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Using Real World Data (RWD) to Assess the Value of New Technology for Patients April 12, 2012 Diana Brixner, RPh, PhD Professor and Chair, College of Pharmacy.

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Presentation on theme: "Using Real World Data (RWD) to Assess the Value of New Technology for Patients April 12, 2012 Diana Brixner, RPh, PhD Professor and Chair, College of Pharmacy."— Presentation transcript:

1 Using Real World Data (RWD) to Assess the Value of New Technology for Patients April 12, 2012 Diana Brixner, RPh, PhD Professor and Chair, College of Pharmacy Director, Pharmacotherapy Outcomes Research Center

2 Key Points Definition of Value The pros and cons of Real World Data Development of Patient-Centered Retrospective Research Registries (PCR3s) within our system Application to value assessment of new technology

3 UHC Technology Reimbursement Considerations under HCR Improving health care efficiency Improving health care quality Allocation of scare healthcare resources ═ VALUE Cost Outcome

4 Information is Needed Beyond RCTs... Garrison LP Jr, Neumann PJ, Erickson P, Marshall D, Mullins CD. Using real-world data for coverage and payment decisions: the ISPOR Real- World Data Task Force report. Value Health. 2007;10(5): RCT Randomized Clinical Trials Efficacy and safety in a small population with a restricted study protocol Real world information to make health care decisions for large populations within defined budgets Patient Population GAP Real World Data

5 Efficacy vs. Effectiveness Efficacy –RCT –High internal validity –Limited generalizability Effectiveness –Observational studies –High external validity –Lack of Controls Holtorf AP, Watkins JB, Mullins CD, Brixner D. Incorporating obser- vational data into the formulary decision-making process-summary of a roundtable discussion. J Manag Care Pharm. 2008;14(3):

6 UU Patient Centered Retrospective Research Registries Collaboration with University of Utah: – Information Technology and Bioinformatics – Utah Population Database – HCI/UHOSP investigators and clinicians – Enterprise Data Warehouse (EDW) Contain longitudinal data on patient cohorts from 1995 to current including clinical, survival and charge data. Used to develop models to predict cost-effective outcomes of new pharmaceuticals and diagnostic tests

7 NSCLC Patient Flown ICD LINKED TO CANCER REGISTRY3201 RESTRICTED BY ICD01879 RESTRICTED BY VISIT COUNTS1228 Ovarian Patient Flown ICD LINKED TO CANCER REGISTRY1150 RESTRICTED BY ICD0455 RESTRICTED BY VISIT COUNTS371 Melanoma Patient Flown ICD LINKED TO CANCER REGISTRY3773 RESTRICTED BY ICD03062 RESTRICTED BY VISIT COUNTS Cancer Cohorts in Development Brain Mets Patient Flown ICD LINKED TO CANCER REGISTRY2210 RESTRICTED BY VISIT COUNTS1602 Restricted to Exclude ICD0 of brain primary site1464 Cohort for HCC, Breast Cancer and CML already completed Prostate cancer cohort is next planned cohort for development Developing one for Atrial Fibrillation in collaboration with CARMA

8 Population Based Research to Inform Individual Care

9 We can determine survival by stage… Stage I Stage II Stage III Stage IV

10 We can determine charges by stage… * * Inpatient and outpatient charges for one year post staging across the Huntsman Cancer Institute and the University Healthcare system

11 The Promise of Personalized Medicine Pharmacogenomic tests can fine tune treatment pathways for patients with breast cancer after surgery – Stratify patients as to whether they should receive treatment based on risk – Stratify patients by which treatment would provide the best response However these tests come at a cost that need to be weighed against the benefit they can bring to patients

12 The Value of Personalized Medicine 100 women after breast cancer surgery Not Tested Tested $0 $ Chemo $10, No Chemo 40 Chemo 60 No Chemo $0 $10,000 $0 90% 5 year survival $750/patient 90% 5 year survival $8100/patient Assist researchers in development Assist payers in reimbursement decisions Assist patients in treatment decisions

13 Summary Development of Patient-Centered Retrospective Research Registries (PCR3s) are in process within our system These PCR3s can be applied to value assessment of new technology for Health Care Reform


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