Mostrando entradas con la etiqueta paciente. Mostrar todas las entradas
Mostrando entradas con la etiqueta paciente. Mostrar todas las entradas

jueves, 15 de marzo de 2012

Patients and access to medicines. Pricing and HTA.


Patients are scared to see that their health will be affected by the saving policies of our national health systems. We also fear that the access to adequate healthcare will depend on the family income, and unequal rights to obtain the best available treatments will be accepted as an inevitable universal fact.

We see how people around the world in countries without reimbursement lose their savings, their houses and everything they worked for if they want a chance to have a better quality of life or life expectancy. We also see that many healthcare systems in Europe provide a better coverage than what I just described and it is jeopardized by the financial crisis we are going through.

Some Governments react in a panic and without a proper evaluation of the damages their measures to cope with the crisis will cause to the healthcare system. Although many generics are as good as the reference drug, also many of them might negatively affect the health of the patient because of subtle but key differences such as how long the active ingredient stays in the body and whether it reaches or not the therapeutic target.

In Spain we are witnessing real horrors due to the royal decree that forces to prescribe the active ingredient instead of the brand. The more fatal and difficult to treat is the disease, the more damage is done through pharmacological malpractice in public hospitals.[1]

There is a need to increase the efficiency of the healthcare system; we have no doubt about it. But improving the efficiency does not mean to decrease the expenditure in the short term to increase it in the medium and longer terms.

Adequate investment in medicines reduces the number of visits to the family doctor, the number of costly tests done by specialists, the average length of stay at the hospital, the absenteeism at the workplace, the cost of the caregivers that have to dedicate their time and workforce to their relatives instead of working and paying taxes increasing the circulation of capital in the market and feeding the meager treasure of the nation.

I cannot help but wonder: where did economists that preach to reduce expenditure regardless of the negative impact on the country’s economy study their careers?

The world is changing. Patients are more and more influential at every level. Our capacity to organize ourselves, to lobby and to make pressure groups is growing. We are receiving training, we are shifting from the “poor me look how much I suffer” to taking an active role in the management of our diseases and making decisions about treatment and therapeutic options.

There is a long way to go, in most countries, HTA agencies do not even think of the possibility of having a patient to give an input about pricing and reimbursement, however, it is the patient that has more at stake in the whole process.

We also play a role in the medicines’ market. We share information about what drugs gave us the best result for this or that disease. What are the unbearable side effects or how to cope with the unavoidable side effects of a pharmacological treatment. We know what medicines we want in the market and which ones we want to see unlicensed.

We do not prescribe, neither have we ever wanted to do it, but we do share information and knowledge about what we receive as a prescription.

As much as I have previously criticized the saving policies of the Ministries of Health, we are very keen in preserving our access to healthcare and medication. Nobody is between the hammer and the anvil as we are. The extremely high prices of drugs render it difficult for our governments in times of financial distress to provide adequate funding for each and every need. There are many more factors to take into account, but a whole revision of unnecessary or overpriced services related to healthcare would not be to the point of this presentation. Just let me highlight that I don’t put all the weight of healthcare expenditure on reimbursement.

I have recently read an article entitled “the fiction behind the cost of new drugs” (http://careandcost.com/2012/02/22/the-fiction-behind-the-cost-of-new-drugs/), it mentions that AstraZeneca’s after-tax profit margin in 2011 was over $10 billion, nearly twice what it spent on R&D.

I cannot and will not go over the accounting of each and every pharmaceutical company. I am fully aware that 2011 has meant a loss of income that means a terrible blow… But let me tell you that I have trouble to understand that reducing an after-tax profit margin that is counted in billions means an out of proportion catastrophe and almost the end of the world.

Do patients want the pharmaceutical companies make a profit? We most certainly do. Research, training of healthcare professionals, support projects and programs for patients, etc come from the pharmaceutical sales. We would never want to see all those funds that are vital for us vanishing in thin air.

Do patients want a healthcare system that can afford the reimbursement of the most expensive drugs? There is no doubt whatsoever about it.

Can patients balance the benefits they obtain from the pharmacological treatments and an adequate price? We are patients, not dumb flocks of sheep! Lawyers, medical doctors, economists, high profile professionals are not disease free, they are also patients and we claim our right to make decisions on our health at every level, which includes our intervention in the design of pricing and reimbursement policies.

Additionally, patients’ associations are there to provide support to the average citizen, we speak the same language, and we know what they need and we can provide useful information so that experts can do more accurate QALY and DALY calculations. There is a term that is not so well known when it comes down to appraise and assess the impact of a new health technology, its monetary value and the non tangible benefits or downsides. It is the HRQL measures, Health Related Quality of Life measures. These measures provide information about the effects of an illness and how that illness affects a person’s day-to-day life.

Economists and medical personnel, in spite of what they may believe, do not really know how the life of a person living with a particular illness is. They can imagine, but they lack personal experience.

Last but not least, we would like stakeholders to consider that patients’ organizations have an added value within the system.

Patients’ organizations have a support system that is not considered as Health Technology. We like to be independent, but sometimes it seems that we are not in the picture at all.

I would like politicians, decision makers, industry, and HTA agencies to give a thought to these questions:

-         What is the value of psychosocial support?
-         How is the quality of life different for a patient that benefits from a help line?
-         How much efficient is the system when patients are empowered and take control over the management of their disease? (better compliance with treatment, less visits to the hospital, better therapeutic choices…?)
-         What is the impact of guides for patients that are adapted to all levels of education and have an understandable language?
-         What is the impact in the healthcare system of dissemination campaigns for prevention and early diagnose carried by patients’ organizations?
-         How does the view and the performance of physicians change when they establish cooperation with patients’ organizations?
-         What is the value of patients in pharmacovigilance and their reports on day-to-day testing once the drugs are on the market?

Just to give an example, the Spanish National Pulmonary Hypertension Association is organizing the celebration of the first World Pulmonary Hypertension Day click here for mor info about WPHD. There will be a scientific symposium where PH physicians will learn about the latest progress in research and new therapeutic options that are in the pipeline and will seriously improve the approach to PH in some aspects. How do stakeholders appraise that input into the system?

We want more room into HTA agencies because we are a key element, not only as target population for health technologies but also as active and valuable contributors to all aspects of healthcare.

I would also like to draw your attention to new technologies that we value and we are supporting as patients.

We see that the world is evolving and we want to go along with it. We are promoting the use of cell phone applications for healthcare. Patients are monitored on daily basis through the information they provide and healthcare personnel can obtain valuable data:

Levels of oxygen depending on physical activity,
levels of glucose,
coagulation rates,
emotional responses to different stimuli (stress, new medication, psychotherapy…),
pain levels in chronic pain patients…

There is an enormous amount of information that can be processed to obtain clinical progress or early warning signs, relieving the system of unnecessary follow-up visits or “too late interventions” that increase the cost of healthcare.

domingo, 4 de diciembre de 2011

Evaluación de Tecnologías Sanitarias, ¿qué le importa a los pacientes?


El primer paso para responder a la pregunta del título es entender qué es la Evaluación de Tecnologías Sanitarias (ETS). En realidad, como pacientes, sabemos muy poco acerca de todos los procesos que terminan haciendo que los tratamientos farmacológicos estén disponibles en nuestro país. 

Aunque es importante saber cómo la investigación de una molécula termina por convertirse en un medicamento que cambia nuestra esperanza o nuestra calidad de vida, este conocimiento  no supone una gran diferencia si el nuevo tratamiento no está previsto en el sistema de salud nacional.

A pesar de que las tecnologías de salud no sean necesariamente un medicamento, es un concepto fácil de entender y lo vamos a utilizar más a menudo en este documento. Pero en beneficio de la claridad, hemos de subrayar que las tecnologías de la salud pueden ir desde los cuidados preventivos (campañas de vacunación o cribado preimplantacional de mutaciones genéticas) hasta el uso de helicópteros para transporte de órganos para trasplante.

El proceso de ETS se refiere a la evaluación económica de la forma en que un nuevo medicamento cambia la vida del paciente. Por ejemplo, los precios de los medicamentos nuevos y / o cómo el nuevo medicamento tiene un valor añadido para el paciente, sus cuidadores y la sociedad va a determinar si la autorización de comercialización que reciben en la Agencia Europea del Medicamento (EMA) se aplica a nivel nacional.

¿Cuál es el costo de un tratamiento y vale la pena para un país pagar por él? La evaluación del impacto en los niveles médico, social, económico y ético que una nueva tecnología de salud produce son los elementos clave que determinan la toma de decisiones. En muchos países, tenemos la política de "todo para el paciente pero sin el paciente" y los pacientes no estamos invitados a dar una aportación en el proceso de evaluación de una tecnología de salud. La formación del paciente sobre cómo funciona la ETS permitirá a sus representantes defender mejor sus intereses cuando se trata de la introducción, el rechazo de reembolso o la aplicación de las nuevas tecnologías por las autoridades sanitarias.

Los pacientes tenemos la tendencia a utilizar las emociones para defender nuestro derecho a acceder a una nueva tecnología (con el propósito de este artículo vamos a considerar como "nueva" cualquier tecnología de la salud que no está disponible en nuestro sistema de salud sin tener en cuenta la antigüedad del fármaco, dispositivo o el procedimiento). Sin embargo, las emociones cuentan muy poco y tenemos que proporcionar datos basados ​​en la evidencia si queremos ser escuchados por quienes toman las decisiones.

La aprobación para el uso humano se basa en la seguridad y la eficacia de la tecnología. La ETS se refiere a aspectos económicos. Economía significa muchas cosas cuando hablamos de ETS, no sólo el coste financiero. Se plantean preguntas del tipo "¿La nueva tecnología reduce las visitas al hospital para el paciente? ¿Permite que el cuidador tenga tiempo de adicional para tener una vida profesional o personal y retrasar o evitar el burn-out?"

Estas dos preguntas son un buen ejemplo, ya que implican diferentes elementos para tomar en cuenta. Imaginemos que la nueva tecnología produce una reducción del número de visitas al hospital para un paciente que todavía puede trabajar (evidentemente se trata de un caso hipotético con parámetros ideales no sujetos a debate):

·         En primer lugar, esto significa un menor coste para el sistema de salud.
o    Si una simple consulta en el hospital cuesta un promedio de 100 € y la atención a los costos de la sala de emergencia, digamos, 800 € (estas cifras son sólo para dar un ejemplo, no reflejan los cálculos de coste real en España)… sacar conclusiones es un ejercicio simple de matemáticas.
o   La menor utilización de los recursos del hospital por un paciente significa un aumento en el número de pacientes que pueden beneficiarse de los servicios del mismo, por lo tanto hay necesidad de menos hospitales para un determinado número de habitantes.

·         También puede establecer la diferencia entre el empleo y el desempleo.
o   El absentismo laboral puede ser una razón para despedir  a una persona de la empresa donde trabaja.
o   Mantener la mente del paciente despreocupada por el próximo seguimiento médico aumentará la productividad.
o   Mantener su puesto de trabajo producirá ingresos fiscales para el gobierno.

·    Y no hay que olvidar el incremento en la capacidad del paciente para disfrutar de la vida y mejorar las vidas de aquellos que están a su alrededor (el cuidado de los niños, eliminar la carga que supone para el cuidador por tener una actitud mental más feliz y más sana ...). Aunque este último parece un parámetro subjetivo, es cuantificable y válido como argumento económico.

Y así sucesivamente...

Nadie más que los propios pacientes sabe lo que significa una mejor calidad y esperanza de vida. Los pacientes pueden presentar pruebas basadas en la evidencia o razonamientos que influyan en la opinión pública o en el juicio de los responsables de políticas de salud.

La comprensión de la Evaluación de las Tecnologías de Salud faculta a los pacientes y las organizaciones de pacientes a intervenir en el proceso de hacer que una nueva tecnología esté disponible en su país. A ambos, pacientes y organizaciones, nos concierne la ETS, sus mecanismos y sus procedimientos, ya que somos los beneficiarios directos de la implantación a nivel nacional de las nuevas tecnologías.