Generation and Use of HTA for Medical Devices in

Alberta: Issues, Challenges, Opportunities

Focus on Alberta

Don Juzwishin PhD FCCHL

CADTH Session D5 Panel Discussion

April 8, 2014

2

Objectives

• Describe what is

happening in Alberta

• Identify issues

• Identify challenges

• Identify opportunities

3

Health reform in Alberta • Reform toward a new

paradigm of health care

delivery

– Integrated

– Coordinated

– Comprehensive

– Accountable - outcomes

– Networked

• Build on foundation of

AHTDP – AACHT

– Macro, Mezzo, Micro

Eric Topol

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Issues

• Multiple entry points – conventional, trial, innovation

• Push versus pull

• Regulatory & reimbursement thresholds

• Unbridled philanthropy

• Medical device is part of a system

• Incremental vs. breakthrough

• Being clear about outcomes

• Creative risk sharing lacking

• Medical device diffusion linked to innovation

5

Challenges

• Medical devices & drugs not same

– Cannot randomize

• Evidence unavailable – who pays

• Pace & dynamics high velocity

• Values & expectations

• Companion – devices & drugs

• National fragmentation

• Perverse incentives - disinvestment

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Opportunities

• Need for new policy tools and HTA methods

– PACE OMICS – Citizen preferences – reassessment

– Access through evidence development

– Post policy implementation & innovation

• Create and sustain Strategic Clinical Networks - pull

– Strategic Patient Oriented Outcomes

• Alberta Innovates Health Solutions

– PHRIS, KT grants, CRIO

• Procurement of innovation – explicit guidelines • Strategic Pipeline to Accelerate Research & Innovation in Care (SPARC)

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SPOR Platforms

1. Data Platforms and Services

2. Pragmatic (provincial) Clinical Trials (+ ethics)

3. Health Systems research, implementation research

and KT

4. Methods Support and Development

5. Career Development in Methods and HSR

6. Patient engagement research

7. Consultation and research Services