On October 17 and 18, the 10th Economic Evaluation Workshop organized by the EEconAES group in collaboration with ISPOR Spain Chapter and the consultant Global health management and held at the Ministry of Health in Madrid. As we have been doing for the third consecutive year, the Workshop was held in two sessions on two consecutive days.
The Workshop began with a training course, on Thursday, October 17, entitled “The choice of the parametric function of event risks for use in economic evaluation models: theory and practice”, taught by Drs. David Epstein (University of Granada) and Leticia García Mochón (Andalusian School of Public Health). The objective of the Workshop was to show attendees the main concepts to take into account to model survival functions from observed data of Kaplan-Meier curves from clinical trials, learn about the methodological problems, as well as have solutions for the choice . of the most appropriate risk function to use in economic evaluation models. To do this, a software package in R created by Dr. David Epstein and other colleagues was used.
On Friday, October 18, the presentation of research papers took place. Five research works are presented that were subsequently commented by experts.
The opening of the Workshop came from the hand of Carlos Martín Saborido, member of the General Directorate of the Common Portfolio of Services of the National Health and Pharmacy System; Zuzana Spacirová, researcher at the Andalusian School of Public Health and David Epstein, both coordinators of the Workshop.
The first work entitled “International comparison of procedures and methodologies in the evaluation of medicines: an analysis of the main health technology agencies”, was presented by Anisia Martínez, doctoral student at the University of Granada. In this work, the authors analyze the approaches and procedures of the main health technology assessment agencies, highlighting the notable diversity in processes and approaches, with a third of countries having variable assessment times and 45.83% without official cost-effectiveness thresholds. Jaime Espín, researcher at the Andalusian School of Public Health, commented on the work, highlighting its importance at this key moment for the Economic Evaluation. Propose a discussion of the analysis of the implications that the existence of explicit or implicit thresholds by each agency has in practice, as well as whether the same medicine with the same evidence is funded or not in each country.
The second work was presented by Mario García Díaz, predoctoral researcher at the Andalusian School of Public Health, and titled “Advantages, barriers, solutions and public financing strategies to carry out efficient drug repurposing projects for Health Systems.” . Mario explains to us the review of the international literature that they have carried out through the ‘snowballing’ technique to look for evidence on financial and regulatory solutions to generic drug repositioning programs. The lack of interest on the part of pharmaceutical companies due to the low return on investment and the lack of knowledge in the commercial authorization process on the part of academics and non-profit organizations hinders the potential investigation of the use of generic drugs for others. . diseases other than those that were originally investigated and the search for efficiency in health systems. Different successful solutions have been found in the USA, the European Union and the United Kingdom. Marta Ortega, professor at the Complutense University of Madrid, has been in charge of commenting on the work, highlighting its economic relevance for efficient management of health resources. It alludes to the need to create a strategic line for Spain based on the reorganization of work ideas and application of each of the possible solutions to the potential scenarios that our health system faces. As a complementary strategy to those obtained in the literature review, it proposes the application of tax incentives to research in the repositioning of generic medicines.
After a brief coffee break, which allowed attendees to recharge their batteries, the work of Modou Diop, personal researcher at the Paris School of Economicstitled “Point of care in acute ischemic stroke triage: empirical estimates of economic value and implications for medical decision making.” The authors evaluate the impact of a new rapid diagnostic tool (Point of attention) in the decisions of triage of acute ischemic stroke and its economic implications for the health system. Based on data from the Endovascular registry Treatment in ischemic stroke (ETIS) and the BOOST clinical trial, developed a theoretical model that determines diagnostic thresholds based on the sensitivity and specificity of the tool. The results suggest that these technologies can significantly reduce delays in stroke treatment, highlighting that the optimal balance between sensitivity and specificity varies depending on the geographical context. Raúl del Pozo Rubio, professor at the University of Castilla-La Mancha, and commentator on the work, highlighted the innovative nature of the work and suggested that it would be useful to expand the explanation of the added value of the study, in addition to incorporating more related literature. On the other hand, it opened the debate on the need to include costs in the analysis and reflect on the use of medical devices (such as telecare buttons) that could be used in the lonely population to avoid unwanted events, and whose discrimination in use could be done through the analysis of family functioning scales.
Óscar Navarro Campàs Health Management UnitMUESOL-MUESIOL, presented the fourth work entitled «The Effect of a Cost-sharing Reform on Dispensed Drugs for Breast Cancer: Evidence from Spain», in which the authors analyzed the impact of the drug co-payment reform implemented in 2012 on Patients with breast cancer in Catalonia. Using a difference-in-differences methodology and an event panel study, they drew on data from 2,163 patients diagnosed between 2007 and 2011. The results revealed that low-income pensioners experienced a significant decrease in the number of medications dispensed, an effect which lasted 10 months after the reform. Oscar Navarro Campàs highlighted the importance of designing co-payment schemes aimed at the most vulnerable groups, particularly for high-value medications, such as endocrine therapy for breast cancer. In his comments, Jorge Mestre, professor at the Carlos III University and economic consultant, congratulated the authors and suggested enriching the study with more literature on pharmaceutical co-payments, as well as incorporating key economic concepts, such as elasticity, to improve interpretation, along with with other recommendations to refine the analysis.
Finally, Hoover Quitian-Reyes, from the Universidad de los Andes in Colombia, presented the fifth paper of the day entitled “Effects of the limits of the effectiveness of health technologies on the demand for medical care products.” In this work, the authors propose a new formulation of Grossman’s (1972) Human Capital model for the demand for health technologies, based on the findings of medical literature and econometric studies that evaluate the effect of health spending on health status. . of health. The result corrects all flaws in the model and provides plausible explanations for the stylized facts. Furthermore, it has new policy implications, because based on its analysis, it is not optimal to use a single cost-effectiveness threshold for the evaluation of health technologies; Instead, different thresholds should be established and applied depending on the severity of the health condition. The professor at the Autonomous University of Madrid, Sara Pinillos Franco, was in charge of commenting on the work. He congratulated the authors and proposed different reflections and questions to include in the model and in this way, perhaps be able to capture other additional and complementary effects.
In short, both days were very enriching. A fabulous work environment was created where experiences, concerns and knowledge were shared. The proactivity of the training course organizers and each and every participant contributed to the development of a learning and fun environment.
Finally, thank all the entities that have made this event possible. Firstly, to the Health Economics Association (AES) for its support of the Interest Groups, and especially to Zuzana Spacirova and David Epstein for their coordination. TO ISPOR Spain Chapterfor their collaboration in the organization of the event for the sixth consecutive edition. TO World Health Management (WHM)for sponsoring the event for the third consecutive year. And, finally, to Carlos Martín Saborido for allowing the event to be organized at the facilities of the Ministry of Health. See you at the next XI EEconAES 2025 Economic Assessment Workshop.
