Innovation in European healthcare â what can Sweden learn? - LIF

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Multitude of bodies within NHS innovation-landscape diffuses responsibility • Innovation funding is managed by different NHS organisations, ranging from SHAs to PCTs to specialist commissioning groups to individual hospitals. • Given the variety of “owners”, how and what these funds are used for can be extremely varied, and the process of applying for funding can be extremely complex. • Industry struggles to identify and then engage with budget holders, the eligibility criteria to access funds may vary across geographies, and how funds are prioritised to address many potential needs is unclear. • Critique of lack of transparency behind the decision making processes as there is no clinical scrutiny or accountability for these local decisions; which is especially problematic when they are contrary to the clinically published opinion of NICE. ‣ “It appears to us that the NHS puts in place multiple structural layers of decision-making which impede access to new medicines.” (Policy Officer, Roche) 162
Multiple structural layers within NHS lead to inefficiencies, duplication and complexity in local decision-making and value assessments Carries out evaluation of new products and provides guidelines Often carry out own assessment and may fund products/procedures not endorsed by NICE NICE PCTs Area Prescribing Committees Especially evaluates clinical costeffectiveness and gives recommendations Final say regarding purchase of new technologies and introduction of new products Commissioners Regional Technology Assessment Groups May carry out additional assessments of new technologies 163
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Innovation in European healthcare -
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Introduction If it was up to the NI
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GDP per capita 2011, thUSD Annual G
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Import Technology uptake Export End
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Venture capital flight away from li
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Issues in Sweden: clinical research
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Issues in Sweden: communication and
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Issues in Sweden: reimbursement for
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Summary - the innovation challenges
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InDex Pharmaceuticals InDex Pharmac
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Addressable Patient Population in E
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What conclusions can be drawn from
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Elekta has established a model for
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The five European countries 27
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German healthcare system • German
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Role of important Government and Of
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Role of important Government and Of
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Germany needs more healthcare for t
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37 DRG was developed in the US in t
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The base rate varied during the con
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There are public, private for profi
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Financing System of the German SHI
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Central Changes in the German healt
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Innovations in the German Health Ca
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Cost of Pharmaceuticals and Medical
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Three steps for Integration of New
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NUB Process in the German DRG Syste
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Innovative drugs in the outpatient
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Implementation and use of innovativ
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Innovations in the outpatient secto
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Implementation and use of innovatio
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New possibility of testing potentia
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Structural Innovations in the Inpat
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Structural Innovations in the Outpa
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During the last ten years two centr
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France The healthcare system in Fra
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Financing of the French health care
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The French medical device industry
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The French Medical Devices Market:
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The average time necessary to get a
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Shortening the reimbursement proces
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A successful solution to provide ad
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2. Pharmaceuticals 89
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Hospitals carry out more and more o
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ATU System: Off label use Exemption
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3. Financial incentives and reimbur
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The evaluation of new products by t
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Some particularly expensive drugs a
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In hospitals, expensive and innovat
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The impact of T2A on innovation Act
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The Support for Innovative and Cost
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Financing innovation through the Pu
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8 clusters specialised in the healt
Page 111 and 112: Medical Devices’ Patenting: less
Page 113 and 114: The example of the SAAT Conectus Al
Page 115 and 116: The UK The healthcare in the UK is
Page 117 and 118: The NHS is underpinned by a set of
Page 119 and 120: Today the PCTs are the main purchas
Page 121 and 122: Prior to the Health and Social Care
Page 123 and 124: Primary Care Trusts (PCTs) have pla
Page 125 and 126: The new national level bodies overs
Page 127 and 128: The NHS, must deliver efficiency sa
Page 129 and 130: PbR was first introduced in 2005/06
Page 131 and 132: The design of HRG4 reflects a signi
Page 133 and 134: PbR is being incrementally reformed
Page 135 and 136: NHS-funded primary care is provided
Page 137 and 138: The Quality of Outcomes Framework (
Page 139 and 140: The Health and Social Care Act (201
Page 141 and 142: The United Kingdom is a major produ
Page 143 and 144: £m Healthcare industries are clust
Page 145 and 146: Several bodies aim to improve the k
Page 147 and 148: National Institute for Health and C
Page 149 and 150: Overview of key NICE assessment pro
Page 151 and 152: NHS National Technology Adoption Ce
Page 153 and 154: “Innovation” has central place
Page 155 and 156: Bodies to support innovation in hea
Page 157 and 158: The UK is a world-leader in life-sc
Page 159 and 160: There still exists large regional v
Page 161: UK rankings and usage as a percenta
Page 165 and 166: NHS lacks control mechanism for imp
Page 167 and 168: Short-term budget-cycles often are
Page 169 and 170: Actions described by respondents du
Page 171 and 172: Actions described by respondents du
Page 173 and 174: Actions deriving from the review
Page 175 and 176: The following measures were suggest
Page 177 and 178: The planned compliance regime is ge
Page 179 and 180: Actions to incentivise innovation t
Page 181 and 182: NICE’s HTA process: NICE’s stan
Page 183 and 184: The implementation of NICE guidelin
Page 185 and 186: Implementation: A recommended proce
Page 187 and 188: The NHS Technology Adoption Centre
Page 189 and 190: The Government has invested a recor
Page 191 and 192: The Government’s funding has also
Page 193 and 194: Case 2: AstraZeneca and NIHR Cancer
Page 195 and 196: The NIHR has also established Healt
Page 197 and 198: As part of the Government’s Life
Page 199 and 200: All applications for the Biomedical
Page 201 and 202: NOCRI has worked together with MRC
Page 203 and 204: Academic Health Science Centres (AH
Page 205 and 206: What can Sweden learn from the UK?
Page 207 and 208: Facts - the proportions of Danish h
Page 209 and 210: The Danish healthcare system is pri
Page 211 and 212: Public-private investments in R & D
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The Danish healthcare industry is a
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Public investments in the future st
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The public renewal fund is meant to
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With the responsibility for adminis
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Organisational chart - the capital
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The Innovation environments invest
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Overall the innovation environments
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Sara established a successful busin
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Infrastructure for Innovation - The
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The networks consist of 22 innovati
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The overall Danish Innovation infra
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The new market maturing-fund will h
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The new Danish Innovation strategy
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Subsidy for new outpatient medicame
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The evaluation and assessment of ne
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Cost reduction in expensive hospita
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The public procurement of Medtech -
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Innovative public procurement of Me
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What can Sweden learn from Denmark?
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The Netherlands are spending more o
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Health insurers are allowed to make
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Financial flows in the Dutch health
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Impact of the reform on providers
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Impact of the reform on patients/in
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Impact of the reform The Dutch heal
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Innovations in the Dutch healthcare
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The reimbursement system should all
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Summary and conclusions 277
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There is a correlation between a co
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Conclusions - what can Sweden learn
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Two general recommendations and one
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Innovation in European healthcare â what can Sweden learn? - LIF

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