The iMTA newletter of june 2016 is online. Please find it here.

In this issue:
– Measuring productivity losses, now in 13 languages
– Free iMTA tool online to assess severity of disease (‘ziektelast’)
– COPD burden of disease
– Updated version of PAID for indirect medical costs
– Vacancy
– PhD theses completed

The iMTA is involved in many health economic projects, with both public and private partners. However, our core research interest is to advance research methodology in our field. In this newsletter we highlight a selection of our publications in Q1 of 2016 that contribute to improved decision-making in health care.

In this issue:
– Preventing Dementia
– The new Dutch tariff for EQ-5D-5L
– Cost-effectiveness of MDFT
– A practical guide for setting up patient registries
– Future costs and fixed health care budgets
– iMTA productivity costs questionnaire
– Maximum reimbursable prices
– Practical model validation tool
– Completed PhD theses

Please redirect here for our April 2016 newsletter.

Volgens nieuwe richtlijnen moeten indirecte medische kosten verplicht worden meegenomen bij economische evaluaties in de gezondheidszorg. Het institute for Medical Technology Assesment (iMTA) is een van de weinige organisaties in Nederland die deze techniek beheerst. In samenwerking met iMTA organiseert Erasmus Academie de Masterclass Indirect Medical Costs: Theory and Practice. De Masterclass is op 10 juni 2016 van 09.30-17.00 uur op de Erasmus Universiteit Rotterdam. Aanmelden kan via www.erasmusacademie.nl/imta.

Nieuwe richtlijn
De nieuwe richtlijn voor het uitvoeren van economische evaluaties in de gezondheidszorg schrijft voor dat alle zorgkosten die zich voordoen in gewonnen levensjaren moeten worden meegenomen. Dit kunnen zowel zogenaamde ‘gerelateerde kosten’ zijn (bijvoorbeeld bloedverdunners na een hartoperatie) of ‘niet gerelateerde kosten’ (bijvoorbeeld de kosten van een gebroken heup in de gewonnen levensjaren na een harttransplantatie). In de oude richtlijn werd aanbevolen om alleen gerelateerde kosten in gewonnen levensjaren mee te nemen. Als gevolg hiervan is er weinig ervaring met het meenemen van niet-gerelateerde medische kosten in gewonnen levensjaren.

Indirecte kosten
De iMTA Masterclass Indirect Medical Costs: Theory and Practice gaat over het meenemen van niet-gerelateerde medische kosten in gewonnen levensjaren in economische evaluaties. De Masterclass wordt geleid door dr. Pieter van Baal. Hij behandelt onder meer de theorie omtrent kosteneffectiviteitsanalyse en de kosten als gevolg van langer leven. Verder gaat hij in op empirische studies die het effect van langer leven op zorguitgaven hebben onderzocht. Deze inzichten worden vervolgens gebruikt als uitgangspunt om niet-gerelateerde medische kosten in gewonnen levensjaren mee te nemen in kosteneffectiviteitsanalyses.

Zelf aan de slag
De nadruk in deze workshop ligt op de praktijk. Oftewel, hoe kun je medische kosten in gewonnen levensjaren meenemen in kosteneffectiviteitsanalyses? Om dit te doen wordt gebruik gemaakt van Practical Application to Include future Disease costs (PAID old.imta.nl/paid). Deelnemers aan de workshop gaan aan de slag met PAID in combinatie met diverse typen kosteneffectiviteitsmodellen. Deelnemers kunnen eigen modellen meenemen.

iMTA-masterclasses
De Masterclass Indirect Medical Costs: Theory and Practice is onderdeel van een serie verschillende bijeenkomsten over medical technology assesment. De masterclasses worden georganiseerd door Erasmus Academie en staan inhoudelijk onder leiding van onderzoekers van het Het institute for Medical Technology Assesment (iMTA) van de Erasmus Universiteit Rotterdam.

Meer informatie over de serie iMTA Masterclasses vindt u op www.erasmusacademie.nl/imta of mail naar goedegebuur@erasmusacademie.nl. Bellen kan ook: 010-408 2522.

[Update: 150 seats all sold out]

If you have not subscribed to our newsletter or have not received it in your inbox, please find the newsletter invite about the new Dutch health economic guidelines here.

Redirect to the full newsletter here if you have not subscribed and received it in your inbox

Please find our June 2015 newsletter here.

In this newsletter you will find updates on:

– Our iMTA iPad app (which you can download here)
– A selection of recent projects (valuation studies / CEA’s / dossier submissions)
– Our iHEA 2015 presence
– Three newly won Horizon2020 projects
– Four recently finished PhD dissertations

We would like to congratulate iMTA researcher dr Lucas Goossens and his co-authors with the ISPOR Paper of The Year Award 2015 award! Dr Goossens set up a discrete choice experiment and applied latent class analysis to identify groups of patients with very distinct preferences for being treated at home or in the hospital.

Full reference:

Goossens, Lucas MA, Cecile MA Utens, Frank WJM Smeenk, Bas Donkers, Onno CP van Schayck, and Maureen PMH Rutten-van Mölken. “Should I Stay or Should I Go Home? A Latent Class Analysis of a Discrete Choice Experiment on Hospital-At-Home.” Value in Health 17, no. 5 (2014): 588-596.

Full article: http://dx.doi.org/10.1016/j.jval.2014.05.004

Disease management programs (DMPs) and innovative payment schemes are potentially powerful instruments to stimulate the delivery of integrated care and influence health care expenditure. This is what Apostolos Tsiachristas concludes in his PhD research about the impact of these instruments. Tsiachristas defends his PhD dissertation on Friday 20 March 2015 at the Erasmus University Rotterdam.

Chronic diseases are a major threat to population health and sustainability of health care systems as well as a challenge to economies worldwide. Integrated care, delivered in the form of DMPs, is a promising concept to tackle this threat. DMPs are frequently supported by innovative payment schemes, which provide health care providers with financial incentives to implement integrated care.

Tsiachristas investigated in his PhD dissertation titled ‘Payment and Economic Evaluation of Integrated Care’ the impact of innovative payment schemes, the variability in costs of DMPs, and the cost-effectiveness of DMPs for cardiovascular risk management (CVRM), COPD, and diabetes.

Reduction in the growth of health care expenditures

Pay-for-performance, pay-for-coordination, and all-inclusive payments provide intended and unintended incentives. A combination of these payment schemes may overcome the unintended financial incentives of each individual scheme. Compared to countries that they did not implement innovative payment schemes, the annual growth of hospital and administrative expenditure was reduced in countries that have implemented pay-for-performance while, the annual growth of outpatient expenditure was reduced by the introduction of all-inclusive payment schemes.

Variability in costs

There is great variability in the health care utilization costs of patients participating in DMPs. These costs are higher in patients that are older, have multi-morbidity (especially when cardiovascular disease is included), and have low quality of life. Patients in COPD DMPs have higher health care utilization costs than patients included in CVRM and diabetes DMPs. There is also wide variation in the development and implementation costs of DMPs. This is driven primarily by the duration of the development phase and the staff needed to develop and implement a DMP. The development and implementation costs of DMPs may be reduced by exploiting existing economies of scale and economies of scope.

More comprehensive more effective

DMPs improve lifestyle indicators such as physical activity and reduced smoking in the short term. However, effects in terms of Quality Adjusted Life Years (QALYs) are insignificant. DMPs that are more comprehensive have the potential to be effective or cost-effective compared to less comprehensive DMPs.

A recent press release of the Value in Health journal highlighted the work of iMTA colleages Isaac Corro Ramos, Maureen Rutten-vanMolken and Mainwenn Al.

Corro Ramos et al. focused on determining the impact of including randomized controlled trials (as an example) at the time a decision is made, and whether the more complex models are always needed to address prioritization of additional research.

Corro Ramos et al. constructed a typical decision model for chronic progressive diseases with four health states and parameters related to transition and exacerbation probabilities, costs, and utilities.

They show that additional uncertainties arising from outcomes studies should be anticipated at an early stage and included in the model because this can have a strong impact on the prioritization of further research.

Link to Value in Health article here