February 28, 2012
Ever since the end of WWII, the reigning clinical philosophy was one whereby there was no limit on medical treatment. From the 80s onwards, this philosophy shifted towards a more balanced approach whereby the benefit of the treatment had to outweigh the potential risks associated with it, with evidence-based medicine being the concept used to assess a new treatment.
We now live in an era where it is critical to assess the full value of medical technology,Â Â the real life clinical effectiveness, but also the overall value for a patient and society at large of a novel technology.
Assessing the overall value means also taking into consideration clinician experience, patient adherence and compliance, and patient co-morbidities to mention but a few. It is telling that a high number of patients, up to 50%, who suffer from a chronic disease and have to take medication to prevent disease progression, do not stick to their prescription schedule. This only underlines the importance of ensuring that appropriate, real life assessments are made. In this context I am looking forward to the outcome of the work package on relative effectiveness (performed by the European Joint Action with EUnetHTA to assess the real life clinical value of health technologies). In any case it will be important to be pragmatic when designing studies to assess the clinical effectiveness and ensure that all available data is taken into account.
Considering patientsâ health related Quality of Life, their satisfaction with the treatment and the impact of short and long term side effects are prerequisites when assessing the value of a novel technology. But this is only a starting point. If we want to achieve a future sustainable European healthcare model, surely it will be critical to assess the full value of a technology and ensure that the socio-economic value and impact on economy and welfare are considered.
Everyone is full of the importance of patientâs quality of life, healthy life years, the sustainability of Europeâs healthcare, the expected shortage of workforce, the shift from curative to preventative care, healthy ageing, etc.â¦. And yet, very little data, and instruments, such as validated questionnaires exist to measure health related quality of life, and even less to assess the social and economic impact of new medical technology. I am therefore very pleased to join the European Health Technology institute (EHTI) as Executive Director. EHTI has a clear focus on investigating the socio-economic value and financing of medical devices.
EHTIâs uniqueness lies in the fact that it brings together highly respected university research centres, industry and policymakers, and is further supported by expert reviewers and a well respected advisory board. Its independent research will investigate the socio-economic value of medical devices, current financing systems and their impact on Europeâs economy. The data coming out of this research will allow industry, Â policymakers and payers to make informed decisions which take into account this socio-economic facet.
At the same time, EHTI, together with well-respected universities such as Bocconi University and London School of Economics, is fostering management programs to start covering medical devices specific curricula and policy debates through workshops.
So whatâs in store for EHTI in 2012? Preparing for the 3rd phase of EHTI, while building further on the current successes, I will be reaching out to other institutes, universities, interest groups, European research, and public and private payers. To facilitate the dialogue between all stakeholders, we will develop a new portal at www.ehti.eu aimed to do exactly that â exchange information. And as such, I welcome any input or suggestions for collaboration you may have.
EHTI Executive Director