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In recent years, payments made by the pharmaceutical industry to doctors and medical institutions have increasingly been questioned critically. In a systematic analysis, the websites of all PHARMIG member companies (113) were once again searched for information on financial contributions to Austrian healthcare professionals and institutions in 2018. In 2018, a total of 138.3 million euros flowed from PHARMIG member companies to doctors and medical institutions as well as to clinical research and observational studies in Austria. In 2015, the total amounted to 104.1 million euros.
Although the number of Pharmig member companies declaring grants increased only slightly compared to 2015 (2015: 69/113, 2018: 76/115), in 2018 almost one third (32.8%) more grants were made - an increase of 34.2 million euros. In 2018, the share of donations to physicians in the total amount was 7% lower than in 2015. Since this figure corresponds exactly to the increase in the category research and development, a re-declaration can be assumed here. The actual willingness to disclose financial contributions, especially from doctors, is still low - the individual disclosure rate (by name) averaged only 21.1% (2015: 21.9%), which corresponds to 18.5% (2015: 17%) of the amounts paid out. In contrast, the willingness to disclose payments to medical institutions by name (institution) was still significantly higher on average at 49.4% (2015: 50.2%).
Sponsoring of Patient Initiatives in Austria 2018. Update of the Systematic Analyses 2014, 2015 and 2016
Information on the year 2018 was found from 49 out of 113 PHARMIG member companies.
In 2018, a total of € 1,657,087 as financial support to patient initiatives were reported. Most grants (around 85% of all financial contributions) were given to initiatives in the nine fields of Oncology & Hematology, Neurology, Hemophilia, Pulmonology, Rare Diseases, Dermatology, Gastroenterology, Rheumatology, and HIV/AIDS. After a significant decline in 2016, the total sum declared represents an increase of +45%. The number of disclosures doubled compared to 2014 (2014: 24/115 PHARMIG companies declared contributions to patient initiatives, 2018: 49/113).
Consistent monitoring by a critical public is still required in order to observe the implementation of the voluntary commitment to more transparency.
We are pleased to introduce our new HSO report.
Biomarkers have become enormously important in oncology in recent years. As so-called “personalised medicine,” they support clinical decisions to assess patients, i.e., their tumours, with regard to response to therapies. Multi-gene panels (such as FoundationOne®Cdx) are just starting to be offered for comprehensive molecular-genetic tumour profiling, enabling the simultaneous analysis of a few to several hundred genetic alterations in disease genes. The health policy issue is whether multi-gene diagnostics using gene panels will lead to better clinical outcomes than conventional, single-biomarker stratification.
Public & philanthropic financial contribution to the development of new drugs: Methodology & 3 Case Studies
The term "access to medicines" was until a few years ago associated with the discussion surrounding cheaper (generic) vital drugs (HIV, tuberculosis, etc.) in developing countries. For some time, Western countries and institutions (OECD, European Commission, etc.) have also begun to focus on "access to medicines" in an attempt to counteract "unsustainable" drug prices.
Expenditure on research and development (R & D) is mostly used by manufacturers as a justification for high prices. The real - resource-consuming and high-risk - basic research takes place mainly in the public sector (in universities and corresponding publicly funded research institutions) instead. Little publicized knowledge on public spending, however, exists so far. The project objective is to collect information on public contributions to drug research and development and thus contribute to the discussion on "Return on Investment of Public Investment".
Diabetes mellitus is a rapidly increasing disease worldwide. In the Austrian Diabetes Report 2017, the number of people with diabetes mellitus in Austria is estimated at about 7 to 11%, with an assumed 30-35% not diagnosed. The—individually adapted—treatment of diabetes mellitus therefore aims to achieve freedom from symptoms and to prevent acute complications and serious secondary diseases. This project report examines whether screening in the general population is recommended in guidelines and, if so, what methods are used to recommend screening in subpopulations.
Publication: LBI-HTA Project report No. 118: http://eprints.hta.lbg.ac.at/1213/
Contact: Claudia Wild
Part I: Overview of screening and prevention programmes in other countries
Part II: Recommendations from evidence-based guidelines (guideline synopsis)
In Austria, the "Mutter-Kind-Pass” (the “mother-child pass") is a screening instrument for children up to the age of 5 years. There are currently no (universal) routine screenings in Austria for children and adolescents older than 6 years. In the present two-part report we researched and presented screening programmes in 9 countries and we identified evidence-based guidelines in guideline databases and via websites of relevant institutions and summarised their recommendations.
Publication: LBI-HTA Project report No. 106: http://eprints.hta.lbg.ac.at/1212/
Re-orientation of the Austrian parent-child preventive care programme. Part XI: Further development of the mother-child-pass: Screening recommendations of the expert working group for pregnancy, puerperium and early childhood (0-6 years)
In the process for the further development of the Austrian screening tool for pregnant women and children (“Mother-Child-Pass”), initiated by the Ministry of Health in 2014, after several reports conducted by the LBI-HTA, an interdisciplinary and multiprofessional expert working group formulated comprehensive (screening) recommendations for pregnancy, puerperium and childhood (0-6 years). The transparent and participatory process was finished in May 2018. The final report includes all protocols of the expert working group meetings as well as all submitted formal statements. Additionally, the recommendations were thematically structured by screening methods and by time.
Publication: LBI-HTA Project report No. 92: http://eprints.hta.lbg.ac.at/1163/
Contact: Inanna Reinsperger
Irreversible electroporation (IRE) is a non-thermal ablative process in which short but strong electric fields are generated using precisely placed needles and computer-controlled potential differences between these needles. In this way, pancreatic and liver tumors located near large blood vessels or other sensitive structures can be removed without damaging them.
There is insufficient evidence that IRE is more effective/safe or at least as effective/safe as the conventional standard of care (chemotherapy, chemoradiotherapy or palliative therapy) in the treatment of inoperable LAPC or that IRE is more effective/safe or at least as effective/safe as the conventional standard of care (TACE, sorafenib or palliative therapy) in the treatment of primary or secondary inoperable liver cancer that is not suitable for thermal ablation.
Publication: LBI-HTA Project report No. 119: http://eprints.hta.lbg.ac.at/1211/)
Contact: Eva Fuchs
We are pleased to introduce our new HSO report.