Date: December 1, 2009 (Tuesday)
Time: 12:30 – 14:00 (sandwich lunch from 12:30 –12:45; seminar begins at 12:45)
Venue: Seminar Room 5, LG/1-F, Laboratory Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong

Abstract:

Health technology assessment (HTA) processes, particularly tying reimbursement to appraisals of cost and effectiveness, are under scrutiny. Canada's system is well-funded, participative and allows for pragmatic clinical trials. The UK NICE process, particularly in its refusal to measure cost savings outside the NHS, is said to retard innovation and restrict access to technologies used in end-of-life care. The French and German HTA systems better recognize innovation and the disease burden. Australia has multiple HTA processes that affect drugs and medical devices, and they are under review.

Pharmacogenomics - and indeed all forms of personalised medicine where an intervention is a hybrid technology (e.g. drug eluting stents) or a test-drug combination (as used in the diagnosis and treatment of breast or colorectal cancer) - present new problems for HTA processes, particularly those using restricted forms of economic appraisal to set reimbursement. Problems will emerge at the level of evidence demanded, the types of costs measured and the comparators allowed.

This seminar discusses the threats to future medical innovation, informed self-care and government healthcare budgets if national HTA processes do not involve all relevant stakeholders, particularly patients.

Bio-sketch:

Dr. Paul Gross is Director of the Institute of Health Economics and Technology Assessment (IHETA) in Australia and Greater China, and its associated consultancy Health Group Strategies Pty Ltd.

His experience includes:

• Commissioner of the National Hospitals and Heath Services Commission in the Whitlam (Labor) and Fraser (Coalition) governments
• Special Adviser in the Social Welfare Policy Secretariat
• Guest scholar at the Brookings Institution, Washington DC
• Member of Australia's first national technology assessment advisory panel
• Director of Australia's fourth largest health insurer from 1988 to 1995
• Member of the NSW Health Council in its review of the NSW hospitals and health services in 1999/2000.

IHETA is currently involved in consultancies in Australia, Canada, USA ,Europe and Asia, including:

• Evaluation of the potential role of personalised medicine, genomics and nanotechnology in national prevention strategies
• Evaluation of the preparedness of national and provincial technology assessment processes in six nations to deal with pricing/reimbursement challenges in an era of hybrid medical technologies, pharmacogenomics and nutrigenomics
• Evaluation of the impact of chronic disorders on the patterns and costs of care of Australian veterans
• Evaluation of the potential impact of different forms of self-care on general practice, nursing and pharmacy
• Evaluation of the impact of economic incentives for obesity prevention and lifestyle change via tax incentives and health savings accounts.