Short Courses
 
SHORT COURSES - THURSDAY, 10 SEPTEMBER 2009
Short courses will be presented in either Portuguese, Spanish or English.  Some courses will have simultaneous translation and are indicated by Please see below for more information regarding short course language.
 
9:00 - 13:00 MORNING COURSES
  INTRODUCTION TO MODELING METHODS (Presented in Spanish)
Room: Vidigal A
Faculty: Jorge Guzmán MD, Access Manager, Novartis Oncology - Mexico, Colonia San Diego Churubisco, Mexico
Course Description: This course includes a review of Markov models, discrete event models, and other modeling techniques and their appropriate applications, including a review of the ISPOR Principles of Good Practice for Decision Analytic Modeling in Health Care Evaluations. Using a series of related examples, the course will carefully review the practical steps involved in developing and using these kinds of models. Examples will be presented using predominantly Microsoft Excel, supplemented with add on simulation software. This course will cover the practical steps involved in the selection and modeling of data inputs and practical aspects related to the determination of when, why and how to handle stochastic (i.e., first order Monte Carlo Simulations) and probabilistic uncertainty (i.e., second order Monte Carlo Simulations). Issues related to the selection of model input parameters and their distributions for use in probabilistic sensitivity analyses will be considered. Participants will learn the steps required in conducting, analyzing, interpreting, and presenting results from probabilistic sensitivity analyses (e.g. using analyses of the cost-effectiveness plane, the "ellipses", and acceptability curves). This introductory course requires a familiarity with decision analysis.
   
PHARMACOECONOMICS (ECONOMIC EVALUATIONS) FOR DECISION-MAKERS
(Presented in Spanish with simultaneous Portuguese translation)
Room: Gávea A
Faculty:
Adolfo Rubinstein MD, MSc, PhD
, President, Institute for Clinical Effectiveness and Health Policy (IECS) & Director of the Master´s Program in Clinical Effectiveness, Faculty of Medicine, University of Buenos Aires, Buenos Aires, Argentina
Course Description: This course is designed to teach clinicians and new researchers how to incorporate pharmacoeconomics into study design and data analysis. Participants will learn how to collect and calculate the costs of different health care or health care economic evaluation alternative treatments, determine the economic impact of clinical outcomes, and how to identify, track and assign costs to different types of health care resources used. The development of economic protocols and data collection sheets will be discussed. Different pharmacoeconomic models and techniques will be demonstrated as well as case studies. These include cost-minimization, cost-of-illness, cost-effectiveness, cost-benefit, and cost-utility analysis. Decision analysis, sensitivity analysis, and discounting, will all be demonstrated and practiced. Participants will also 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.
   
  HEALTH CARE & REIMBURSEMENT SYSTEMS IN LATIN AMERICA (Presented in Portuguese)
Room: Gávea B
Faculty: Fernanda O. Machado BDS, MSc, Medical & Health Economics Senior Manager, Johnson & Johnson Medical Brasil, São Paulo, Brazil
Course Description:Many countries in Latin America have only recently begun formulating the use of pharmacoeconomics and health outcomes research in medical decision-making at an official level. They are grappling with questions from payers and decision-makers on outcomes research and its use while still educating the general decision-making public on pharmacoeconomics and health outcomes research. This is particularly important for developing countries, where there is even more resource scarcity to be used in health technology assessment as well as a short supply of data on cost and effectiveness. The Latin American context requires special attention in (i) technical issues such as the election of the appropriate discount rate or the time horizon, (ii) a series of practical questions such as: should evidence be requested for all new drugs?, or just some?; how should drugs be prioritized for evaluation?; should data from other countries be accepted and, if so, which?; what are the major institutional constraints in the context of Latin American countries? This session will first discuss the current health care systems in the main Latin American countries, discussing research implementation and its linkage with regional priorities. The faculty will then describe the reimbursement legislation, processes and organizations within these countries as well as the role of the pharmaceutical and/or medical device manufacturer. This course will then focus on providing participants with an understanding of the various procedures employed by Latin American health authorities to regulate market access based upon the appraisal of the clinical and in some countries economic value of new medical technologies. Formulary submission guidelines set analytical and evidentiary standards which drug manufacturers and others are required to meet in making a case for their product. Faculty will discuss evidentiary standards in formulary submissions. This is an introductory level course.
   
  EXTRACTING COST DATA FOR ECONOMIC ANALYSIS IN LATIN AMERICA (Presented in Spanish)
Room: Vidigal B
Faculty: Ximena Burbano MD, Research Director of HEORT – Colombia & Research Associate for Health Economics and Outcomes Research in the Fundación Santa Fe de Bogota – Colombia; Nelson Alvis Guzmán MD, MSc, PhD, Faculty of the Economic Sciences Department and Director of the Health Economics Research Group, Cartagena University, Cartagena, Colombia; Heidy Cárceres MD, MSc, Vice-President, ISPOR Colombia Chapter & Outcomes Research Manager, Pfizer Colombia, Bogotá, Colombia
Course Description: This course will focus on practical aspects of cost development for pharmacoeconomic studies. The objective is to help the participant bridge the gap between understanding pharmacoeconomic theory and the practice of developing cost estimates. Factors to consider when costing pharmacoeconomic analyses, such as perspective, data sources, data classification systems, developing resource use profiles, obtaining unit costs, and making cost adjustments will be presented. Examples of issues encountered when identifying and extracting cost data will be discussed. This course is designed for those with some experience with pharmacoeconomic analysis.
14:00 - 18:00 AFTERNOON COURSES

 

APPLIED MODELING (Presented in Spanish)
Room: Vidigal A

Faculty: Federico Augustovski MD, MSc, Director, Health Economic Evaluation and Technology Assessment, IECS (Institute for Clinical Effectiveness and Health Policy) & Staff Physician, Family and Community Medicine Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Prof. Andrés Pichon-Riviere MD, MSc, PhD, Executive Director, IECS, Buenos Aires, Argentina; Sebastián García Martí MD, MSc, Health Technology Assessment & Economic Evaluation, IECS, Buenos Aires, Argentina; Lisandro Colantonio, MD, MSc, Research Fellow, IECS, Buenos Aires, Argentina
Course Description: This course is a hands-on introduction to the use of software in the creation and analysis of cost-effectiveness decision models. The basics of cost-effectiveness decision making, building and analyzing a simple decision tree will be discussed. Markov modeling and Monte Carlo simulation will be introduced. All participants must bring a Windows laptop computer with a copy of TreeAge Pro Suite installed and running. You will be provided download and installation instructions when you pre-register for the course. All participants will receive a cd-rom at the training. This course is suitable for those who have are familiar with the various modeling methods or who have taken the morning course, ‘Introduction to Modeling Methods

   
  HEALTH TECHNOLOGY ASSESSMENT (Presented in Portuguese)
Room: Gávea B

Faculty: Carisi Polanczyk MD, PhD, Cardiology Service, Clinical Hospital of Porto Alegre – UFRGS & Associate Professor of Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
Course Description: Health technology assessment (HTA) is the systematic evaluation
of properties, effects and/or impacts of health care technology. Throughout the process of introducing a new technology, evaluating its effectiveness, approving its addition to the market and related decision-making, important ethical, clinical and economic issues need to be addressed. This course will discuss current processes used globally to introduce a new technology and the agencies that perform these processes. It will include a review of the various methods used to evaluate safety, efficacy, and technology adoption and diffusion, with emphasis on how to conduct HTA using real-world evidence. Faculty will address some of the issues facing current HTA processes such as their impact on the social and economic environment, the need for best practices, and the need for better cooperation among stakeholders. This course is designed for those with some experience in pharmacoeconomics.
   
  UTILITY MEASURES (Presented in Spanish)
Room: Vidigal B
Faculty: Rafael Alfonso MD, MSc, Scientific Director, RANDOM Foundation and PhD Student, University of Washington, Seattle, WA, USA & Bogota, Colombia
Course Description: Utility measurement is a method of determining an individual’s preference for a certain outcome represented by a quantitative score (utility). During this course, methods for measuring preference-based outcomes like the standard gamble, time trade-off, and visual analogue scale will be demonstrated. Additionally, utility-based instruments (EQ-5D, HUI, QWQ, SF-36) will be breifly discussed. Utility measurement however is not only about mastering these techniques; it is about using them in such a way that health care decision-makers can apply the results, for instance in cost per QALY-analyses. For this purpose, one needs to be aware of shortcomings of the available utility measures and potential solutions. Furthermore one should be aware of the decision-making context and the way results are interpreted. To equip participants with expertise in the field of utility measurement, the most important issues will be discussed: for instance we will consider potential insensitivity of generic instruments for particular disease specific problems, and discuss to what extent adaptation of generic or disease-specific quality of life instruments may offer a solution. Also the issue of “whose values count: patient values or values from the general public?” will be discussed. Finally we turn to the interpretation in the context of resource allocation. This course is for those with some experience with quality-of-life measures in health economic evaluation.
   
TRANSFERABILITY OF COST-EFFECTIVENESS DATA BETWEEN COUNTRIES
(Presented in English with simultaneous Portuguese & Spanish translation)
Room: Gávea A
Faculty: Michael Drummond PhD, Professor of Health Economics, University of York, Centre for Health Economics, Heslington, York, UK; Federico Augustovski MD, MSc, Director, Health Economic Evaluation and Technology Assessment, IECS (Institute for Clinical Effectiveness and Health Policy) & Staff Physician, Family and Community Medicine Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; David Thompson PhD, Vice President, Global Health Economics, i3 Innovus, Medford, MA, USA
Course Description: Although the number of countries requiring an economic dossier as part of the submission dossier for public reimbursement of new drugs is growing, the pharmaceutical industry cannot conduct economic evaluations in every potential market. Clinical trials are increasingly done in international settings in order to quickly recruit a sufficient number of patients and to have at least some economic data from multiple countries. However, national decision-makers require country-specific or region-specific data on health care costs and are only willing to accept foreign data or international data when they are translated to their own specific setting. But little guidance on how to do this exists. This course starts with a discussion of factors that make economic data more difficult to transfer from one country to other countries than clinical data, and the evidence on the variability of cost-effectiveness results across countries. Then we will review the methods that have been presented to offer a solution to this problem and their pros and cons. Finally, we will discuss the emerging international guidance for dealing with issues of transferability, including the suggestions made by the ISPOR Good Practices Task Force on this topic.  The methods to be discussed include various types of regression based approaches and Markov models. An interactive exercise will be included and there will be discussion of the specific needs of the Latin American region. This course is for those with basic understanding of cost calculation and modeling.

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