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Sponsoring of Patientinitiatives in Austria. Systematic Analysis
As part of the professionalization of patients organizations and the expansion of their activities (eg. awareness campaigns, advisory services for patients and their relatives, etc.) the need for financial resources is also increasing. This need is often covered by pharmaceutical and medical device manufacturers. This report analysed the extent of financial support for patient organizations from pharmaceutical companies in Austria. 24 of 115 PHARMIG member companies have declared donations to patient organization for the year 2014. A total of € 1,145.718.- grants were given. Most grants (63%) were given to four fields of diseases: neurology, haemato-oncology, rheumatology and haemophilia.
Publication: Rapid Assessment No 7b: http://eprints.hta.lbg.ac.at/1072
Contact: Claudia Wild
Outpatient neurological rehabilitation: goal attainment in stroke patients. Systematic review.
In the Austrian rehabilitation plan aims for outpatient rehabilitation have been defined. These can be summarised as a higher flexibility of the therapy plan, a higher participation into the living environment, a higher activation of the self-help capability, a better re-integration into the work process and a better cooperation with aftercare units. Aim of this report (a master´s thesis) is to analyse, if outpatient stroke patients are able to achieve these goals. 7 observational pre-post studies (4 with control group) fulfilled the inclusion criteria. For the domains ‘functionality’ and ‘participation’ most of the studies found positive effects. The heterogeneity of instruments led to different results in the domain ‘satisfaction’. Positive trends could be observed for the domain ‘re-integration into the work process’. Finally, none of the studies reported results for the domain ‘aftercare’. Overall, the risk of bias of included studies has to be rated as high. We did not aim at comparing different rehabilitation settings. Future studies should aim at the further standardisation of instruments, the randomized allocation of patients to the rehabilitation settings and the investigation of patients’ expectations and needs.
Publication: Decision Support Document No. 92: http://eprints.hta.lbg.ac.at/1071
Contact: Brigitte Piso
Horizon Scanning in Onkology - Reports
We are pleased to introduce our four new HSO reports.
DSD HSO No. 52
Carfilzomib (Kyprolis®) for patients with relapsed multiple myeloma who have received one to three prior lines of therapy
DSD HSO No. 53
Nivolumab (Nivolumab BMS®) for the second-line therapy of metastatic squamous non-small cell lung cancer
Biodegradable stents for the treatment of refractory or recurrent benign oesophageal stenosis
Biodegradable ("resorbable") esophageal stents to treat benign refractory and/ or recurrent esophageal strictures were recently developed as alternatives to self-expanding metal stents (SEMS) and self-ex¬pandierenden plastic stent (SEPS). Only one product - the SX-ELLA stent Esophageal Degradable ™ BD - holds CE marking (since 2007) on the European market. Only a few studies of very low quality were available for the assessment of efficacy and safety. Currently, the biodegradable esophageal stents is an experimental procedure in an early stage of use.
Publication: Decision Support Document Nr. 89: http://eprints.hta.lbg.ac.at/1067/
Contact: Claudia Wild
Background Analysis for National HTA Strategy for Lithuania: Focus on Medical Devices
Health policy goals in Lithuania until 2020 include increasing transparency, cost-effectiveness and rational use of resources. Despite repeated initiatives, a systematic application of HTA is so far not in place in Lithuania. In the context of a EU funded project we formulated a HTA-Strategy for Lithuania (http://eprints.hta.lbg.ac.at/1064). For this we undertook a background analysis of the Lithuanian healthcare system, together with local partners. We locally conducted 19 expert interviews with stakeholders. In addition a systematic search of the literature was made for HTA strategy papers, complemented by hand searches. The recommendations developed for Lithuania (and activities proposed) based on this analytical report are published in a separate document, the HTA-Strategy for Lithuania (http://eprints.hta.lbg.ac.at/1064).
More generally it was found that the regulatory environment is essential for the role of HTA. HTA’s impact is greatest, when conducted for supporting concrete decisions. Timely HTAs of good quality with clear messages are important. Not only HTA products themselves require transparency, also the entire HTA process (from topic selection to implementation) demands it for ultimate acceptability of the method. HTA needs to be independent from health policy and from providers (professions, industry) in order to be respected, which also requires a stable funding-basis for HTA.
Publication: Decision Support Document No. 90: http://eprints.hta.lbg.ac.at/1063
Contact: Claudia Wild
HTA-Strategy for Lithuania
The HTA-Strategy for Lithuania was formulated based on a thorough analysis of the Lithuanian health care system (“Background Analysis for National HTA Strategy for Lithuania - Focus on Medical Devices”: http://eprints.hta.lbg.ac.at/1063). It aims to boost the use of HTA-information in Lithuania. Its goals are to support the establishment of both a framework to promote, enforce and facilitate the uptake of HTA and of the necessary organizational structures for the timely, efficient and good-quality provision of HTA-information.
Recommendations and short/ medium/ long terms suggestions for implementation activities are presented for four strategic objectives: regulatory embedding and ensuring legitimacy of HTA; organization of HTA; quality assurance of HTA; capacity building for HTA.
A change of culture (in decision making) takes time. The ultimate success of the HTA-Strategy for Lithuania will be for its health sector stakeholders to increasingly take ownership of the HTA process. In the meantime the HTA-Strategy for Lithuania proposes that raising awareness for HTA works best by successfully realizing “flagship projects” that increase the quality of patient services, decrease inappropriate or even harmful interventions or create savings that can be reinvested for other services.
Publication: Decision Support Document No. 90a: http://eprints.hta.lbg.ac.at/1064
Contact: Claudia Wild
Evaluation of individual medical procedures 2015 - Reports
We are pleased to introduce our new reports.
Decision Support Documents 2015:
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DSD 81: Fully bioresorbable scaffolds for coronary artery disease
http://eprints.hta.lbg.ac.at/1060 -
DSD 82: Transcatheter mitral valve-in-valve implantation (TMViVI)
http://eprints.hta.lbg.ac.at/1058 -
DSD 83: Endovascular embolization of unruptured intracranial aneurysms with flow diverters
http://eprints.hta.lbg.ac.at/1054 -
DSD 84: Defibrotide for the treatment and prophylaxis of hepatic veno-occlusive disease
http://eprints.hta.lbg.ac.at/1061 -
DSD 85: Intrastromal corneal implants for ectatic corneal disorders
http://eprints.hta.lbg.ac.at/1055 -
DSD 86: Sphenopalatine Ganglion (SPG) stimulation of patients with therapy-resistant cluster headache
http://eprints.hta.lbg.ac.at/1062 -
DSD 87: Injectable bulking agents for faecal incontinence
http://eprints.hta.lbg.ac.at/1059
+2 Updates:
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DSD 44/ 2nd Update 2015: Percutaneous left atrial appendage closure for the prevention of thromboembolic events in patients with atrial fibrillation
http://eprints.hta.lbg.ac.at/1056
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DSD 68/ 1st Update 2015: Percutaneous transluminal angioplasty (PTA) of periphery arteries with drug-eluting balloon (DEB)
http://eprints.hta.lbg.ac.at/1057
Sponsoring Austrian CME/ continuing medical education for physicians. A systematic analysis of the CME-Database
In recent years, the sponsorship of CME/ continuing medical education for physicians by the pharmaceutical and medical device industry is increasingly scrutinized. The question in this project was the scope of sponsoring in the Austrian CME-training. From the CME database of the Austrian Academy of doctors 13 medical fields (from a total of 56) were selected with the aim to analyse the number of events that were financially supported by manufacturer. The investigation shows that a sponsorship of at least 14.3% and at most 67.2% of the events took place. The sponsors are, as might be expected, pharmaceutical and medical product suppliers in the respective subject, mainly from "high-cost and / or high-volume" products.
Publication: Rapid Assessment 7a: http://eprints.hta.lbg.ac.at/1053
Contact: Claudia Wild
Vaccination against human papillomavirus (HPV). Decision-aid for young women and girls
In 2008 the German AOK-Bundesverband commissioned the LBI-HTA to develop a decision-aid on the vaccination against Human Papillomavirus (HPV) for young women and girls (online since June 2009). After smaller updates in 2010 and 2011, the updated, completely revised and partly new structured decision-aid went online in March 2015 (www.hpv-entscheidungshilfe.de).The first part of the decision aid contains information about the virus and HPV related diseases. The second part of the decision aid informs about the HPV-vaccine(s). Finally, the third part of the decision aid summarises information of parts I and II: eleven short information blocks can be rated according to the relevance for the decision (mainly pro or mainly contra vaccination or of no influence). In the present project report online contents are available in paper form for the first time. Hence, we were able to add country specific data for Austria and provide further, more detailed information (which has not been included in the online version due to complexity).
Publication: Decision Support Document No. 79: http://eprints.hta.lbg.ac.at/1050
Contact: Brigitte Piso
Horizon Scanning in Onkology - Reports
We are pleased to introduce our new HSO report.
DSD HSO No. 50
Nivolumab (Opdivo®) as single-agent first-line therapy for unresectable or metastatic melanoma
