Suchergebnisse

Intro -- Preface -- Contents -- Contributor Bio -- List of Figures -- List of Tables -- List of Boxes -- Chapter 1: Diary of a Policymaker -- References -- Chapter 2: The Scourge of Modern Lifestyles -- 2.1 Tobacco Use -- 2.1.1 Prevalence of Tobacco Use -- 2.1.2 Health Consequences of Tobacco Use -- 2.1.3 Tobacco Control Policies -- 2.1.4 Tobacco Control: Looking Forward -- 2.2 Physical Activity -- 2.2.1 Prevalence of Physical Activity -- 2.2.2 Getting More People Moving and Moving More -- 2.2.3 Policies to Address Physical Activity -- 2.2.4 Physical Activity: Looking Forward -- 2.3 Breastfeeding -- 2.3.1 Prevalence of Breastfeeding -- 2.3.2 Economic Cost of Suboptimal Breastfeeding -- 2.3.3 Breastfeeding Support Policies: Looking Forward -- References -- Chapter 3: ROI Analysis: Art or Science? -- 3.1 The Science of ROI Analysis -- 3.2 Applicability of ROI Analysis in Public Health -- 3.3 The Art of ROI Analysis -- References -- Chapter 4: What Is ROI, By The Way? -- 4.1 Defining the Decision Problem -- 4.1.1 Defining the Audience -- 4.1.2 Framing the Decision Problem -- 4.2 Developing Conceptual Framework and Economic Model -- 4.2.1 Population of Interest -- 4.2.2 Perspective of Analysis -- 4.2.3 Disease Process -- 4.2.4 Interventions -- 4.2.5 Resources and Costs -- 4.2.6 Timeframe of Analysis -- 4.2.7 ROI Metrics -- 4.2.8 Understanding the Current Situation -- 4.2.9 Usability Requirements -- 4.3 Collection of Supporting Data to Populate the Model -- 4.4 Using ROI Results to Make Business Cases -- References -- Chapter 5: Modelling the ROI of Public Health Interventions -- 5.1 Objective -- 5.2 Defining the Audience and Assessing Their Needs -- 5.3 Population of Interest -- 5.4 Perspectives of Analyses -- 5.5 The Economic Model -- 5.6 Model Structure -- 5.6.1 Modelling Smokers -- 5.6.2 Intervention Efficacy, Uptake and Costs.

Melissa Thompson,1 Chris Henshall,2 Louis P Garrison,3 Adrian D Griffin,4 Doug Coyle,2,5 Stephen Long,6 Zayna A Khayat,7 Dana L Anger,1 Rebecca Yu8 1Cornerstone Research Group Inc., Burlington, ON, Canada; 2Health Economics Research Group, Brunel University London, London UK; 3Pharmaceutical Outcomes Research and Policy Program, School of Pharmacy, University of Washington, Seattle, WA, USA; 4Government Affairs & Policy, Johnson & Johnson, High Wycombe, UK; 5School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada; 6Health and Life Sciences, Global Public Affairs, Calgary, AB, 7Health Systems Innovation at MaRS Discovery District, Toronto, ON, Canada; 8Strategic Health Technology Assessment, Government Affairs & Market Access, Janssen Inc., Toronto, ON, Canada Objectives: To address the uncertainty associated with procuring pharmaceutical products, product listing agreements (PLAs) are increasingly being used to support responsible funding decisions in Canada and elsewhere. These agreements typically involve financial-based rebating initiatives or, less frequently, outcome-based contracts. A qualitative survey was conducted to improve the understanding of outcome-based and more innovative PLAs (IPLAs) based on input from Canadian and international key opinion leaders in the areas of drug manufacturing and reimbursement. Methods: Results from a structured literature review were used to inform survey development. Potential participants were invited via email to partake in the survey, which was conducted over phone or in person. Responses were compiled anonymously for review and reporting. Results: Twenty-one individuals participated in the survey, including health technology ­assessment (HTA) key opinion leaders (38%), pharmaceutical industry chief executive officers/vice presidents (29%), ex-payers (19%), and current payers/drug plan managers/HTA (14%). The participants suggested that ~80%–95% of Canadian PLAs are financial-based rather than outcomes-based. They indicated that IPLAs offer important benefits to patients, payers, and manufacturers; however, several challenges limit their use (eg, administrative burden, lack of agreed-upon endpoint). They noted that IPLAs are useful in rapidly evolving therapeutic areas and those associated with high unmet need, a quantifiable endpoint, and/or robust data systems. The Canadian Agency for Drugs and Technologies in Health, the pan-Canadian Pharmaceutical Alliance, and other arms-length organizations could play important roles in identifying uncertainty and endpoints and brokering pan-Canadian PLAs. Industry should work collaboratively with payers to identify uncertainty and develop innovative mechanisms to address it. Conclusion: The survey results indicated that while challenging, use of IPLAs may be associated with various benefits. Collaboration among stakeholders remains key: Canadian agencies could play an important role in the success of these agreements, while industry should be proactive in offering solutions that will help improve outcomes across the entire health care system. Keywords: product listing agreement, survey, innovative, Canada, CADTH, pCPA

Introduction: Tobacco smoking claims 700 000 lives every year in Europe and the cost of tobacco smoking in the EU is estimated between €98 and €130 billion annually; direct medical care costs and indirect costs such as workday losses each represent half of this amount. Policymakers all across Europe are in need of bespoke information on the economic and wider returns of investing in evidence-based tobacco control, including smoking cessation agendas. EQUIPT is designed to test the transferability of one such economic evidence base—the English Tobacco Return on Investment (ROI) tool—to other EU member states. Methods and analysis: EQUIPT is a multicentre, interdisciplinary comparative effectiveness research study in public health. The Tobacco ROI tool already developed in England by the National Institute for Health and Care Excellence (NICE) will be adapted to meet the needs of European decision-makers, following transferability criteria. Stakeholders' needs and intention to use ROI tools in sample countries (Germany, Hungary, Spain and the Netherlands) will be analysed through interviews and surveys and complemented by secondary analysis of the contextual and other factors. Informed by this contextual analysis, the next phase will develop country-specific ROI tools in sample countries using a mix of economic modelling and Visual Basic programming. The results from the country-specific ROI models will then be compared to derive policy proposals that are transferable to other EU states, from which a centralised web tool will be developed. This will then be made available to stakeholders to cater for different decision-making contexts across Europe. Ethics and dissemination: The Brunel University Ethics Committee and relevant authorities in each of the participating countries approved the protocol. EQUIPT has a dedicated work package on dissemination, focusing on stakeholders' communication needs. Results will be disseminated via peer-reviewed publications, e-learning resources and policy briefs. ...