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

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The Netherlands is using the “Dunning Funnel” • Decisions about the composition of the benefit package are guided by an algorithm, which has become known as the “Dunning Funnel” (The Dunning Funnel resulted from a committee which was chaired by Dunning in 1991) • The committee defined four cumulative criteria: • (1) services should be essential, • (2) effective, • (3) cost-effective and • (4) unaffordable for individuals Is the care effective? Is the care essential? Own account and responsibility? Is the care efficient? Basic benefit package 262
Innovations in the Dutch healthcare system Role of Government and CVZ • Central idea for the SHI (Zvw): – Cover under the Zvw provides for essential care, as checked against its demonstrable effect, cost effectiveness and need for collective financing – It is necessary to check the insured cover against these criteria from time to time to determine whether certain types of care need to be removed from or indeed added to the health insurance package, with a long-term view to keeping cover affordable • The Dutch government decides about the principal scope of the standard package and changes of the standard package within the statutory health care insurance • Ministerial proposals for changing the benefit package have to be passed by parliament • Decisions about the possibility of reimbursement of medical-technical products within the DBC system for specialist care are taken by CVZ • Innovative medical devices in outpatient care: application dossier -> CVZ • Yearly advice of the CVZ on the basis of all application dossiers • Possible additional guidelines of the insurance companies for reimbursement: – Maximum reimbursable tariff – Maintenance devices – Preferred providers – Co-payments of patients 263
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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
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Medical Devices’ Patenting: less
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The example of the SAAT Conectus Al
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The UK The healthcare in the UK is
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The NHS is underpinned by a set of
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Today the PCTs are the main purchas
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Prior to the Health and Social Care
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Primary Care Trusts (PCTs) have pla
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The new national level bodies overs
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The NHS, must deliver efficiency sa
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PbR was first introduced in 2005/06
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The design of HRG4 reflects a signi
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PbR is being incrementally reformed
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NHS-funded primary care is provided
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The Quality of Outcomes Framework (
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The Health and Social Care Act (201
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The United Kingdom is a major produ
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£m Healthcare industries are clust
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Several bodies aim to improve the k
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National Institute for Health and C
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Overview of key NICE assessment pro
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NHS National Technology Adoption Ce
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“Innovation” has central place
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Bodies to support innovation in hea
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The UK is a world-leader in life-sc
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There still exists large regional v
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UK rankings and usage as a percenta
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Multiple structural layers within N
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NHS lacks control mechanism for imp
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Short-term budget-cycles often are
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Actions described by respondents du
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Actions described by respondents du
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Actions deriving from the review
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The following measures were suggest
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The planned compliance regime is ge
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Actions to incentivise innovation t
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NICE’s HTA process: NICE’s stan
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The implementation of NICE guidelin
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Implementation: A recommended proce
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The NHS Technology Adoption Centre
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The Government has invested a recor
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The Government’s funding has also
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Case 2: AstraZeneca and NIHR Cancer
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The NIHR has also established Healt
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As part of the Government’s Life
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All applications for the Biomedical
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NOCRI has worked together with MRC
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Academic Health Science Centres (AH
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What can Sweden learn from the UK?
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Facts - the proportions of Danish h
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The Danish healthcare system is pri
Page 211 and 212: Public-private investments in R & D
Page 213 and 214: The Danish healthcare industry is a
Page 215 and 216: Public investments in the future st
Page 217 and 218: The public renewal fund is meant to
Page 219 and 220: With the responsibility for adminis
Page 221 and 222: Organisational chart - the capital
Page 223 and 224: The Innovation environments invest
Page 225 and 226: Overall the innovation environments
Page 227 and 228: Sara established a successful busin
Page 229 and 230: Infrastructure for Innovation - The
Page 231 and 232: The networks consist of 22 innovati
Page 233 and 234: The overall Danish Innovation infra
Page 235 and 236: The new market maturing-fund will h
Page 237 and 238: The new Danish Innovation strategy
Page 239 and 240: Subsidy for new outpatient medicame
Page 241 and 242: The evaluation and assessment of ne
Page 243 and 244: Cost reduction in expensive hospita
Page 245 and 246: The public procurement of Medtech -
Page 247 and 248: Innovative public procurement of Me
Page 249 and 250: What can Sweden learn from Denmark?
Page 251 and 252: The Netherlands are spending more o
Page 253 and 254: Health insurers are allowed to make
Page 255 and 256: Financial flows in the Dutch health
Page 257 and 258: Impact of the reform on providers
Page 259 and 260: Impact of the reform on patients/in
Page 261: Impact of the reform The Dutch heal
Page 265 and 266: The reimbursement system should all
Page 267 and 268: Innovations in the Dutch healthcare
Page 277 and 278: Summary and conclusions 277
Page 279 and 280: There is a correlation between a co
Page 281 and 282: Conclusions - what can Sweden learn
Page 283 and 284: Two general recommendations and one
Page 285: www.vascoadvisers.com Supported by
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