Health System and COVID-19 - ISPOR Egypt Chapter Perspectives
Worldwide, healthcare systems have been moving toward more value-driven approaches that focus on evaluating therapeutic options based on effectiveness and value to the patient. Value-based assessments of health care interventions would influence payer, provider, and patient outcomes . In Egypt, the current pricing system is the external reference pricing (ERP) . ERP as a pricing regulation has been rendered “non-optimal” both by experts and in literature when compared to other pharmaceutical pricing approaches, such as cost-effectiveness or value-based pricing (VBP).
A recent systematic review of 45 studies where primary evidence was collected through survey distribution to experts in 21 countries, thoroughly analyzed the ERP system . This study found that ERP can reduce pharmaceutical prices in the short-term, but it cannot recognize the value of innovative products in improving patient outcomes can delay the launch of new products in low-price countries or in countries with highly regulated prices at ex-factory level and also . Therefore, the effect of ERP needs to be considered not only within a country’s borders, but also beyond it.
Step by step, healthcare systems are actively shifting from being volume-based systems towards becoming more value-based. This shift is achieved by embracing value-driven approaches that evaluate healthcare interventions on the basis of health outcomes, value to the patient, and effectiveness compared to other potential treatment options . A recent systematic review of 38 articles from the peer-reviewed literature search found 22 distinct approaches to assess the value of health care interventions . According to this study, incremental cost-effectiveness ratio did not adequately meet the needs of decision-makers as a measure of value and the utilization of multiple criteria and the account for patient-reported measures have shown increased significance. .
ISPOR special task force report discussed defining the elements of value in healthcare. Typically, there are four elements of value that are routinely included in value assessments. The report suggests 8 additional values to be included in economic evaluations and refers to these elements as “novel elements of value”. These novel elements are reduction in uncertainty, fear of contagion, insurance value, severity of disease, value of hope, real option value, equity, and scientific spillovers .
In pandemics like the COVID-19, the true significance of value-based assessment becomes very prominent. The fear of contagion in highly infectious diseases as such places high value on home therapies . For instance, end-stage renal disease (ESRD) patients on hemodialysis will be willing to pay more for in-home peritoneal dialysis to avoid the risk of infection in hospitals when undergoing their usual hemodialysis sessions. Pandemics usually also witness an unusual pressure on healthcare centers and utilities, which may affect the availability of treatment for the usual patient population. Assessment of the true value and the consequences of innovative treatments saves scarce healthcare resources necessary to be allocated to face any crisis in a country with a large population size like Egypt. Thus, it is very important to adopt value-based pricing for healthcare interventions to better allocate our resources in the current situation and he future.
It has become clear that value-based assessment is our choice to an improved healthcare and better economy. Volume-based systems and external reference pricing are proving less effective as medicine advances, and efforts are now shifting towards perfecting the value system.
1. Dubois, R. W., & Westrich, K. (2017). Value assessment frameworks: how can they meet the challenge. Health Affairs Blog. http://www. Health affairs. org/do/10.1377/hblog20170302, 58979.
2. Wanis, H. (2015). Pharmaceutical Pricing in Egypt. In Pharmaceutical Prices in the 21st Century (pp. 59-78). Adis, Cham.
3. Kanavos, P., Fontrier, A. M., Gill, J., & Efthymiadou, O. (2019). Does external reference pricing deliver what it promises? Evidence on its impact at national level. The European Journal of Health Economics, 1-23.
4. Solow, B., & Pezalla, E. J. (2018). ISPOR’s initiative on US value assessment frameworks: the use of cost-effectiveness research in decision making among US insurers. Value in Health, 21(2), 166-168.
5. Seixas, B. V., Dionne, F., Conte, T., & Mitton, C. (2019). Assessing value in health care: using an interpretive classification system to understand existing practices based on a systematic review. BMC health services research, 19(1), 560.
6. Lakdawalla, D. N., Doshi, J. A., Garrison Jr, L. P., Phelps, C. E., Basu, A., & Danzon, P. M. (2018). Defining elements of value in health care—a health economics approach: an ISPOR Special Task Force report . Value in health, 21(2), 131-139.
ISPOR Egypt Chapter 4th Annual Conference
October 20, 2019, Cairo, Egypt
This year’s agenda focused on discussing topics such as: the health technology assessment status in Egypt, moving to universal health coverage, and the social impact of and access to innovative medicines presented by experts from the Middle East. Among 180 invited attendees were decision makers, representatives from academia, payers, providers and regulators.
A report from the conference will be available and published on this page in the coming days.
ISPOR Egypt Chapter 3rd Annual Conference
October 11, 2018; Cairo, Egypt
The focus of the conference was to identify best practices, common problems and propose further directions to implement health technology assessment (HTA) in the region and answer questions related to HTA capacity building, financing HTA research, process and organizational structure for HTA, standardization of HTA methodology, use of local data, and international collaboration in HTA. Over 150 participants representing academia, Ministries of Health, and industry attended the event which also served as an opportunity to raise awareness about HEOR and ISPOR in Egypt.
Practice Workshop on Pharmacoeconomics
May 15, 2018; National Hepatology and Tropical Medicine Research Institute; Cairo, Egypt
The workshop was organized by the Chapter and focused on the practical skills of conducting economic evaluation to inform decision and policy makers to improve health of the Egyptian population. The event was attended by physicians and pharmacists involved in purchasing decisions of pharmaceutical products.
- Understand the concept and the steps of the decision analysis.
- Differentiate between decision tree and Markov model in practical sessions.
- Calculate costs and outcomes of new interventions in two case studies.
Educational Seminar of ISPOR Egypt Chapter and ISPOR Hungary Chapter
November 27, 2017; Budapest, Hungary
The Role of Private Health Insurance in Countries in the Transition to Universal Health Coverage
ISPOR Egypt Chapter and ISPOR Hungary Chapter joined efforts to hold an educational seminar with the focus of “The Role of Private Health Insurance in Countries in the Transition to Universal Health Coverage.”
This seminar took place this November 27th, 2017 in Budapest Hungary at the Eötvös Loránd University (ELTE).
The seminar had the participation of Dr Ehab Abouelmaged, Head of Egyptian Healthcare Management Society; Dr Zoltán Kaló Professor of Health Economics, ELTE University/Syreon Research Institute; Dr Jenny Sedlak, Roche, Market Access Manager Eastern Europe, Middle East and Africa; and Dr Sherif Abaza, President Elect of the Egypt Chapter.
ISPOR Egypt Chapter Annual International Conference
1 October 2017
The Role of Real-World Evidence in Healthcare
ISPOR Egypt Chapter Annual International Conference was held on 1 October 2017 and was attended by academic institutions, healthcare regulators, heads of hospitals, drug manufacturers and healthcare insurance companies in the region. Invited speakers included experts from global pharmaceutical companies, Ministry of Health, health insurance companies, Quintiles IMS global RWE experts and key opinion leaders within the region. The conference has presented the perfect opportunity to learn more about:
- Engaging key stakeholders in generating real-world evidence
- Role of HTA and learning from EU healthcare real-world data collection
- Unlocking the real value from sourcing and integrating anonymized patient level data in Egypt
- Leveraging technology and analytics to extract, analyze, and visualize data
- Use of real-world evidence to support regulatory decision-making
The conference represented an important opportunity to meet the experts in the field, discuss and learn about the latest trends in HTA.
Invited speakers from 5 countries made their presentations during the conference and over 150 attendees have participated in the event.
Pharmacoeconomics Practice and Implementation Educational Workshop
20 September 2017; Cairo, Egypt
ISPOR Egypt Chapter has conducted one day educational workshop on 20 September 2017 held at the Elkasr Eleiny Hospital, Cairo University. The topic of the workshop was:“Pharmacoeconomics Practice and Implementation."
Dr Gihan Elsisi, Head of Pharmacoeconomics Unit, Central Administration for Pharmaceutical Affairs, Ministry of Health was the faculty of the workshop. Twenty key decision makers who are responsible for medications purchasing at Elkasr Eleiny Hospital, Cairo University have participated in this educational event.
The main objective of the workshop was to make use of the existing expertise in the field of pharmacoeconomics and building capacity of the new calibers in this science to benefit from when dealing with lists of medicines at all hospitals and to develop expertise and skills of hospital physicians and pharmacists. (Reported by ISPOR Egypt Chapter)
Workshop - Case Studies
Egypt Regional Chapter Office
21 Abdulaziz Alsoud Street, Room 307
Tel/fax: +202-2535-4100 Ext 1902
|President||Mahmoud Diaa Elmahdawy, PharmD|
|President-Elect||Sherif Abaza, RPh, MBA|
|Secretary Treasurer||Gihan Elsisi, RPh, MSc|
|Research Coordinator||Amr El Shalakani, MD, MBA|
|Public Relations Coordinator||Tarek Barakat, BSPharrm|
Attendees at the ISPOR Chapter 3rd Annual Conference on October 11, 2018
Attendees at the Practice Workshop on Pharmacoeconomics on May 15, 2018
Attendees of the 1-day workshop at the Hospital of the Egyptian Authority for Electricity, Cairo, Egypt