Generating evidence for change: Implementing the post-ICIUM research agenda Dennis Ross-Degnan, ScD...
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Generating evidence for change: Implementing the post-ICIUM research agenda Dennis Ross-Degnan, ScD Harvard Medical School and Harvard Pilgrim Health Care
Generating evidence for change: Implementing the post-ICIUM
research agenda Dennis Ross-Degnan, ScD Harvard Medical School and
Harvard Pilgrim Health Care WHO Collaborating Center in
Pharmaceutical Policy Boston, USA
Slide 2
Overview Research methods Cross-cutting research areas Other
research gaps Who will pay for research?
Slide 3
Research Methods Best practices in multi-disciplinary,
multi-method health systems research to evaluate complex
interventions Development of methods for political analysis,
stakeholder mapping, and other qualitative methods in
pharmaceutical policy research Development of methods for WHO Level
2 surveys to ease data collection, improve reporting, link facility
and household analysis, and increase use by policymakers Training
in use of accessible longitudinal research methods for policy
analysis using routine data IMS Institute for Health Care
Informatics Global Health Research Program Call for Proposals on
Dec 1, 2011 Defined policy themes Will combine provision of IMS
Health data with training in their use
Slide 4
Research with a Health Systems Focus Impacts of new business
models to promote judicious access to newly developed antibiotics
Changes in transparency, accountability, efficiency and access in
new multi-stakeholder engagement processes Impact of emergence of
resistance (antibiotics, antimalarials, HIV and TB medicines) on
health and economic outcomes Impacts of different components of
community awareness and advocacy campaigns on awareness, behavior,
and access
Slide 5
Medicines and Insurance Coverage Impact of reducing financial
barriers to health care through insurance coverage on utilization,
outcomes, financial burden, and non-health expenditures Targeted
analyses of effects of policy and program changes in insurance
systems, such as formulary management, benefit design, provider
contracting, or educational outreach activities Extent to which
health insurance coverage leads to increases in utilization of
medicines that meet unmet needs, versus encouraging clinically
unnecessary overuse of medicines
Slide 6
Information Technology Evaluation and return on investment of
scaling up promising m-Health interventions to improve supply chain
management and patient adherence Impact of use of electronic
dispensing and medical record systems on provider behavior,
efficiency, safety Use of information technology to support AMR
containment activities
Slide 7
Generic Policies and Medicines Generic medicines, including
barriers to entry, market uptake, patterns of use, effects of
competition on price, consumer and provider perceptions Research
and dissemination of information about the quality of generics in
the public and private sector supply chain and Impact of
interventions to change consumer and provider perceptions about
quality of generics (assuming adequate evidence of quality)
Slide 8
Role of Private Sector and Consumer Preference Performance of
private sector providers related to appropriate use of medicines
and its determinants Link between public and private sector
practice Research on supply chain mark-ups and a reasonable markup
for private sector sellers that can be standardized and monitored
Private sector access to ACTs and TB medications Joint facility and
household surveys to link care seeking, provider choice, medicines
availability, and household access
Slide 9
Other Research Gaps Disaggregated statistics on the role of
gender, geography, and socioeconomic status in access to medicines,
quality of care, and outcomes Cost of inefficiencies in health care
systems and their impacts on access and health outcomes More and
better-designed studies of the impact of national policies to
reduce medicines prices Factors that promote sustainability of
interventions and costs and cost-effectiveness of bringing
effective interventions at scale
Slide 10
Other Research Gaps Best practices of pharmaceutical companies
to improve access and appropriate use Pharmacovigilance structural
and process indicators Public health impacts of counterfeit
medicines Impacts of affordability on adherence Medicine use in
chronic conditions among children, adolescents, elderly
Availability, use, costs, and effects on clinician behavior of
rapid diagnostic tests Best methods for supervision in settings
with multiple competing priorities and low resources
Slide 11
Who (not WHO) Will Pay for Research? Advocacy for alignment and
coordination of donor and country research funding in
pharmaceuticals around the ICIUM 2011 agenda Need for a policy
research set-aside in large donor programs, such as The Global
Fund, PEPFAR, UNITAID, World Bank, Gates and Clinton Foundations
Lobby for investment of government funds in policy evaluations
Greater emphasis on research using available routine data (IMS
Health, insurance programs, hospital electronic systems), with
initial investments to develop data sources for research
Slide 12
ICIUM 2011 More than 600 More than 200 One research study each
to advance the ICIUM 2011 research agenda will mean over 800 pieces
of well- designed research from over 80 countries for the 4 th
ICIUM conference!!