Applying Value Based Health Care to MedTech

Yves Verboven, Director Access & Economic policies

100+ Corporations*

45+ medical technology associations

OUR MEMBERS

*medical devices, diagnostics and digital health

Medical Technology sector is highly diverse with more than 500,000 products grouped in +20,000 generic groups, divided into 2 major categories; community/home care and hospital care.

Medical Technology Sector is highly diverse with more than 500,000 products grouped in +20,000 generic groups, divided into 2 major categories; community/home care and hospital care.

Medical Technology in Community, Home, and Daily Care

5

CASE STUDY: HF MANAGEMENT – EPISODE CARE MAASTRICHT UNIVERSITY MEDICAL CENTRE, THE NETHERLANDS

Date | ©2015 Medtronic. All rights reserved. 5

Supporting oncology care teams to review, collaborate, and align on

treatment decisions for patients.

A comprehensive dashboard for cancer care teams - integrates all

the disparate pieces of clinical data from multiple specialists into one

useful dashboard built for collaboration.

Decision Support Portfolio

NAVIFY Tumor Board solution for oncology

care teams

Now available in select markets

NAVIFY.com/tumorboard

© 2017 Roche Molecular Systems, Inc.

All trademarks recited herein are Roche trademarks

“Value” as a Guide for Investing in Health and Care - “Most Economic Advantageous”

€ Value

Efficiency, effectiveness

of health systems

2012: Contract for Healthy Future, Role of Medical Technologies

in Steering Health Care Systems Onto a Sustainable Path

2017: Value Based

Technology-based

Payment based on regulatory

requirements MDR/ IVDR

HTA-based

Payment based on the

relative clinical

effectiveness and

incremental cost-

effectiveness ratio

Value-based

Payment linked to value to patient,

institution, health

system and broader societal benefits

Outcome-based

Payment linked to the real-world

patient outcome

MedTech Europe CEO Round Table

1. Technology-based payment

2. HTA informed financing

3. Value-based pricing

4. Outcome-based financing

5. None of the above 0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

11.67% 11.67%

56.67%

18.33%

1.67%

If you were free to choose one preferred market access model short-term (from now to 5 years), which one would you choose?

Focus : Healthcare inefficiencies Message eg : 0.5% Efficiency Gain/ Year to address ageing related expenditure

growth

Commented by C. Schweirz, DG ECFIN

Health care Environment in Europe

…delivers timely access

(safe, performant with a clinical benefit (manufacturer claimed)

…rewards value creation of benefit to patients (citizens), health systems, society and the economy.

…fosters appropriate use of medical technologies and solutions

MedTech Value Based Access Model

Value =

Outcomes that matter to patients

Cost of delivering those outcomes

(1) Value based Healthcare: better outcomes at same or lower cost

Source: What Is Value in Health Care? Michael E. Porter, Ph.D. New England Journal Medicine 363;26 nejm.org December 23, 2010

Tier 1 outcomes Survival rate - HR QOL – Symptoms - morbidity

Degree of health achieved or maintained

Tier 3 outcomes Sustained health / recovery and recurrences

Long-term consequences of therapy

Time to recovery and return to normal activities

Disutility of the care or treatment process Tier 2 outcomes Michael Porter's outcomes

hierarchy

(2) Value and Value for Money – View Health Care Actors

“ Value”

• Value is specific to eye

beholder and dependent

on context

Patient

Perspective

General Public/

Societal perspective

Health System

perspective

Industry

perspective

HTAi Policy Forum, International Journal of Technology Assessment in Health Care, 00:0 (2013), 1–7.

“ Value for money”

Value is provided at a cost,

(3) Value of Diagnostic Information - VODI

MedTech Europe initiative – International Platform.

Concept paper submission to Scientific Journal

(4) Economic Value – A Guide for investing in Health & Care

MedTech Europe Initiative : Economic Value at all levels :

Concept and Policy Paper at MedTech Europe site

Value from different perspectives, Value of information, economic value (2)(3)(4)

Outcomes beyond patients also to be included as secondary considerations

Bringing benefits to all healthcare actors, health system and supporting policy initiatives, leading to societal, economic, industrial, … benefits.

Societal impacts Other benefits

Other benefits healthcare actors and system,

Outcomes

Costs incl. care delivery

Value-based health care MedTech Value Framework

=

HC Value

Outcome

Cost

Our Value Framework : Comprehensive - ALL Value considerations

(Diagnostic) Information

MedTech Europe Value Framework - Multi Criteria

Other benefits for key

stakeholders

At Core :

outcomes vs. costs

Broader impact on

society

Societal - economic

impact

HCP

Info

rma

l care

rs

Health

system

Ins

titu

tio

ns

Outcomes

Costs incl. care delivery

Diagnostic Information

MCDA - Economic most advantageous Investment

Innovation and Awarding Value

Starting Point: Open Access to Medical Technologies

Key Pillar : (MEAT) Value Based Procurement of medical technologies and solutions

21

MedT

ech E

uro

pe

-Valu

e B

ased P

rocure

ment-

Webin

ar-

9S

ep2015

-vS

ent.

pptx

“From administrative work to creating value”

2015

2016

2017-2018

2019 +

Develop solution

Build awareness

Create PULL

Pilot deployment

Learning Curve

Drive broad adoption

Build Community of Practice

Progressive adoption to a new EU method

The MEAT Value Based Procurement Journey

Russia (European part) Estonia

Latvia

Lithuania

(to Russia)

Denmark

Norway Sweden

Finland

Iceland

Austria

Croatia

Macedonia

Albania Turkey

Romania

Bulgaria

Moldova

Ukraine

Hungary

Slovakia Czech Rep.

Poland

Belarus

Bosnia and Herzegovina

Serbia

Andorra Italy

France Switzerland

FYR

Germany

Netherlands

Luxembourg

Belgium

Spain

Portugal

Great Britain

Ireland

Greece

Cyprus Malta

Montenegro

National Sykehosinkop

Oulu Hospital district area Stent – Balloon

Hospital Clinic Barcelona -TAVI

UNIHA Lyon -Hypothermia system

Children’s Hospital Group

Soresa

NHS Wales - NWSSP.

DIFI Training program

South Lake

Running MEAT VBP

Slovenia

Completed MEAT VBP

Learning Curve – Experiments & Pilots

In start up MEAT VBP

Hospital clinical Barcelona - Diapers

Experiments - Pilots Community Practice

SPMS

RESAH

UGAP

NHS WALES

Consip

E17

Ankara

Vilnius.

NHS – Wales POC Anti –coagulation mngt

Medtech industry position

MedTech Europe Position on Future EU Cooperation on Health Technology Assessment

Joint medical technologies industries’ recommendations.

Few Transformative Innovations –HTA …

MEAT Value based procurement Value based contractual agreement Innovation Funding Modern fit-for-purpose HTA to inform Investment needed to transform Healthcare and use of innovative technologies – solution Special financing schemes

The MedTech Value Based Access Model

Driver to Value Based Health Care

Use of tailored instrument

Thank you!

Yves Verboven Director Market Access & Economic Policies, MedTechEurope Mail to: Y.Verboven@MedTechEurope.org Phone: +32 (479) 07 94 14