News Across Asia Volume 8 No. 4 (January 2020)
Happy New Year from your family at ISPOR! We wish you and your family a very healthy, prosperous and blessed 2020. We are very pleased to present News Across Asia Pacific Winter 2020 issue, which provides timely health policy updates from Asia Pacific and ISPOR regional news. We hope you enjoy this issue and remember to submit your abstracts to ISPOR Asia Pacific 2020 by March 11, 2020!
News Across Asia Co-Editors Alex Fu, Sang Soo Lee, and Fang Zhang
HEOR Updates from the Region
- Health policy updates from ISPOR Asia Consortium meeting in Copenhagen
- Moving towards a value-driving medical technology assessment in Asia Pacific: A multi-stakeholder perspective
- ISPOR HTA roundtable Asia Pacific Summary
- ISPOR Patient Representatives Roundtable Asia Pacific Summary
- Key Health Awareness Initiatives undertaken in India
ISPOR Member News
- ISPOR Asia Pacific 2020 Conference – abstracts are open, theme, plenaries and short course program published!
- ISPOR Asia Consortium 2020 agenda
- ISPOR Chapter Leadership training 2020
- Chapter Leadership Training Webinar held in December 2019
ISPOR Headquarters News
- New ViHRI Editor-in-Chief
- ISPOR Travel Grants
- Sponsored Webinars
- Updating your ISPOR Profile
- Upcoming ISPOR Conferences
- Become an ISPOR Member
About ISPOR Global Networks
This article is an introduction to the HTA process and landscape in Australia.
HEOR UPDATES FROM THE REGION
Health policy updates from ISPOR Asia Consortium meeting in Copenhagen
Kazakhstan has been undergoing a phased reform towards a single-payer social health insurance system since 2017, with the full system-wide transition set to roll out from January 2020. During the transition period, efforts of healthcare authorities have been concentrated on creating the foundations for the system through establishing the national social health insurance fund and defining the contribution rates and criteria for different population segments. While the new system has been touted to facilitate improvements in efficiency, transparency and accountability in healthcare, achieving these objectives will not be possible without evidence-based decision-making in place. The role of HTA as a bridge between evidence and decision-making in healthcare is thus set to increase. The ISPOR Kazakhstan Chapter proposes to hold an interdisciplinary conference to provide a medium for discussion of current issues and trends in HTA and health economics and outcomes research (HEOR) in the context of healthcare systems in lower-and-middle income countries (LMICs) and healthcare.
The use of HTA and real-world evidence have rapidly gained popularity in China in recent years. In 2019 China Nation Healthcare Security Administration (NHSA), responsible for the state-run health insurance program, established an expert panel composed of 40 HTA and HEOR specialists. This expert panel, led by the ISPOR Asia Consortium members Professor Shanlian Hu, Professor Kun Zhao, and Professor Wen Chen, had evaluated 150 drugs including 119 new drugs and 31 renewal drugs. 70 new drugs and 27 renewal drugs have been negotiated successfully with price cuts reaching as high as 60.5% and 26.4% on average, respectively. The updated National Reimbursement Drug List was released on 28 November 2019.
Under the support of the National Medical Products Administration and other national professional societies, the China Real-World Data and Studies Alliance (ChinaREAL), led by President of ISPOR West China Chapter took a leadership role on the development of a series of technical guidance documents including databases and registries for research purposes, epidemiological and statistical considerations in the assessment of treatment effects, and key methodological issues in pragmatic randomized controlled trials. Five RWD technical guidance documents were officially released in 2019.
The Singapore Ministry of Health aims to make healthcare more affordable, accessible and comprehensive. The healthcare budget is forecast to reach SGD 15 billion in year 2020, more than triple from 2010 at SGD 4 billion. This makes healthcare the 3rd largest spending item, behind education and defense. Recent healthcare initiatives development and progress are as follows: 1) Moving care beyond hospital to the community: The MOH goal was achieved in 2019 when finance minister allocated SGD 6.1 billion in recognition of primary healthcare as the critical nodes in the network of care. This provided more affordable healthcare closer to home in managing aging population and the rise of chronic diseases. Government subsidies expanded to cover treatments for complex chronic conditions in addition to common illnesses at private general practitioners. Private practitioners made up 80% of the primary care physician workforce and by increasing coverage for management of complex chronic conditions there has been a reduction in the bottleneck at public health facilities. 2) Infrastructure: There is a plan to build one hospital every 2 years, preparing for the expected surge in demand from the aging population. The concept of the new hospital is a comprehensive integrated care hub with acute and community hospital nodes. A community hospital provides step-down care including rehabilitation to support patients in transition back to home and the broader community. 3) Technology – telemedicine: Woodland Health Campus (north region of Singapore) is expected to be completed in 2022. Every patient will be given an electronic device like a wearable watch that can monitor vital signs, activity and location. It will alert nurses when patients’ blood pressure goes up by too much or where to locate a dementia patient’s whereabouts. The device also continues to monitor patient’s condition after they return home and the continuum of care covers tele and/or video conferencing. 4) Public-private partnership: the primary prevention program “Healthy Living Singapore” is a true prevention program beyond health screening. All Singaporean residents are encouraged to hit 10,000 steps per day through a National Step Challenges (5th year in running). Singaporean citizens and permanent residents were given a free fitness tracker with heart rate monitoring. Fitbit partnered with the Health Promotion Board, giving out free fitness trackers with a 1-year premium membership sign up. In addition to the step challenge, the Health Promotion Board (HPB) partnered with other private fitness centers to offer 12 free fitness classes from October to December 2019. Classes range from yoga, Zumba, boxing, Pilates and many more. There is also a separate program targeted at overweight individuals.
The Thailand HTA guideline version 3.0 has been in the process of finalization. For this round, it has a total of 19 chapters including core chapters e.g. costing/ discounting/outcomes/SA/ model validation/BIA/feasibility and special chapters such as HTA for public policy, vaccine, screening, medical device, cancer, special e.g. rare disease, biosimilar, complex interventions and RWE. The final Thai version is expected to be completed by the end of 2019 and the English version is to be drafted and published in Q1/ 2020.
There has also been a discussion at the National List of Essential Medicines committee. It has been agreed that decision criteria including a willingness to pay (WTP) threshold should be revisited. The framework will look at questions such as:
1) Is there any evidence demonstrating that the current decision criteria and threshold used has been inappropriate and should be revised?
2) What is the direction of the revision (increasing or decreasing the threshold)?
3) What are the pros and cons of revising the threshold and its effect on the healthcare system, healthcare professionals, patients, R&D, industry and general population?
4) What are the current research methodology options to determine the threshold?
5) What are the pros and cons for each approach?
6) Which one is appropriate and feasible to be used in the Thai context?
7) If revision is needed, is it recommended to have a different threshold for “prevention” and “treatment?” Should there be a difference between “general population” vs “rare disease” or “terminally ill patients?
8) What are the pros and cons of having different thresholds and what are their effects on the healthcare system, healthcare professionals, patients, R&D, industry and the general population?
Potential gradual tax increases for sweetened beverages have been suggested to be introduced but the tax was not earmarked for chronic disease prevention or management. The tax for salty snack foods has been proposed and it may happen in 2022. There has also been an initiative to have a rare disease working group under the Universal Coverage Benefit Package committee to devise a system and have a comprehensive view on how to handle the issue of rare diseases.
Moving towards a value-driving medical technology assessment in Asia Pacific: A multi-stakeholder perspective
The MedTech Industry is facing a rapidly changing healthcare ecosystem across Asia Pacific (APAC). Epidemiological shifts, changing regulatory and policy environments, increasing healthcare cost containment pressure and evolving reimbursement systems are all key drivers impacting patient access to medical devices across the region. This landscape presents a unique opportunity for stakeholders from across the healthcare ecosystem to work together to ensure value is at the heart of healthcare decision-making. As part of the Asia Pacific Medical Technology Association (APACMed) MedTech Forum on October 9th in Singapore, a Summit was held to discuss value definitions and value-based assessment approaches for MedTech across the APAC region from the perspectives of multiple stakeholders and experts in the healthcare ecosystem. The Summit welcomed over 130 participants from across the region.
Insights into the challenges and opportunities in value assessment for medical technologies were presented by experts in the field: Ms Miyeong Kim (Patient Advocate and Executive Director of the Korean Society of Type 1 Diabetes), Mr Markus Siebert (Senior Director, Health Economics & Reimbursement, Abbott), Ms Sirinthip Petcharapiruch (Principal, Real World Solutions, IQVIA APAC), Professor Jianwei Xuan (Professor & Director, Sun Yatsen University), Professor Stephen Goodall (Deputy Director, Centre for Health Economics Research and Evaluation), Professor Ataru Igarashi (Associate Professor, Unit of Public Health and Preventive Medicine, School of Medicine, Yokohama City University), and Dr Mingdong Zhang (Chief Medical Officer & Vice President of Strategic Medical Affairs, Boston Scientific Asia Pacific).
A number of key considerations in assessing the value of medical technologies were raised during the presentations, including the multidimensional nature of value; the importance of incorporating the patient perspective in value-based decision making; the current heterogeneity of the HTA landscape and comparatively less established methods for assessing value across the region; differences between pharmaceuticals and medical technologies, and subsequent HTA development and application in each space; as well as differences in incentivizing innovation, with current HTA processes for medical technologies being seemingly disconnected from reimbursement outcomes. A number of opportunities for redefining and improving government policy on HTA for medical technologies were suggested by the group, including increased linkages between HTA for medical technologies and reimbursement; considering alternative reimbursement arrangements, such as risk-sharing agreements; consider the use of real-world evidence, multi-criteria decision-making in HTA methods; and develop frameworks to embrace digitization. In addition, industry should also seek to establish the value of products to patients and regulators early in the product life cycle. During the panel discussion, panelists highlighted the importance of aligning the definition of value across different stakeholders in the HTA process so as to effectively capture the true value of a medical technology to the health system. The panelists agreed that there needs to be a holistic view of value, including preventive benefits, and highlighted the need to converge the eligibility criteria and willingness-to-pay for medical technologies and pharmaceuticals.
Summary: As healthcare reimbursement models move from being price-based to value-based, HTA processes must be updated to support this. To address the challenges intrinsically linked to evaluating medical technologies, there is a need for clearer guidance on the process of evaluating medical technologies. This will involve establishing clear guidelines on the evaluation process and evidence requirements. Such guidance not only increases transparency around funding criteria but can also support innovation among the industry, as the link between funding decisions and innovation is made clearer. There will be opportunities for various stakeholders to reshape the field. Knowledge generated by researchers is crucial to improving HTA processes, and input from providers and patients can help to inform funding decisions. Governmental bodies and manufacturers also play an active role in defining HTA. Manufacturers can undertake this by establishing strong product value propositions early in the product life cycle, by understanding the evidence requirements in each market, and by building partnerships with providers, patients, and decision makers for sustainable outcomes.
Founded in 2014, the Asia Pacific Medical Technology Association (APACMed) is the first and only regional association to provide a unified voice for the medical technology industry across Asia Pacific. The mission of APACMed is to improve patient access to high quality healthcare and life enhancing technologies. APACMed works proactively with bilateral, regional and local government bodies and other healthcare stakeholders to shape policies, foster innovation and promote regulatory harmonisation. APACMed works with medical device associations and companies in Asia Pacific to jointly advance regional issues, codes of ethics and share best practices.
ISPOR HTA Roundtable Asia Pacific Summary
Against the backdrop of rapid institutional reform and development for national health technology assessment (HTA) in China, ISPOR hosted an HTA Roundtable discussion in Beijing, China on Friday, 25 October 2019. The ISPOR HTA Roundtable is an invitation-only discussion table for representatives from public HTA bodies, public and private payers, decision makers, and government-contracted academic centers (if no HTA body exists in the country) from Asia Pacific to discuss the topics pertinent to HTA and healthcare decision making.
During this roundtable, topics surrounding high cost drugs, curative therapies, and HTA development and utilization were discussed, with participants presenting key cases of managed entry schemes, negotiation mechanisms and approaches for pricing and reimbursement, HTA harmonization across the globe, HTA in universal health coverage implementation, and patient involvement in healthcare decision making. The roundtable had representation from key HTA bodies in the region including Pharmaceutical Benefits Advisory Committee (Australia), HTAIn (India), HTA Committee (Indonesia), HIRA and NECA (South Korea), CDE (Taiwan), National Institute of Public Health and National Institute of Social Security and Population Research (Japan), MaHTAS (Malaysia), Philhealth (Philippines), ACE (Singapore), HITAP (Thailand) and HTA Group (Mongolia).
Key Questions / Takeaways
- How can HTA be more timely, relevant and usable for decision makers? It should be an inclusive and transparent process that proactively emphasizes local horizon scanning and priority setting.
- Where should patients and decision makers be involved in the HTA process?
- Development and utilization of local population data will be an essential priority for Asia Pacific countries in near term to mitigate global data reliance. Patient-reported outcomes data are also set to play a more prominent role in future evidence considerations, including in China.
- To make managed-entry and risk-sharing agreements more feasible in the region, additional work needs to be done by innovators to generate acceptable evidence for payers to lessen their burden and mitigate uncertainty and risk where possible. Study design and time horizons should be better reflective of the nature of the investment and anticipated outcomes. Payers should also have a better understanding of the potential market impact of reimbursement and renegotiation decisions.
- It will be essential for HTA stakeholders to effectively translate their recommendations into policy. A model for this could be Malaysia, which involves government payers in assessment priority setting through criteria and discusses evidence with decision-makers on the local context.
ISPOR HTA Roundtable Asia Pacific Delegates
The next ISPOR HTA Roundtable – Asia Pacific will take place during the ISPOR Asia Pacific 2020 Conference, to be held on 12-15 September 2020 in Seoul, South Korea. For more information on these and other initiatives, please visit here.
ISPOR Patient Representatives Roundtable Asia Pacific Summary
As patient-centered healthcare continues to grow in prominence globally and in the Asia Pacific, ISPOR convened its second patient representative roundtable in Asia Pacific on 25 October, 2019 in Beijing, China. The ISPOR Patient Representative Roundtable provides a platform for patient representatives, academicians and researchers, government and HTA bodies, and the medical technology industry to discuss the role of patient participation in HTA in the Asia Pacific region and how to make decision-making more patient-centric.
The roundtable enjoyed broad representation from key decision-making bodies from the region such as PBAC (Australia), HTAIn (India), HTA Committee (Indonesia), HIRA and NECA (South Korea), CDE (Taiwan), National Institute of Public Health and National Institute of Social Security and Population Research (Japan), MaHTAS (Malaysia), Philhealth (Philippines), and HITAP (Thailand). Patient organizations that were represented included the Heart to Heart Foundation (Thailand), Lymphoma Association of China, China Organization for Rare Diseases, Philippine Alliance of Patient Organizations, Vietnam Hemophilia Group, China Rare Disease Organizations Development Network (Mainland China) and the Psoriasis Association Taiwan.
The roundtable agenda covered presentations by several patient representatives and HTA bodies on their experiences with patient participation in HTA and healthcare decision-making and included robust discussion on how this can be further strengthened.
Key Questions / Takeaways
- What is the patient role in healthcare priority setting and decision-making, and what can they meaningfully provide to decisionmakers?
- Data are an important tool for patient organizations to present their case to decision-makers, but they must be presented in a way that is useful to decision-makers.
- There is an important role for patients to play in clinical trial and observational study design and interpretation.
- Where are the systematic weaknesses or gaps globally in evidence for patients? How can this be addressed in a standardized way with HEOR?
- Patient-generated data is going to continue to grow in importance and relevance in healthcare decision-making in Asia Pacific
ISPOR Patient Representatives Roundtable Asia Pacific Delegates
The next ISPOR Patient Representatives Roundtable – Asia Pacific will take place during the ISPOR Asia Pacific 2020 Conference, to be held on 12-15 September 2020 in Seoul, South Korea. For more information on these and other initiatives, please visit here.
Key Health Awareness Initiatives undertaken in India
ISPOR regional chapter and student chapter members in Amaravati, India undertook several important and highly impactful educational initiatives in the fall to raise awareness about key health issues:
- Breast Cancer Awareness Month (October 2019)– Members conducted an awareness program, which included conducting screening for breast cancer for 90 patients, a guest lecture on breast cancer risk factors, and an awareness rally conducted in different areas in the province. Over 400 people participated in the lecture and rally.
- National Cancer Awareness Day (November 7, 2019) – A lecture was provided on the topic of cancer awareness and risk factors, as well as preventative life styles, with 350 people participating.
- World Pneumonia Day (November 12, 2019) – A lecture was conducted surrounding pneumonia awareness to all patient caregivers in pediatric wards and PharmD students distributed leaflets about prevention, symptoms and treatment, with 300 people participating in the talk.
- World Diabetes Day (November 14, 2019) – PharmD students distributed leaflets about prevention, symptoms and treatment of diabetes and generated awareness of the disease, with glucose screening also provided to the public. There were over 400 participants.
- National New Born Week (November 15-21, 2019) – An awareness program was conducted about newborn care at a local hospital, and students distributed leaflets to raise awareness about newborn care including healthy lifestyle, breastfeeding and immunization, with 300 people participating.
Pneumonia Screening initiative in India in November 2019
Breast Cancer Awareness Rally in India in October 2019
For more information, please visit the ISPOR India – Amaravati Chapter website.
ISPOR MEMBER NEWS
ISPOR Asia Pacific 2020 Conference
Abstracts are now open for the conference through March 11, 2020. Submit your abstracts here.
We are delighted to announce the Conference theme, plenaries and short course program are published on the website. The theme of the conference is “The Next Generation of Healthcare in Asia Pacific: Where Technology Meets Patients to Improve Care,” and there will be 3 plenaries covering key topics:
- Advancing Precision Medicines in Asia Pacific: Progress, Opportunities, and Challenges
- Patient Involvement in HTA and Health Policy: Global Experiences and Lessons Learned
- Innovative Approaches to Pricing, Value Assessment, and Patient Access to High Cost Interventions
There will also be 18 total short courses featured in Seoul, including 6 new courses:
6 New courses for Seoul
- Study Design with Real-World Data
- Health Technology Assessment for Rare Diseases
- Access & Value Assessment of Medical Devices
- Introduction to Machine Learning in Healthcare
- Adapting Cost Effectiveness Models across Countries
- Using Multi-Criteria Decision Analysis in Health Care Decision Making: Approaches & Applications
- Reimbursement Systems for Pharmaceuticals in Asia Pacific
See you in Seoul in 2020!
ISPOR Asia Consortium 2020 Agenda
ISPOR Asia Consortium will have another active year in 2020, with plans to carry ISPOR’s mission forward through the region. Key objectives and activities for 2020 include:
- Continue to grow ISPOR strategic presence in Asia Pacific
- Increase engagement of members in the region and participation in leadership positions at ISPOR
- Generate region-specific content for consumption by members
- Implement Asia Consortium 2020 annual agenda successfully
- Build partnerships with global organizations and civil society
- Support and preparation for ISPOR Asia Pacific 2020 Conference
- Support ISPOR HTA and Patient Representatives Roundtables
- Contribute scientific content for the Asia Pacific region in the form of webinars, invited sessions, forums and health policy articles
- Keep members engaged and informed of ISPOR initiatives and projects, including key leadership positions, working groups and task forces, and education
- Content generation for the region, including 2 webinars, 4 health policy articles, and 1-2 educational sessions organized
- Organize ISPOR Asia Consortium meetings throughout the year
- Provide ISPOR Chapter engagement, training and financial support
For more information and to join ISPOR Asia Consortium please contact email@example.com.
ISPOR Chapter Leadership Training 2020
ISPOR will be organizing several training webinars for ISPOR regional chapter leaders throughout 2020 on a variety of topics that include both HEOR and policy topics as well as leadership skills training. Stayed tuned for more information on the upcoming schedule and how to participate.
Chapter Leadership Training Webinar held in December 2019
ISPOR recently organized a training webinar entitled, “Sharing Good Practices for Students and Regional Chapters Collaboration to Increase Engagement,” on December 12, 2019. The webinar’s objective was to provide training to ISPOR regional and student chapter leaders and members on the topic of engagement with students and new professionals, with the aim of fostering new leadership, fresh perspectives, and sustainable development. The webinar used real-world examples from Chapter leaders in the USA, Colombia and Ethiopia and had over 60 global participants. To view the webinar recording please visit here.
ISPOR Asia Consortium Activities at ISPOR Europe 2019
ISPOR Asia Consortium hosted a business meeting during the ISPOR Europe 2019 Conference on Tuesday, 5 November 2019 which had 55 participants. ISPOR Global Networks also organized a forum entitled “Use of MCDA in HTA, Coverage and Reimbursement Decision-Making: Experience and Insights from EMEA, Latin America and Asia-Pacific” on Tuesday, 5 November 2019 which had nearly 200 participants. There were over 400 registrants from Asia Pacific attending ISPOR Europe, which is a record number for participants from the region attending an ISPOR European or International meeting. The next ISPOR Asia Consortium meeting will be held during ISPOR 2020 Conference in Orlando, look forward to seeing you there!
ISPOR Asia Consortium meeting participants in Europe
ISPOR HEADQUARTERS NEWS
Congratulations to Manuel Espinoza, the new editor-in-chief for ISPOR Value in Health Regional Issues!
Dr Espinoza is an associate professor with the Department of Public Health at Pontificia Universidad Católica de Chile in Santiago, Chile. Prior to his appointment as editor-in-chief for ViHRI he was serving as an associate editor for Value in Health, the Society’s flagship journal. A longtime active member of ISPOR, Dr Espinoza has held many leadership positions within the Society, including president of the Latin America Consortium, president of the Chilean Society for Pharmacoeconomics and Outcomes Research (ISPOR Chile Chapter), and director on the ISPOR Board of Directors.
ISPOR Travel Grants
The program supports attendance at the Society’s scientific conferences for eligible ISPOR members. Additional information on ISPOR Conference Travel Grants can be found at:
- Travel Grants
For members in countries classified by the World Bank list of economies as Low/Lower-Middle/Upper-Middle classification
- Student Travel Grants
For student members
- Patient Representatives Travel Grants
For patient representative members
Stay tuned for the next opportunities to participate in this program! For more information about the travel grant eligibility and criteria, please visit ISPOR Travel Grants. Questions can be also sent to firstname.lastname@example.org.
Use the power of ISPOR’s research to bring your message directly to the global HEOR community. ISPOR’s sponsored webinars provide a unique opportunity to reach and educate a targeted audience of HEOR researchers and decision makers. For more information contact Sean Gormley, Associate Director, Exhibits and Meeting Partnerships at: email@example.com
Updating your ISPOR Profile
Please activate your ISPOR user profile in the new system to access ISPOR’s HEOR content and resources with a single sign-on, including Value in Health and Value in Health Regional Issues articles, Good Practices for Outcomes Research Reports, and other HEOR resources. To activate your user profile, please:
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Upcoming ISPOR Conferences
May 16-20, 2020
Orlando, FL, USA
- Submission Open Date: November 1, 2019
- Submission Close Date: January 15, 2020
- Author Notification: March 2, 2020
12-15 September 2020, Seoul, South Korea
Abstract Submission Deadline: 11 March 2020
29-30 September 2020, Dubai, United Arab Emirates
ISPOR Europe 2020
14-18 November 2020, Milan, Italy
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ABOUT ISPOR GLOBAL NETWORKS
Join ISPOR Asia Consortium
The ISPOR Asia Consortium Consortium is comprised of professionals interested in promoting health economics and outcomes research (HEOR) excellence to improve healthcare decision making in Asia Pacific and globally. The Asia consortium provides a platform for information-sharing and institutional collaboration on HEOR and health policy, facilitating professional networking opportunities through scientific activities and global ISPOR initiatives.
Want to join? Contact firstname.lastname@example.org
There is more!
To learn about the latest HEOR news in (Latin America / EMEA) and read about activities and initiatives of ISPOR global groups in the (Latin America /EMEA) regions, please access the January 2020 issue of News Across Latin America . / January 2020 issue of News Across EMEA.