"Health economics in the context of health care system

1
"Health economics in the context of health care
system Experience from Serbia

• Tomislav Stantic, MSc,MD
• State secretary, Ministry of Health of Serbia

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Inherited delusions about health care system in
Serbia

• Health care services in Serbia are free of
  charge, and there is enough money to finance all
  expectations of population
• Health system is capable to solve all health
  problems of the population in Serbia
• Health care system in Serbia is efficient,
  effective and provides good quality of health
  care
• Health care system reform will solve over night
  all problems in the health system of Serbia

3
Determinations

• Regarding Quality Improvement in Health Care
  System and following the approach of Health Care
  System Reforms, Ministry of Health has recognized
  that its focus should be on a wider range of
  quality-related issues such as health technology
  assessment, pharmacoeconomics and health
  economics.

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What has been done through the Serbia Health
Project?

• Health Technology Assessment (HTA) subcomponent
  has been developed to build up capacity on how to
  use HTA and pharmacoeconomics as a knowledge base
  for improving the quality of health care and to
  answer the needs of policy and decision makers
  addressing the questions on efficacy, safety, and
  cost-effectiveness.

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Current process of decision making (1)

• HIF Managing Board makes decision on the Drug
  List according to the proposals from the Central
  Expert Committee. Central Expert Committee
  prepares the proposals based on opinions and
  assessments obtained from many Expert
  Subcommittees for Medicines for areas defined by
  the ATC classification of medicines and the
  Committee for Pharmacoeconomics.

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Current process of decision making (2)

• HTA Committee, established by MoH, handle the
  evaluation of the healthcare technologies on the
  basis of analysis of medical, ethical, social,
  and economic consequences and effects of
  development, spreading or use of healthcare
  technologies in providing health care.

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ResultJeopardized accessibility
Why do we need economic analyses?

• Background
• The contents and the scope of the right to the
  health care includes nearly all health services
• together with rapidly increasing costs of health
  care

GoalIncreased accessibilityby selection of the
method/technology ensuring the highest
cost-effectiveness, i.e. technologies
characterized by the best health-related
results and costs as low as possible.
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Future Developments

• Interactive key-word
• Integrating various disciplines
• Recognizing different agendas
• Policy makers payers
• HTA professionals
• HC professional users
• Patients
• A transparent and rational system for setting
  priorities for
• HTA and pharmacoeconomic analyses
• Even if the decisions belong to policy makers,
  HTA
• professionals should enable (empower) healthcare
• professionals and patients to appraise policy
  decisions

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• Since the globalization of science and technology
  and all of their numerous applications is a
  reality of modern world, this conference should
  be a model of educational initiative that
  incorporates science and daily practice

• I expect the truth and nothing but the truth.
• I expect assistance in discerning between the
  truth vs marketing and advertisement.
• I expect presentation of scientific proofs in
  favor or against current health care policy.
• Els Bost-Eilers, Dutch Minister of Health,
  Cochrane Colloquium in Rome 2000