EH 6/2014

Überlebensstrategien für Krankenhäuser Survival strategies for hospitals © 2014 PricewaterhouseCoopers Aktiengesellschaft Wirtschaftsprüfungsgesellschaft. Alle Rechte vorbehalten. „PwC“ bezieht sich auf die PricewaterhouseCoopers Aktiengesellschaft Wirtschaftsprüfungsgesellschaft, die eine Mitgliedsgesellschaft der PricewaterhouseCoopers International Limited (PwCIL) ist. Jede der Mitgliedsgesellschaften der PwCIL ist eine rechtlich selbstständige Gesellschaft. www.pwc.de/krankenhausberatung Ihre Ansprechpartner Your Contacts Michael Burkhart Geschäftsbereichleiter Gesundheitswesen Head of Division Healthcare Tel.: +49 69 9585-1268 michael.burkhart@de.pwc.com Armin Albat Leiter Krankenhausberatung Head of Hospital Advisory Services Tel.: +49 511 5357-5315 armin.albat@de.pwc.com Dr. Martin von Bergh Ärztlicher Leiter Krankenhausberatung Medical Director Hospital Advisory Services Tel.: +49 69 9585-3765 martin.von.bergh@de.pwc.com Würden Sie einem Arzt vertrauen, der Sie therapiert, ohne Sie zuvor zu untersuchen? Wir auch nicht. Mit innovativen Beratungsansätzen und durch den Einsatz neuster technologischer Systeme durchleuchten wir sämtliche Abläufe in Ihrer Klinik und zeigen Ihnen vielseitige Optimierungspotentiale auf. Im Anschluss unterstützen wir Sie bei der Entwicklung und Umsetzung zukunftsfähiger Strategien, die Ihr Krankenhaus überlebensfähig machen. Gemeinsam verfolgen wir ein Ziel – eine gesunde Zukunft. Would you trust a physician who treats you without examining you ﬁrst? We wouldn’t either. With innovative consulting approaches and the use of cutting edge technologies we screen the entire clinical workﬂow in your hospital and highlight the potential for optimisation. Afterwards we support you to develop and implement sustainable strategies ensuring your hospital is viable for the future. Together we follow one goal – a healthy future. Die PwC Krankenhausberatung kennenlernen (3 Minuten Video) Get to know PwC’s Hospital Advisory Services team (3-minute Video) PwC_Anz_Healthcare_European_Hospital_A4_RZ.indd 1 12.12.14 11:55 www.european-hospital.com 3NEWS & MANAGEMENT ore equality in healthcare Dr François Meyer, International Adviser to the French Haut Autorité de Santé (HAS) ventions evaluated by national HTA bodies using criteria, procedures and rules that are defined at that national level. This means that across mem- ber states there are differences in HTAs’ processes; the only common obligations being to take decisions based on objective and verifiable cri- teria and the respect of timeframes e.g. 90 or 180 days for a new drug. This means that, in Europe, there are country specific differences in access to health technologies complicating cross-border healthcare. In fact, two major models are used in Europe. One, used in countries such as France, is based on deter- mination of added clinical benefit, which then leads to price nego- tiation and a final decision. In other countries, such as the UK, a health economics analysis using the price proposed by a company is instigated and then the decision is based on the calculation of the estimated cost/ QALY and this is then compared to the threshold acceptable for the country’s policy makers. The licensing of drugs is already carried out at a pan-European level by the EMA, so why not go further and have a centralised approach to HTA? The EUnetHTA Joint Action 2 Grant Agreement has been in place since 1 October 2012 and is sched- uled to run for three years. Thirty-seven partners in 26 EU Member States are involved in the project, which focuses on strength- ening the practical application of tools and approaches to cross-bor- der HTA collaboration to establish a sustainable structure for HTA work in the EU. To convert this into reality and ensure that all European citizens have best possible healthcare now and in the future, with resources allocated according to need rather than economic climate, two types of collaborative action have been attempted. As Dr Meyer explained during his presentation, the first is to cooperate on HTA production. Its aims are to avoid duplication of work (e.g. between 2005 and 2008, seven HTA reports on drug eluting stents were produced) and increase consistency and transparency. To achieve these, joint assessment reports of core HTA information have been created, as have tem- plates for companies to submit data and methodological guidelines for HTA bodies to follow. A concrete example of this collaboration is the methodological guidelines put in place for the assessment of the rela- tive effectiveness of a new drug. In this case nine guidelines have been put in place to be followed by HTA bodies when assessing a drug. They cover the choice of end points, com- parators and comparisons and levels of evidence. The second type of collaboration is a project to improve the quality of data produced in primary research. The objectives of this initiative are to improve the development plans of new technologies and the addi- tional data collection (to reduce uncertainty after initial assessment). The tools put in place to help obtain these are ‘early dialogues’, disease specific guidelines and a definition of common core protocols for the collection of additional data. An on-going example is the devel- opment of disease specific guide- lines for osteoarthritis; the draft document will be available for pub- lic consultation later this year (Q4). Early dialogues are an initiative whereby the company presents its development plan and ask questions to HTA bodies to check whether the choices made are appropriate (e.g. the choice of comparator, endpoint, population and so forth). The completely confidential meet- ings are funded under the umbrella of EUnetHTA and another European initiative, SEED (Shaping European Early Dialogues) which is coordinat- ed by the HAS, France. These meet- ings are attended by between to five to 12 different HTA agencies with the EMA invited as observer. To date, 14 different projects for new drugs have undergone early dialogue with great success in improved efficiency and six more projects are about to enter the process. Despite the apparent advances from this EU sponsored model many questions remain unanswered. How will the European cooperation on HTA be financed in the long term? Will there be a fee for service for some activities? How will HTA bod- ies work together in the future? Which HTA bodies will participate? What will be the priorities of the permanent HTA network? How will national HTA bodies used the joint work for the production of their national HTA reports?This October, these vital questions were addressed and debated at the HTA 2.0 Europe conference in Rome. Details: www.mapigroup.com/ www.eunethta.eu/ http://ec.europa.eu/health/technology_ assessment/policy/network/index_en.htm Tel.: +49699585-1268 Tel.: +495115357-5315 Tel.: +49699585-3765 PwC_Anz_Healthcare_European_Hospital_A4_RZ.indd 112.12.1411:55

EH 6/2014

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