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Actionsandprograms againstpaininFrance
FrançoisMeyer,MD Head,HTADivision HauteAutorité deSanté,France DIAEuromeeting2011! Geneva
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Publicactions Before2006
Actionsandprograms againstpaininFrance FranoisMeyer,MD - - PowerPoint PPT Presentation
Actionsandprograms againstpaininFrance FranoisMeyer,MD - - PowerPoint PPT Presentation
Actionsandprograms againstpaininFrance FranoisMeyer,MD Head,HTADivision HauteAutorit deSant,France DIAEuromeeting2011! Geneva 01 Publicactions Before2006
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Fightagainstpain: PublicactioninFrance(1)
- 1991Firstsetofministerialregulationson
chronicpain
- 1998– 2002Firstnationalprogramofactions
- 2002
! "
- 2002– 2005Secondnationalprogramof
actions
- #$
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2004:Surveyofemergencymanagementof acutepaininpre!hospitalsettinginFrance
- Objectives.! AssessmentofpracticeofMobil
IntensiveCareUnits(MICU)physiciansin severeacutepain(SAP)management.
- Phonequestionnaireaddressedtoemergency
physiciansin360unitsinFrance
- %&'(&'(
- !)
- !)
- *
+,"'-'.*
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2004Surveyofmanagementofacutepain! Resultsandconclusions
- 49% ,Nationalguidelines
- 63% !localanalgesicsguidelines"
- SAPassessment'/0'&1&2$34
)17%.
- Efficacyassessment/0'&1&534
)14%.
- )67"
- +)dosesandwaitingperiods)
!)6% 28%.
- Lowknowledgeaboutsevereacutepainmanagement
inout!of!hospitalsetting,bothforpainassessment andtreatment.Therewerefewlocalguidelinesto
- vercomethisdeficiency.
- 8
+,"'-'.*
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02
Whatchanges since2006?
- $
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NewPublicinstitutionsatnationaland regionallevel
- 2005
: National French Health Authority Independentpublicscientificbody
- 9
%%!(()9 :
- ;+
- 9'
- ;!
- '<
/)4!
- 2009:RegionalHealthAgencies
- 9.')
!
- 6
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2006:Thirdministerialactionplan
- =)
! "
- >
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- (
,!) ,)"
- >))
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- =
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- <
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2006:Thirdministerialactionplan
Fourpriorities
- Improvedmanagementofthosemostvulnerable
(children,elderlyandendoflifeperiod);
- Enhancedtrainingofhealthprofessionals;
- Betteruseofmedicationsandnon!
pharmacologicmethods
- Restructuringofcarepathways.
- #
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Restructuringofthecarepathways
- 5actions
- A
##<B
- !
B
- @
!) B
- !,CB
- )?!
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HowcanHAScontributetotheplan?
- Healthtechnologyassessment
- %
- %!
- D!
- Clinicalguidelinesdevelopment
- Assessmentoforganisationalaspects
- Actionsonthequalityofpractice
- (9;DE
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Cooperations
- Nationalinstitutions:Frameworkagreements,
jointactionplans
- 1;>'/1'
F 4'/-9( &'4"""
- RegionalHealthAgencies
- 9'&!
!
- Healthprofessionals:
- %!NationalProfessionalBoards
(! !"
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Appropriatecarepathwaysforpatients withchronicpain
- 2007
- /&-G=%49'&
- "
- HASembarkedontwocomplementaryprojects:
- clinicalpracticeguideline,
- statusreporton theorganizationalaspects
- H(!I
B
- !/4
- ).9
'"
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01
TheroleofHealth Technology Assessment (HTA)
- *
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Marketing Authorisation Access to reimbursement
CEPS
Economic Committee for Healthcare Products
UNCAM
- Nat. Health Insurance Union
Ministry of Health,
- M. of Social Security
L I S T I N G Criteria: ► Actual benefit (SMR) ►Clinicaladdedvalue (ASMR) Criteria: ►Pharmaceutical quality ►Efficacy ►Safety
Transparency Committee Guidance Decision
; !
(
- 8
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- $
Clinicaleffectiveness G!
- Others
&! >)
- &.
& > '&. 1 ! ' ! 1) .)
- ()
- Dimensions
Criteria Results P R I C I N G
HTA:HASGuidance
Ministry Economic Committee Relativeeffectiveness:
;!! @J
Initialassessment:FromHTAtodecision makingonpriceandreimbursement
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6 6
InternationalcooperationonHTA
HASinternal assessors
HAS Transparency Committee
HAS Guidance
Reviewof availabledata
“ ASSESSMENT” “ APPRAISAL”
Dossierfrom Pharma! ceutical Company Literature
Economic Committee ! Ministryof Health ! NHIfunds
Pricing and Decision
- HTA
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< <
InternationalcooperationonHTA
HASinternal assessors
HAS Transparency Committee
HAS Guidance
Reviewof availabledata
“ ASSESSMENT” “ APPRAISAL”
Dossierfrom Pharma! ceutical Company Literature
Economic Committee ! Ministryof Health ! NHIfunds
Pricing and Decision
- HTA
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Theuseofopioidsinchronicnon cancerpain(Afssapsrecommendations)
- ThemanagementofCNCPisglobal
- Thestepapproachforusinganalgesicsdoes
notapplytoallchronicpainsyndromes,
- OpioidslimitationsinCNCP
- =)
- &!
- K)),!
- Opioidsrelatedriskstobeconsidered
- #
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Drugandnon!drugtherapies
- Nondrugtherapies
- !!)
- D,9'&1%=
- Pharmaceuticals:
- 1!
- 9!!
- '
- 9=')
- %!
- ();(%:
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VariousproductionsofHAS
- Healthtechnology
assessment:
- Clinicalguidelines
- Recommendationson
- rganisationalmeasures
- ,/
.9 '4
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- Thankyouforyourattention
http://www.has!sante.fr