISIÃN SISTEMÃTICA CON METANÃLISIS
4:00PM - 4:15PM
Posso M1 , Canelo C1 , Niño de Guzman Quispe EP1 , Rodriguez L1 , Pacheco K1 , Balbin Ramon GJ 2 1 Grupo de Evaluación de Tecnologías e Investigación en Servicios Sanitarios, Lima, Peru, 2 Grupo de Evaluación de Tecnologías e Investigación en Servicios Sanitarios, Lima, LIM, Peru
OBJECTIVES En pacientes con cáncer gástrico temprano, el tratamiento quirúrgico ha sido clásicamente utilizado, sin embargo, los avances en las técnicas endoscópicas han cambiado este paradigma. El objetivo de este estudio es evaluar la efectividad y seguridad de la resección mucosa endoscópica (RME) frente a la disección submucosa (DSE) en éstos pacientes. METHODS Se realizó una revisión sistemática con metanálisis siguiendo las recomendaciones de la Colaboración Cochrane y la declaración PRISMA. La búsqueda se realizó en las bases de datos Medline (PubMed) y Lilacs (BIREME) hasta diciembre de 2017. Se incluyeron estudios observacionales, publicados en inglés o español, que evaluaran la efectividad y seguridad de la RME comparado con la DSE en adultos con cáncer gástrico temprano. Se realizó un metanálisis de efecto aleatorio con la herramienta REVMAN 5.3. RESULTS De los 277 resultados de la búsqueda, 20 estudios se revisaron en texto completo y 9 fueron incluidos. Los estudios fueron retrospectivos en base a registros hospitalarios. Siete estudios fueron realizados en Japón, uno en Corea y uno en Italia. El riesgo de sesgo de los estudios, según la escala NEWCASTLE-OTTAWA, fue moderado o bajo. Un estudio (n=714) reportó que no se observaron diferencias en el número de supervivientes a tres años entre ambos grupos (RR: 1,01; IC: 1,00-1,03). El metanálisis de nueve estudios mostró una menor probabilidad de resección histológica completa con la RME (RR: 0,56; IC: 0,45-0,69) así como una menor probabilidad de perforación gástrica (RR: 0,37; IC: 0,18-0,78). Por otro lado, el metanálisis de cinco estudios mostró una mayor probabilidad de recurrencia con la RME (RR: 26,61; IC: 7,60-93,20). CONCLUSIONS Comparado con la RME, la DSE presentó una mayor efectividad en la resección histológica completa y menor probabilidad de recurrencia a expensas de incrementar la probabilidad de perforación y sin diferencias en la supervivencia a tres años.
CM4: TIME TO TREATMENT EFFECT, EVENT-FREE SURVIVAL, AND MOTOR MILESTONE ACHIEVEMENT IN TYPE I SPINAL MUSCULAR ATROPHY PATIENTS TREATED WITH ONASEMNOGENE ABEPARVOVEC (AVXS-101) OR NUSINERSEN CONTRASTED TO NATURAL HISTORY
4:45PM - 5:00PM
Dabbous O
OBJECTIVES: SMN1 ) deletion/mutation. This cross-study comparison describes the impact of onasemnogene abeparvovec (AVXS-101) on survival, motor milestone achievement, and time to treatment effect in SMA1 patients contrasted with response to nusinersen and untreated patients in natural history studies. METHODS: SMN2 copies) were treated with AVXS-101 (CL-101; NCT02122952; cohort 2; N=12) or nusinersen (ENDEAR; NCT02193074; N=80). Event-free survival (EFS, composite endpoint of time to death or permanent ventilation), motor milestone achievement, nutritional/ventilatory support, and CHOP INTEND (CL-101, ≥20 months; ENDEAR, ≥14 months of age) were contrasted with natural history studies (14 months of age): Pediatric Neuromuscular Clinical Research network (PNCR; N=23) and NN101 (NCT01736553; N=16). RESULTS: CONCLUSIONS:
CM3: REVIS SISTEMÃTICAS DOS MODELOS DE ORGANIZAÇÃO DE SISTEMAS PÚBLICOS DE SAÚDE PARA O CUIDADO DA OBESIDADE INFANTIL E SUA EFETIVIDADE NO MUNDO
4:30PM - 4:45PM
Mosegui G 1 , Vianna C2 , Valle PM3 , Motta AL1 , Camara JD1 , Costa TMAD1 1 Universidade Federal Fluminense, Niterói, Brazil, 2 Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil, 3 UERJ, Rio de Janeiro,, Rio de Janeiro, Brazil
OBJECTIVES: Determinar a efetividade das políticas, práticas ou programas em serviços de assistência à infância, na promoção de uma alimentação saudável e/ou atividade física e/ou que redução de comportamentos sedentários que possam atuar no controle do sobrepeso e da obesidade infantilDeterminar a efetividade das políticas, práticas ou programas em serviços de assistência à infância, na promoção de uma alimentação saudável e/ou atividade física e/ou que redução de comportamentos sedentários que possam atuar no controle do sobrepeso e da obesidade infantil METHODS: Realizou-se uma revisão sistemática para determinação das intervenções vigentes que buscam o combate do acúmulo do peso corpóreo em indivíduos em idade pré-escolar (2 a 6 anos). Foram incluídos estudos controlados randomizados, cuja finalidade tenha sido avaliar a efetividade de estratégias, políticas, práticas e programas voltados para a melhoria de hábitos alimentares, aumento de atividade física ou tratamento e prevenção de obesidade infantil, em serviços de assistência à infância, comparados a um grupo controle mantivesse as atividades usuais. RESULTS: Apenas dois estudos, 9% do total, encontraram uma redução significativa no IMC e um (4,5%), uma diminuição média. Dois deles também (9%) apresentaram um decréscimo no subgrupo de crianças com sobrepeso e obesidade, e outro (4,5%) com o subgrupo de menor condição socioeconômica. 14 das avaliações realizadas, aproximadamente 63% do total, não conseguiram verificar qualquer efeito significativo na prevenção da obesidade medidos pela diferença do IMC. CONCLUSIONS: Intervenção durante os anos pré-escolares é vista como um passo crítico na interrupção da epidemia de obesidade. Essas premissas não se sustentam a partir das indicações aqui levantadas. Pouco mais de 60% dos estudos selecionados não encontraram nenhuma evidência significativa que possam prevenir a obesidade. Aumento das atividades físicas, melhoria da dieta e ingesta de frutas e verduras, programas educacionais e informativo sobre hábito saudáveis parecem não ter efeito visível sobre a obesidade infantil no período pré-escolar
VALUE-BASED CONTRACTING – ARE WE THERE YET?
PURPOSE: This workshop will provide an overview of the experience to date with outcomes- and financial- based contracts in Latin America, review existing hurdles to implementation, and arrive to a consensus on success factors and optimal disease areas for implementation that allow healthcare systems in the region to more sustainably integrate and provide access to innovation generated by industry.
DESCRIPTION: The last five years have seen an increase in the receptivity to alternative contracting agreements among stakeholders in Latin America, given they provide a platform through which payers and pharmaceutical companies can provide better access to patients while managing potential uncertainty around the clinical data or budget impact of innovative therapies. However, despite growing interest, examples of effective implementation remain scarce in Latin America, likely driven by internal and external implementation hurdles.
The workshop will explore different value-based payments models (financial- and outcomes-based), and examples of publicly disclosed contracts that have been successfully implemented in Latin America. Then, the speakers will discuss locally-relevant internal and external implementation hurdles that should be considered when designing and implementing these payment models in Latin America. Speakers will close the session by sharing key success factors and implementation considerations from the perspective of different industry stakeholders (e.g., payers, pharmaceutical companies, wholesalers) that pharmaceutical companies looking to implement value-based contracts in the region should contemplate.
Discussion Leader
Ramon Camacho, MS, PhD, MBA
Merck Sharp Dohme, Kenilworth, NJ, USA
Eduardo dos Santos, MBA
Merck Group, Sao Paulo, Brazil
Diego F Guarin, MD, MPH, MA
EMD Serono, Miami, FL, USA
Miguel Martin De Bustamante, BA
CBPartners, San Francisco, CA, USA
TRIPLE META EN SALUD PARA GENERAR VALOR- UNA MIRADA DESDE LOS DIFERENTES ACTORES DEL SISTEMA DE SALUD EN COLOMBIA
ISSUE
: La triple meta en salud se ha abordado poco en latinoamérica. Es necesario discutir desde diferentes perspectivas
¿Cómo entender el valor a partir de la triple meta, su impacto y retos para los sistemas de salud en el ámbito local y regional? OVERVIEW
: La triple meta en salud implica lograr conjugar al tiempo los siguientes indicadores en el ámbito asistencial o poblacional: Efectividad (mejorar desenlaces en salud), Seguridad-Calidad (mejorar la experiencia de los pacientes), Optimización de recursos (disminuir el costo per cápita). Este concepto se ha trabajado mucho en los países desarrollados, poco se ha abordado en el contexto latinoamericano. Actualmente el gobierno colombiano ha planteado como pilar la necesidad de poner en la agenda pública los temas relacionados con la calidad del servicio, lo cual está directamente relacionado con la evaluación de tecnologías en salud. En este contexto, se plantea un panel para discutir desde diferentes perspectivas (prestación de servicios de salud, industria farmacéutica, academia y gobierno) ¿Cómo entender el valor generado a partir de la triple meta, su impacto y retos para los sistemas de salud en el ámbito local y regional?
Moderators
Dario Londoño, MD MSc
Fundación Santa Fé de Bogotá, Bogotá, Colombia
Panelists
Juan Guillermo Ariza, MD MSc MBA
BAXTER, BOGOTA, Colombia
Henry Gallardo, MD
Fundación Santa Fe de Bogotá, Bogotá, Colombia
Ivan Darío Gonzalez, MD
Ministerio de Salud y Protección Social, Bogotá, Colombia
(SI) EVALUACIÓN DEL VALOR DE TECNOLOGÍAS SANITARIAS INNOVADORAS- DESAFÍOS Y PERSPECTIVAS
ISSUE
: Existe un debate importante en el ámbito de la ETS sobre cuál es el verdadero impacto de las tecnologías innovadoras, derivado principalmente de la falta de consenso en la forma correcta de valorarlo. El principal reto radica en tener en cuenta y ponderar adecuadamente todos los factores que contribuyen a dicha evaluación, no solamente la eficacia, la seguridad y el impacto presupuestario, sino también la calidad de vida del paciente, el gasto de bolsillo, los costos sociales evitados, la mejoras en la productividad laboral y otras dimensiones tales como el miedo al contagio o el valor de la esperanza (value of hope).
OVERVIEW
: Este panel presentará diferentes puntos de vista sobre cómo debe ser medido el valor de una tecnología. Rubén Torres moderará el panel presentando una breve introducción y abriendo el debate con preguntas. Rony Lenz, en representación de la academia, hablará sobre los diferentes enfoques que impulsan el concepto de valor de manera amplia e integral. Adriana Robayo, representando a las agencias de ETS presentará los principales desafíos y las metodologías utilizadas en Colombia para la evaluación del valor de tecnologías. Jan Weinreich, en representación de los productores de tecnología, explicará qué atributos considera que no son suficientemente tenidos en cuenta por los sistemas de salud. Luego, se abrirá una discusión durante la cual los panelistas explorarán estos puntos de vista y desarrollarán una lista de temas clave para el diseño de futuras políticas.
Moderators
Rubén Torres, MD, MSc
Universidad iSalud, Buenos Aires, Argentina
Panelists
Rony Lenz Alcayaga, MA
Universidad Nacional Andrés Bello, Santiago, Chile
Adriana Robayo García, MD, FETP
Institute of Technological Evaluation in Health- IETS, Bogota, Colombia
Jan Weinreich, Ph.D.
Hoffmann-La Roche, Basel, Switzerland
