Worldwide, healthcare systems are facing increasing costs and restrictions in their budgets. Those facts have been exacerbated by both the increasing aging of western societies and by the current global economic crisis due to the COVID-19. Moreover, the COVID-19 pandemic is not only devastating economies but also it is changing the way we live and receive care, disrupting national healthcare systems in unprecedented ways (Camille Maringe, 2020) (Corso, 2020) (David Blumenthal, 2020) (Coe, 2020). All together implies that nowadays ,more than ever before, healthcare authorities must consider thoroughly any investment in innovation. Therefore, health economics evaluations are key for healthcare decision-makers for prioritizing investing based on clinical and cost-effectiveness evidence (Dan Chisholm, 2007). Health economic models have become the main analysis tool for planning investments, health resources, and the potential adoption of new technologies and interventions. (Charokopou, 2015)
Therefore, within the ASCAPE activities, we will assess, ideally, the extent to which breast and prostate cancer patients will benefit from the ASCAPE proposed intervention, without significant increments in the associated cost, compared to a standard follow-up. During the piloting phase, we will gather both clinical outcomes and costs data for assessing the economic and medical effectiveness of the ASCAPE platform. That information is key for demonstrating economics affordability and clinical evidence to decision-makers, payers, and overall patients and clinicians.
Moreover, we will also take into consideration the results of the economic evaluation for refining the strategy of the business plans propositions for ASCAPE , providing valuable insights towards successfully commercializing ASCAPE services. The economic evaluation will be adapted to the pilot features and will vary from country to country as different healthcare providers have different reimbursement systems and associated costs what will lead to different cost-effectiveness models. Therefore, the pilot-specific outcomes could be used for adjusting the commercialization plans by adapting the pricing of the ASCAPE services and margins to the particularities of each country or region.
The health economics models will provide valuable information not only for technical and clinical refinement but also for building and refining suitable business models based on country/region cost-effectiveness evidence that will support specific rollout along European regions.
ASCAPE's health economics analysis will use the MAFEIP web service tool (www.mafeip.eu) what is based on the Markov model, to assess the impact of ASCAPE innovations in terms of QoL outcomes and economics resource use (Figure 1).
The model will provide information regarding the cost-effectiveness of the ASCAPE implementation in the real-world settings where ASCAPE is going to be piloted; extrapolating the model to other clinical sites requires some assumptions and further inputs related to the specificities of these clinical sites. However, these extrapolations can be performed assuming the experimental limitations and their particular features.
Figure 1 Example of the cost-effectiveness graph. The graph is based on a simulation made with fake data. The blue point shows the ratio between QALY[1] and intervention cost. In this example, the intervention is dominant comparing with standard care. That would mean that it would less expensive and would provide better healthcare outcomes. The discount line shows the willingness to pay by the healthcare system for providing specific care. The simulation model was performed using the MAFEIP tool. www.mafeip.eu
Blog post prepared by ATOS.
References
Camille Maringe, P. e. (2020). The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. DOI:https://doi.org/10.1016/S1470-2045(20)30388-0: The Lancet Oncology.
Charokopou, M. (2015). Using health economic models to help guide. https://www.tandfonline.com/doi/pdf/10.1185/03007995.2015.1102721?needAccess=true: Current Medical Research and Opinion.
Coe, E. H. (2020). Understanding the hidden costs of COVID-19’s potential impact on US healthcare. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/understanding-the-hidden-costs-of-covid-19s-potential-impact-on-us-healthcare#: McKinsey & Company.
Corso, P. V. (2020). Impact of COVID-19 pandemic on clinical and surgical breast cancer management. https://doi.org/10.1016/j.eclinm.2020.100523: EClinicalMedicine- The Lancet.
Dan Chisholm, D. B. (2007). Economic evaluation in health: saving money. Journal of Medical Economics, 10: 325–337.
David Blumenthal, M. M. (2020). Covid-19 — Implications for the Health Care System. https://www.nejm.org/doi/full/10.1056/nejmsb2021088: N Engl J Med 2020; 383:1483-1488.
[1] Quality Adjusted Life Year.