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The EvidenceDecision-Making Disconnect
Evidence is often not enough
Shahira Bhimani BScPT MSc HTAManager Strategic Initiatives HTX ndash The Health Technology Exchange
Panelists
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence
Decision Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull Mr John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Agenda
bull The problem ndash The PVP journey
bull Aligning HTA and commercialization mandatesbull Minimizing the evidencedecision-making
dividendash Pre-market HTAndash Hospital HTAndash Innovation procurement via lsquobridge-financingrsquo
bull QA
Changing Tideshellip
bull Technology Photo-selective Vaporisation of the Prostate (PVP) a minimally invasive surgical ablation tool used to manage Benign Prostate Hyperplasia (BPH)
bull Technology Indication BPH is a non-cancerous enlargement of the prostate It is the most common age-related disorder affecting men affecting over gt 80 of men over the age of 80
bull Medical Management
Lifestyle mods Pharmaceuticals Surgery
Province-specific Adoption Processes An Illustrative Canadian Example
2003 2014
2004
2010
2006
Independent HTA done by Alberta
HC approval
HQO firmly supports PVP
2007
PVP field evaluation by OHTAC in anticipation for increased diffusion in ON
A Look at Prostate Photovaporization Adoption in Canada
2 Units adopted (ONT) 3rd unit adopted (Alb)
2011
First unit installed in QC
20112010 2011
CUA supports PVP
2007
Alb HTA ResultSAFEhospitalization stay and catheterizationSimilar f-up care as TURP$301 million in avoided costs over 5 years Result
Similar health benefits to TURPcosts to the HC System vs TURPAvoidance of $14 million and 28000 in-patient days
SO what really happened
Overall market penetration (2011)bull Canada - Laser accounts for approx 76 of total BPH surgeries bull US - TURP represents lt 40 of the BPH procedures -
If evidence is not enough then what is
Manitoba New BrunswickBCON QC Alb
206-9
15
13
Distribution of Laser procedures in Canada
The evidencedecision-making disconnect If evidence is not
enough ndash what is
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
Research and Development
Experimental Technology
InnovativeTechnology
General Use ObsolescenceReplacement
Use
Time
HTA and Diffusion of Health Technologies
HTA
HTA
HTAMedical Device Licensing
Innovation
Disinvestment
Obsolescence
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Panelists
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence
Decision Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull Mr John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Agenda
bull The problem ndash The PVP journey
bull Aligning HTA and commercialization mandatesbull Minimizing the evidencedecision-making
dividendash Pre-market HTAndash Hospital HTAndash Innovation procurement via lsquobridge-financingrsquo
bull QA
Changing Tideshellip
bull Technology Photo-selective Vaporisation of the Prostate (PVP) a minimally invasive surgical ablation tool used to manage Benign Prostate Hyperplasia (BPH)
bull Technology Indication BPH is a non-cancerous enlargement of the prostate It is the most common age-related disorder affecting men affecting over gt 80 of men over the age of 80
bull Medical Management
Lifestyle mods Pharmaceuticals Surgery
Province-specific Adoption Processes An Illustrative Canadian Example
2003 2014
2004
2010
2006
Independent HTA done by Alberta
HC approval
HQO firmly supports PVP
2007
PVP field evaluation by OHTAC in anticipation for increased diffusion in ON
A Look at Prostate Photovaporization Adoption in Canada
2 Units adopted (ONT) 3rd unit adopted (Alb)
2011
First unit installed in QC
20112010 2011
CUA supports PVP
2007
Alb HTA ResultSAFEhospitalization stay and catheterizationSimilar f-up care as TURP$301 million in avoided costs over 5 years Result
Similar health benefits to TURPcosts to the HC System vs TURPAvoidance of $14 million and 28000 in-patient days
SO what really happened
Overall market penetration (2011)bull Canada - Laser accounts for approx 76 of total BPH surgeries bull US - TURP represents lt 40 of the BPH procedures -
If evidence is not enough then what is
Manitoba New BrunswickBCON QC Alb
206-9
15
13
Distribution of Laser procedures in Canada
The evidencedecision-making disconnect If evidence is not
enough ndash what is
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
Research and Development
Experimental Technology
InnovativeTechnology
General Use ObsolescenceReplacement
Use
Time
HTA and Diffusion of Health Technologies
HTA
HTA
HTAMedical Device Licensing
Innovation
Disinvestment
Obsolescence
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Agenda
bull The problem ndash The PVP journey
bull Aligning HTA and commercialization mandatesbull Minimizing the evidencedecision-making
dividendash Pre-market HTAndash Hospital HTAndash Innovation procurement via lsquobridge-financingrsquo
bull QA
Changing Tideshellip
bull Technology Photo-selective Vaporisation of the Prostate (PVP) a minimally invasive surgical ablation tool used to manage Benign Prostate Hyperplasia (BPH)
bull Technology Indication BPH is a non-cancerous enlargement of the prostate It is the most common age-related disorder affecting men affecting over gt 80 of men over the age of 80
bull Medical Management
Lifestyle mods Pharmaceuticals Surgery
Province-specific Adoption Processes An Illustrative Canadian Example
2003 2014
2004
2010
2006
Independent HTA done by Alberta
HC approval
HQO firmly supports PVP
2007
PVP field evaluation by OHTAC in anticipation for increased diffusion in ON
A Look at Prostate Photovaporization Adoption in Canada
2 Units adopted (ONT) 3rd unit adopted (Alb)
2011
First unit installed in QC
20112010 2011
CUA supports PVP
2007
Alb HTA ResultSAFEhospitalization stay and catheterizationSimilar f-up care as TURP$301 million in avoided costs over 5 years Result
Similar health benefits to TURPcosts to the HC System vs TURPAvoidance of $14 million and 28000 in-patient days
SO what really happened
Overall market penetration (2011)bull Canada - Laser accounts for approx 76 of total BPH surgeries bull US - TURP represents lt 40 of the BPH procedures -
If evidence is not enough then what is
Manitoba New BrunswickBCON QC Alb
206-9
15
13
Distribution of Laser procedures in Canada
The evidencedecision-making disconnect If evidence is not
enough ndash what is
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
Research and Development
Experimental Technology
InnovativeTechnology
General Use ObsolescenceReplacement
Use
Time
HTA and Diffusion of Health Technologies
HTA
HTA
HTAMedical Device Licensing
Innovation
Disinvestment
Obsolescence
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Changing Tideshellip
bull Technology Photo-selective Vaporisation of the Prostate (PVP) a minimally invasive surgical ablation tool used to manage Benign Prostate Hyperplasia (BPH)
bull Technology Indication BPH is a non-cancerous enlargement of the prostate It is the most common age-related disorder affecting men affecting over gt 80 of men over the age of 80
bull Medical Management
Lifestyle mods Pharmaceuticals Surgery
Province-specific Adoption Processes An Illustrative Canadian Example
2003 2014
2004
2010
2006
Independent HTA done by Alberta
HC approval
HQO firmly supports PVP
2007
PVP field evaluation by OHTAC in anticipation for increased diffusion in ON
A Look at Prostate Photovaporization Adoption in Canada
2 Units adopted (ONT) 3rd unit adopted (Alb)
2011
First unit installed in QC
20112010 2011
CUA supports PVP
2007
Alb HTA ResultSAFEhospitalization stay and catheterizationSimilar f-up care as TURP$301 million in avoided costs over 5 years Result
Similar health benefits to TURPcosts to the HC System vs TURPAvoidance of $14 million and 28000 in-patient days
SO what really happened
Overall market penetration (2011)bull Canada - Laser accounts for approx 76 of total BPH surgeries bull US - TURP represents lt 40 of the BPH procedures -
If evidence is not enough then what is
Manitoba New BrunswickBCON QC Alb
206-9
15
13
Distribution of Laser procedures in Canada
The evidencedecision-making disconnect If evidence is not
enough ndash what is
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
Research and Development
Experimental Technology
InnovativeTechnology
General Use ObsolescenceReplacement
Use
Time
HTA and Diffusion of Health Technologies
HTA
HTA
HTAMedical Device Licensing
Innovation
Disinvestment
Obsolescence
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
bull Technology Photo-selective Vaporisation of the Prostate (PVP) a minimally invasive surgical ablation tool used to manage Benign Prostate Hyperplasia (BPH)
bull Technology Indication BPH is a non-cancerous enlargement of the prostate It is the most common age-related disorder affecting men affecting over gt 80 of men over the age of 80
bull Medical Management
Lifestyle mods Pharmaceuticals Surgery
Province-specific Adoption Processes An Illustrative Canadian Example
2003 2014
2004
2010
2006
Independent HTA done by Alberta
HC approval
HQO firmly supports PVP
2007
PVP field evaluation by OHTAC in anticipation for increased diffusion in ON
A Look at Prostate Photovaporization Adoption in Canada
2 Units adopted (ONT) 3rd unit adopted (Alb)
2011
First unit installed in QC
20112010 2011
CUA supports PVP
2007
Alb HTA ResultSAFEhospitalization stay and catheterizationSimilar f-up care as TURP$301 million in avoided costs over 5 years Result
Similar health benefits to TURPcosts to the HC System vs TURPAvoidance of $14 million and 28000 in-patient days
SO what really happened
Overall market penetration (2011)bull Canada - Laser accounts for approx 76 of total BPH surgeries bull US - TURP represents lt 40 of the BPH procedures -
If evidence is not enough then what is
Manitoba New BrunswickBCON QC Alb
206-9
15
13
Distribution of Laser procedures in Canada
The evidencedecision-making disconnect If evidence is not
enough ndash what is
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
Research and Development
Experimental Technology
InnovativeTechnology
General Use ObsolescenceReplacement
Use
Time
HTA and Diffusion of Health Technologies
HTA
HTA
HTAMedical Device Licensing
Innovation
Disinvestment
Obsolescence
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
2003 2014
2004
2010
2006
Independent HTA done by Alberta
HC approval
HQO firmly supports PVP
2007
PVP field evaluation by OHTAC in anticipation for increased diffusion in ON
A Look at Prostate Photovaporization Adoption in Canada
2 Units adopted (ONT) 3rd unit adopted (Alb)
2011
First unit installed in QC
20112010 2011
CUA supports PVP
2007
Alb HTA ResultSAFEhospitalization stay and catheterizationSimilar f-up care as TURP$301 million in avoided costs over 5 years Result
Similar health benefits to TURPcosts to the HC System vs TURPAvoidance of $14 million and 28000 in-patient days
SO what really happened
Overall market penetration (2011)bull Canada - Laser accounts for approx 76 of total BPH surgeries bull US - TURP represents lt 40 of the BPH procedures -
If evidence is not enough then what is
Manitoba New BrunswickBCON QC Alb
206-9
15
13
Distribution of Laser procedures in Canada
The evidencedecision-making disconnect If evidence is not
enough ndash what is
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
Research and Development
Experimental Technology
InnovativeTechnology
General Use ObsolescenceReplacement
Use
Time
HTA and Diffusion of Health Technologies
HTA
HTA
HTAMedical Device Licensing
Innovation
Disinvestment
Obsolescence
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
SO what really happened
Overall market penetration (2011)bull Canada - Laser accounts for approx 76 of total BPH surgeries bull US - TURP represents lt 40 of the BPH procedures -
If evidence is not enough then what is
Manitoba New BrunswickBCON QC Alb
206-9
15
13
Distribution of Laser procedures in Canada
The evidencedecision-making disconnect If evidence is not
enough ndash what is
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
Research and Development
Experimental Technology
InnovativeTechnology
General Use ObsolescenceReplacement
Use
Time
HTA and Diffusion of Health Technologies
HTA
HTA
HTAMedical Device Licensing
Innovation
Disinvestment
Obsolescence
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
The evidencedecision-making disconnect If evidence is not
enough ndash what is
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
Research and Development
Experimental Technology
InnovativeTechnology
General Use ObsolescenceReplacement
Use
Time
HTA and Diffusion of Health Technologies
HTA
HTA
HTAMedical Device Licensing
Innovation
Disinvestment
Obsolescence
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Research and Development
Experimental Technology
InnovativeTechnology
General Use ObsolescenceReplacement
Use
Time
HTA and Diffusion of Health Technologies
HTA
HTA
HTAMedical Device Licensing
Innovation
Disinvestment
Obsolescence
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
CERT
AIN
TY O
F EV
IDEN
CE
EFFECTIVENESS
Evidence certainEffective
Uncertain evidenceNot effective
Evidence certainNot effective
Uncertain evidence Effective
Promising technology
Ineffective technology
Technology to be adopted
2 Reassessment
1 Assessment amp Appraisal
4 Innovation
3 Access with Evidence Development
5 Education amp Dissemination
OUTCOMES
Certainty of Evidence and Effectiveness
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
HTA and the Health Technology Commercialization process
Health Technology Assessment
bull Deliberate and evidenced-based
bull Rigorous evaluation of evidence to ensure effectiveness and cost-effectiveness
bull Risk averse process to ensure opportunity costs are surpassed
Technology Commercialization
bull Rapid and market driven
bull Decision-making dependent of extending market share and generating shareholder value
bull Risk tolerant process to ensure profits are generated
Traditionally HTA and Technology commercialization processes have had competing objectives
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Resource scarcityHealth care systems are characterized by a limited supply of resources Therefore provision of care is constrained by available budgets
Two central challenges in health technology adoption
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
HTA and the Health Technology Commercialization process
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Buy Side Sell Side
CommercializationHTAInnovation
Due to misalignment of objectives successful technology adoption
occurs haphazardly when offering matches need
Can this degree of alignment be improved
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
HTA and the Health Technology Commercialization process
Private companies
Shareholder Perspective
Return on Investment
Projected revenue gt Projected Expenses
DCF
Sell Side
Commercialization
Buy Side
Public Institutions
Societal Perspective
Opportunity Cost
Expected Gain gt Benefit Foregone
ICER
HTA
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
HTA and the Health Technology Commercialization process
Integration of HTA into the Technology Commercialization process can improve alignment
between health systems and companies facilitating permeation of new products into health systems
Product Development Uncertainty
Product Adoption time lag
Mechanism
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Don Juzwishin PhD FCCHLDirector Health Technology Assessment amp InnovationAlberta Health Services
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
April2015
MaRS Excellence in Clinical Innovation and Technology Evaluation program
CADTH Symposium April 14 2015
Zayna Khayat I zkhayatmarsddcom I ZaynaKhayat
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
18
The Case for a new way for HTA hellip EXCITEbull Innovation defines us as a civilization It is also an easy
victim of neglect bull Innovationindustry - part of the health system not apart
from itbull New evidence to ldquopolicerdquo adoption following regulation -
too much too late expensive inefficient stifles innovationbull Harmonized pre-market process that addresses regulatory
coverage and other concerns more efficient Regulation and coverage processes are discrete and occur sequentially
bull Time for change ldquoInsanity is doing the same thing over and over again and expecting different resultsrdquo Albert Einstein
bull EXCITE ndash emerging from proof of concept
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
January2015
Concept
RegulationTIME
UPre-Market
Post-Market
Cost Effectiveness (CE)
Systematic review
Effectiveness
Obsolescence
Diffusion
Yes
Unconditional No
bull Efficacy Safety
bull Value (CE) Affordability
bull Ethical amp societal
bull Post-market conditions
E f f e c t i v e n e s s
Cost Effectiveness
Systematic review
bull Efficacy Safetybull Value (CE)
Affordabilitybull Ethical amp societalbull Post-market
conditions
Reimbursement
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
April2015
The EXCITE Collaboration Model
bull Dr Les Levin CSObull Dr Zayna Khayat Directorbull Adel Aziziyeh Project Managerbull Lily Lo Coordinator
bull Advice on science methodologybull Allocation of projectsbull Heads of 5 methodology centresbull Dr Les Levin CSO
bull Advise prioritization of technologiesbull Advice on clinical study designbull Support in conditions of adoptionbull Comprised of implementation sub-
committee of OHTAC
Management Board
bull Advice oversight directionbull Approve technologies protocol budgetbull Senior reps health economic development
HTA AHSCs industry
bull Review protocols for safetybull Chair Tony Easty
bull Excellence in complex clinical trial design and execution in collaboration with 24 Research Hospitalsbull Contracted in by EXCITE
bull Design study with industry bull Execute and publish the study
bull Early advice on design of the evidence package and study
Methodology Centres
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
bull Since April 2012 49 companies applied in 7 Calls for Innovation
bull Technologies selected
- 9 currently active (1 multinational 2 US 1 BC 5 Ont)
- 6 under review (to be approved at April 23 board)
bull Publicly discloseable projects are
- Home sleep apnea test- Renal denervation for hypertension (discontinued)- Rna disruption for early prediction of clinical
response to chemo in breast cancer- Electrical stimulation for voluntary upper limb
movements in stroke
Current state of the EXCITE program
November 2014
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Whatrsquos next 1 Conditions of Adoption
To read the full report visit wwwohiccaApril2015
Projected Adoption Rates
Infrastructure Readiness
Reimbursement Considerations
Economic Projections
Knowledge Translation
Procurement
EXCITE + Office of Health Innovation to work collaboratively to prepare the system
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Whatrsquos next 2 International collabortion
April 2015
EXCITE International Planning Summit (March 27 2015)bull UK ndash NICE NHS regulators
AHSNbull US ndash FDA BCBS Kaiser Mayo
MDIC hellipbull Canada ndash Health Canada
Industry Canada DFATD Federal Innov Panel
bull Ontario ndash MoHLTC CAHObull Industry ndash small and
multinational (Can US UK NZ)
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
On the horizon hellip Paying for outcomes
April 2015
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
April2015
Zayna KhayatDirectorzkhayatmarsddcom
Lily LoAssociatellomarsddcom
Adel AziziyehProject Manageraaziziyehmarsddcom
Les LevinChief Scientific Officerllevinmarsddcom
For more information visit wwwexcitemarsddcomTwitter MaRSEXCITE
Or contact us at
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Evidence is Often Not Enough
Innovation Adoption and DiffusionhellipThe Missing Link in the Chain
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Changing Perceptions and Building Capacity for Innovation Procurement
bull Procurement Challengesbull Coalescing Adoption Initiativesbull ldquoREACHrdquo- Innovation Procurement
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
CBoC ndash Innovation Procurement Survey
bull erere
Innovation is Important
We donrsquot tell the Market what we need
We minimize costhellip
hellipBut we Donrsquot Procure it
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
MEDEC Industry Data SurveyAbility to sell at home in CanadaOntario is a Challenge
HTXMEDEC Survey ndash Fall 2013
Baylis Medicalrsquos Innovative Atrial FibrillationAccess Catheter Developed in OntarioMarket Share
bull 30 Japanbull 20 Germanybull 1 Canada
Ontario needs to more rapidly adopt its ownhome-grown world-class technology
Ontario One of the Most Challenging Markets to EnterSub-optimizing ROI on RampD Investment
Any market seemed easier than Ontario
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Medtech is a Small Fraction of Health SpendhellipBut Can Have Major Impacts
(Canadian Health Policy Institute Report - Courtesy of MEDEC)
CDA per capita spend on Medical
Devices ranks 22nd in OECD top 25
$170 per capita
3 of total per capita
spend
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
Coalescing Initiatives Aligning Incentives
HTX REACH
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
REACH A New Innovation Procurement ProgramResources for Evaluation Adoption and Capitalizing on Healthcare Technology
TechnologyProduct Development
Validation
Maturing Evidence
Generation
Scale Diffusion Export - Local
Global
Intake(Pipeline)
OntarioSales
$ MNEs
SMEs
AcademicSpinoffs
USEU
ROCChina
Ont
US
EU
Rest of Canada
China
Ontario
HTX REACHTraditional InnovationSupport
Pre-MarketDevelopment Post-Market Evaluation
and AdoptionForeign Market Access
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
REACH Highlights
bull Seeking innovation procurement projects solving high-priority health system problems
bull Methodsndash Facilitated Partnering Workshopsndash 2 Calls for Innovationndash Subsidies
bull $300K-$1M per project requiring 50 or greater matchingbull Pilots or Innovation Procurementsbull UniqueInnovative Ontario and non-Ontario solutions
ndash Innovative Technology Registryndash Health System Problem Registry
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
REACH PartnersOntario Healthcare ProvidersInnovatorshellipand
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
John Soloninka PEng MBAPresident and CEO HTX
jsoloninkahtxca
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
- QA -
bull Shahira Bhimani - Manager Strategic Initiatives HTX ndash The Health Technology Exchange
bull Dr Don Juzwishin ndash Director Health Technology Assessment and Innovation Alberta Health Services
bull Dr Zayna Khayat - Director MaRS EXCITEbull Dr Janet Martin ndash Director Medical Evidence Decision
Integrity and Clinical Impact (MEDICI) - LHSC Associate Professor Schulich School of Medicine and Dentistry Western University
bull John Soloninka ndash PresidentCEO HTX The Health Technology Exchange
