European Heart Journal Advance Access published online on February 13, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi794
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1 Department of Cardiology, Cork University Hospital Wilton, Cork, Ireland
* To whom correspondence should be addressed. The European Society of Cardiology (ESC) organized a one-day workshop with clinicians, health economic experts, and health technology appraisal experts to discuss the equity of patient access to novel medical technologies in Europe. Two index technologies were considered: implantable cardioverter defibrillators (ICDs) and drug-eluting stents (DES). The use of ICDs range from 35 implants/million population in Portugal to 166 implants/million population in Germany, whereas for implants of DES (as percentage of total stents) it is lowest in Germany at 14% and high in Portugal at 65%. These differences can in part be explained by a lack of structured implementation of guidelines, the direct cost in relation to the overall healthcare budget, and to differences in procedures and models applied by Health Technology Assessment (HTA) agencies in Europe. The workshop participants concluded that physicians need to be involved in a more structured way in HTA and need to become better acquainted with its methods and terminology. Clinical guidelines should be systematically translated, explained, disseminated, updated, and adopted by cardiologists in Europe. Clinically appropriate, consistent and transparent health economic models need to be developed and high-quality international outcome and cost data should be used. A process for funding of a technology should be developed after a positive recommendation from HTA agencies. Both the ESC and the national cardiac societies should build-up health economic expertise and engage more actively in discussions with stakeholders involved in the provision of healthcare.
Received January 19, 2006
Accepted January 26, 2006
ESC Workshop Report
Improving patient access to novel medical technologies in Europe
Peter Kearney 1 *,
Graham Stokoe 2,
Günter Breithardt 3,
Carole Longson 4,
Jean Marco 5,
John Morgan 6,
Silvia Priori 7,
Alric Ruether 8,
Rod Taylor 9,
Michaël Hertog 10,
and
on behalf of the Taskforce 2 of the ESC-Cardiovascular Round Table
2 Guidant Europe, Park Lane, Culliganlaan 2B, Diegem, Belgium
3 Universitätssklinikum Münster, Albert-Schweitzer Strasse 33, Münster, Germany
4 National Institute for Health and Clinical Excellence, MidCity Place, London, UK
5 Clinique Pasteur, Unité de Cardiologie Interventionnelle, Toulouse Cedex 3, France
6 Wessex Cardiac Centre, Southampton University Hospital, Southampton, UK
7 IRCCS Fondazione Salvatore Maugeri, Department of Molecular Cardiology, Pavia, Italy
8 DIMDI-German Institute of Medical Documentation and Information, Waisenhausgasse, Köln, Germany
9 Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham, UK
10 European Society of Cardiology (ESC), 2035, Route des Colles, BP 179, F-06903, Sophia Antipolis, France
Peter Kearney, E-mail: peterkearney{at}eircom.net
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