1 / 29

Health Technology Assessment

Health Technology Assessment. Anban Pillay Acting Cluster Manager: Health Economics and Financing National Department of Health. Outline. Dispensing fee International Benchmarking Draft Guidelines on the Submission of Economic Analysis Health Technology. DISPENSING FEE.

Samuel
Télécharger la présentation

Health Technology Assessment

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Health Technology Assessment AnbanPillay Acting Cluster Manager: Health Economics and Financing National Department of Health

  2. Outline • Dispensing fee • International Benchmarking • Draft Guidelines on the Submission of Economic Analysis • Health Technology

  3. DISPENSING FEE

  4. Dispensing definition • 3 activities: • Evaluation of script (advice for OTC) • Preparation of medicine • Advising patient • Excludes: • Compounding & admixing • Delivery to patient – separate, transparent fee so patient can decide (but does include transport for emergency stock access)

  5. Principles • Appropriate: Affordability and availability • Viability: cover costs and fair return on investment (ROI) but appropriate volume (2,300 pm – pharmacist & assistant) • Closely approximate a professional fee (most flat rate) • Encourage appropriate incentives

  6. Costing • ‘Normative’ model/zero-based estimate: key informant interviews, supplier data • 100% dispensary only costs (fridge, etc.) • 43% of space related (rent, electricity, etc.) • 70% other costs (stationery, etc.) • ROI of 10% on R450,000 (NHRPL precedent) • Cross-check with stakeholder data • R21-R22 VAT exclusive

  7. Estimating income • Estimate average dispensing fee per item – target of costs + ROI • SEP bands critical: • Medical schemes (90% of market) • PSSA ‘mega-sample’ of pharmacies • Key issue: • 95% of volume have SEP< R250

  8. Recommended dispensing fee (VAT exclusive)

  9. Average dispensing fee

  10. Response after Promulgation of the Dispensing fee • PSSA prevented the implementation of the fee • MoH agreed provided that case is heard on urgent basis • Exchange of papers between parties • No date for court hearing

  11. International Benchmarking

  12. Process • Invitation for proposals on methodology • Review of proposals • Finalisation of draft methodology • Publication for comment • Review of comments • Finalisation of methodology • Implementation

  13. Methodology • Originator medicines • Generic Medicines

  14. Combination Drugs • Assessed based on individual active ingredients • TOTAL SEP = SUM OF COMPONENTS • Dual methodology may apply

  15. Different Trade Names • Same Manufacturer • Same actives • Different trade names • Lowest SEP applicable

  16. OTHER ISSUES • “Temporary” price reductions • Pharmacy administration fee – inappropriate • Price changes and new product price introductions

  17. Risk Sharing Proposals • Pharmaceutical industry has come up with a range of risk sharing • Proposals are related to rare diseases where therapy is expensive • Usually limited clinical evidence to support use of the therapy • Pricing committee needs to give approve such proposals

  18. Billing for Anaesthetic gases • Manufacturers of gases sell gases in ml or mg • Patients cannot be billed for gases in minutes • Low flow delivery available at private hospitals • Hospital groups have been informed that their billing systems are inappropriate

  19. Draft Guidelines on the Submission of Economic Analysis

  20. Key Areas • Details of the proposed drug and its proposed use • Data from comparative randomised trials • Modelled economic evaluation for main indication • Estimated extent of use and financial implications

  21. HEALTH TECHNOLOGY

  22. Health Technology Assessment • Quality • Safety • Efficacy • Cost • Cost Benefit / Cost Effectiveness

  23. Health Technology - Quality Assessment of the quality of health technology • Components of the devices • Stds for the component/s • Assessment of each component • Assessment of all components operating as unit

  24. Health Technology - Safety Assessment of the safety of health technology • Safety to the patient • Safety to the operator/ administrator • Safety of the environment

  25. Health Technology - efficacy Assessment of the efficacy of health technology • Does the health technology do what is claimed? • How well does it do this? • How well does the technology work compare to the technology that we currently have?

  26. Health Technology cost effectiveness/ cost benefit • Comparative effectiveness of the new technology compared to technology currently available • Comparative cost of the new technology compared to technology currently available

  27. Clinical and Health Technology Guidelines Is there a need for separate public and private sector guidelines

  28. GUIDELINES • Both clinical guidelines and health technology assessment guidelines are based on evidence based medicine. • Reasonable for the industry to adopt the public sector guidelines.

  29. THANK YOU

More Related