Advancing Access to Newer Treatments for Atrial Fibrillation. Canadian Cardiovascular Society Congress October 24, 2010 Montreal, Canada

Transcription

1 Advancing Access to Newer Treatments for Atrial Fibrillation Canadian Cardiovascular Society Congress October 24, 2010 Montreal, Canada

2 The Canadian Conundrum D. Wayne Taylor, PhD, F.CIM The Cameron Institute Canadian Cardiovascular Society Congress October 24, 2010 Montreal, Canada

3 Value for money Who here pays taxes? Who here likes paying taxes?

4 Economic Drivers vs. Riders Myth: Number #1 driver of costs is drugs Drugs are an expense or a rider FACT: Number one driver of costs is our own ill health

5 Another fact

6 And another Source, CIHI, Health Care In Canada, 2009

7 Two tier pharmacare

8 And 40% of private is O-O-P!

9 Comparative health systems (no US) #23

10 #30 Comparative health systems cont d

11 Government creates financial barrier to care p.35

12 Inequity in the system Private drug insurance coverage 75% policies are open Out-of country coverage common today Public drug plans are restricted (seniors, lower income patients) INCLUDING hospital formularies (all patients!!!)

13 Common Drug Review First institutionalized barrier to access Decision-based evidence-making Thus, drugs being denied to some Canadians (contrary to CHA) E.g. Orphan drugs $6-50m*/$20B spent, or 0.25 of 1%! vs. the $10B to be saved on generics if tendered 95% Canadians favour access to orphan drugs for rare diseases; 87% favour government funding** * Robarts Research Institute, 2005 ** Pollara, September 2007 for BIOTECanada

14 Common Drug Review cont d Rx&D Report, /3 Canadians rely on public drug plans for Tx of Ca, CVD, diabetes, osteoporosis, mental health, HIV/ AIDS etc. #17/18 re public spend on Rx #16/18 re public access (only Aust. & NZ worse) 46% YES (78 HC approvals) vs. 91% in EU and 88% in the US Longest approval wait times

15 Common Drug Review cont d

16 Comparative Drug Utilization CDR Medicare Part D

17 Implicit Policy Decision? Canada has chosen static efficiency over dynamic efficiency in its healthcare rationing decisions Static efficiency: lowest price for existing products and services Dynamic efficiency: incentives for innovation i.e. research, development, commercialization and diffusion of new products and services

18 Intentions vs. Outcomes Health economics and health technology assessment (HTA) have become tools for cost containment NOT relative cost-effectiveness i.e. takes away choice rather than informs choice Medicare/CHA was always about health financing (wealth=health) NOT cost containment (healthcare=cost)

19 Advancing the Patient Voice in Ensuring Access to Newer Treatments for Atrial Fibrillation Siobhan Cavanaugh, Ward Health Strategies Canadian Cardiovascular Congress October 24, 2010 Montreal, Canada

20 Why Advance Public Education for Detection/Treatment of Atrial Fibrillation Medical and financial costs significant burden on patients and the health system: Approximately 250,000 patients with AF in Canada Approximately 43,000 hospitalizations/year Hospital costs are about $5,160/per event Costs of in patient care alone $225 million AF affects primarily patients over age 45, so economic burden will only increase with aging population Quality of life-chronic fatigue, sleep apnea, affecting overall productivity Co-morbid conditions: diabetes, hypertension, CHF, increase risk of stroke adding to burden of care

21 Comprehensive Strategy to Raise Awareness of Need to Treat AF Identify cardiac and co-morbid conditions medical associations and advocacy groups Establish public awareness campaign to reach affected patients Facilitate communication between doctors and patients Facilitate communication between patients affected by AF Provide information on effective tools for detecting and treating AF

22 Benchmarking Awareness of AF In order to build a comprehensive strategy, we need to understand current constituent outreach activities and then identify gaps. We have undertaken the following process: Identified and prioritized stakeholder advocacy organizations whose constituents are affected by atrial fibrillation Held preliminary interviews with those groups to benchmark level of public outreach in support of AF The Cameron Institute will host consensus conference (Oct.27/28)with these leaders to identify issues, barriers, and opportunities to improve detection and access to innovative treatments for patients affected by AF.

23 Prioritized Groups Canadian Cardiovascular Society Canadian Stroke Network Canadian Diabetes Association Ontario Lung Association Stroke Survivors Association Canadian Hypertension Society

24 Advocacy in Other Jurisdictions United States: StopAfib.org ( developed for patients by patients) Heart Rhythm Society (for health professionals and patients) September AF Awareness month Europe/Global: AF AWARE comprised of four leading patient and medical association to highlight and issues that contribute to the growing burden of AF.

25 Improving Outcomes for Canadian Patients with AF Mitigating the economic and social burden of AF in Canada: More public education and awareness of AF symptoms, detection and treatment Creation of effective partnerships/ alliances and actively engage organizations whose patients have co-morbid conditions diabetes, hypertension Advocate for access to innovative AF treatments to improve population health outcomes Advocate for innovative disease management strategies to evaluate the effectiveness of innovative treatments and support ongoing quality improvements in the care of patients affected by AF.