Isabelle Lepage-Nefkens Budget Impact Analysis CREATING VALUE IN BIOMEDICAL BUSINESS DEVELOPMENT Joris van Dijk Isabelle Lepage-Nefkens Maarten IJzerman Lotte Steuten Slides prepared for: Bench-Can WP 6 Budget Impact Analysis 14-05-14

WP 6 – Semester 2 What is WP6? What is done? What is in progress? What is next? Walk through of current BIA parameter template (BPT)

What is WP6 The purpose of the WP6 is a Budget Impact Analysis to: To create a framework to collect financial performance and volume parameters to determine the operational efficiency 2. To estimate the financial cost and consequences of the implementation of BenchCan (operational benchmark by WP4) 3. Optional: To set financial benchmark To estimate the financial cost and consequences of specific services :kunnen we niet beloven BIA: analysing (macro) budgetary impact of implementing innovation FB: comparing the operational efficiency of (similar) hospitals Mauskopf et al Value in Health, 2007

WP6 milestones A framework for carrying out budget impact analysis M1 Aug 2013 Results of financial analysis of publicly available information   M2 Feb 2014 Results of budget impact analysis in selected pilot sites M3 Aug 2015 Agreement with Advisory Group and pilot sites on which approach to use in comprehensive cancer centres and tumour services respectively M4 BIA formulae are integrated into the benchmarking manual (WP7) M5 Dec 2015 What should be done by now?

Milestone 1+ Objectives How What BM input, medical and technical efficiency & financial performance of multiple CCC. How BIA parameter template For cost and volume collection To allow benchmarking What Detail of cost collection Description of parameters/indicators to include Objectives; BM input, medical and technical efficiency & financial performance of multiple CCC. Excel BIA parameter template (BPT) for standardized data collection Based in cost, volume and financial data Benchmarking: baseline characteristics, compare centers; more is better! What: last core group meeting we already discussed the level of detail all costs are collected; in short, institution level to allow comparison between centres and prevent burdersome cost collection Hospital and/or Department level: data available through public reports, accreditation processes and financial controllers of hospitals

What is done last semester Last time: Draft BPT ready Current version: Definitions parameters Inclusion pathway colorectal cancer New step by step layout BPT validated by NKI controller for relevance, comprehensiveness and feasibility of the BPT

What is in progress WP6 M2: Dry run with publically available data Annual (financial) reports (preferably in English) OECI quantitative questionnaire used in OECI accreditation First pilot BPT ongoing in NKI! Adaptation to other WPs Efficiently combine the BPT and the performance benchmark in WP4 and WP6? MS2 financial data, later more… Dry run data did not work out that well, lot of different languages, definitions used and very burdensome to sort this out for these 15 parameters. More beneficial when centers provide these themselves. By collecting a baseline; including all pilot centers of WP 4, will allow sufficient data for comparison and yield best practice. First pilotting in 3!

What is next? WP6 M2: Finish report dry run publicly available financial data WP6 M3: Create framework to estimate financial cost implementation BenchCan WP6 M3: Arrange pilot visits to: NIO, Budapest, Hungary IPO, Porto, Portugal … The aim is to include all pilot centers of WP 4 in our data collection. Anke will ‘check’ the data, yet using video conference centres will be instructed by Panaxea what and how to collect it all.

Walkthrough BPT What are you missing? Do you agree with all definitions? Do you consider it possible to collect most of these parameters?

M1: Parameters for BIA (as previously discussed) Level of detail Hospital and/or Department level: data available through public reports, accreditation processes and financial controllers of hospitals Cost drivers per patient Based on literature, guidelines, the OECI accreditation manual and expert opinions Direct cost: E.g. staff, length of surgery, medications, radiation therapies Indirect cost (weighted) : the costs of leasing medical equipment and staff cost Overhead cost excluded Unit cost Total cost = unit cost x number of units used Divided in “Inpatient”, “outpatient”, “consults” Department level: case mix problemen. General surgery has only 40% oncology, how to differentiate if only department level in- and output data?

Opening Excel Workbook and walkthrough

Limitations & Challenges Current Challenges How to comparing different type of centers? Based on specialization/type of institution (tumor-mix) Size (#beds, budgets) Health care system (funding) How to register cost of medication? Perfect integration in/with WP 4

Questions and Remarks, please?

CREATING VALUE IN BIOMEDICAL BUSINESS DEVELOPMENT Thank you! CREATING VALUE IN BIOMEDICAL BUSINESS DEVELOPMENT isabelle.nefkens@panaxea.eu Joris.van.dijck@panaxea.eu maarten.ijzerman@panaxea.eu lotte.steuten@panaxea.eu

Who we are University of Twente spin-off company Affiliated to the department Health Technology & Services Research Main interest in market access and reimbursement of new drugs and medical devices Contracts with several large pharma and device companies Health economics aims to determine the “value” of new medical products (to patients and society) with reference to the price society is willing to pay for that value In addition to the added value, health economists also address the budget impact PANAXEA b.v. is an independent consultancy company spun-out from the University of Twente, Enschede, the Netherlands. The company is led by a board of directors. PANAXEA works with a large international network of professionals to best serve our clients and to achieve the highest level of flexibility.