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Détermination du ticket modérateur en fonction de la valeur sociétale de la prestation ou du produit / Irina Cleemput / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)
Détermination du ticket modérateur en fonction de la valeur sociétale de la prestation ou du produit [printed text] / Irina Cleemput , Author ; Carl Devos , Author ; Stephan Devriese , Author ; Maria-Isabel Farfan-Portet, Author ; Carine Van de Voorde, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2012 . - VI, 122 p. : Ill, ; A4. - (KCE Reports B. Health Services Research (HSR); 186B) .
ISSN : D/2012/10.1273/63 : € 0,00
Languages : English (eng) French (fre)
Descriptors: Classification
W 74 Medical economics. Health care costs (General)
Indexation
2010-19 ; Cost-sharing ; Deductibles and Coinsurance ; Health Care Reform ; Health Services Accessibility ; Insurance, Health ; R186Abstract: Les tickets modérateurs existent en Belgique depuis près de 50 ans, et ils sont fort différenciés et complexes. À la demande de l'INAMI, le Centre Fédéral d'Expertise des Soins de Santé (KCE) a étudié un nombre de points sensibles importants. Le système gagnerait à être simplifié. Ainsi, les différences de tickets modérateurs en fonction du nombre de patients examinés pour les visites à domicile du médecin généraliste ou le lieu de la visite pourraient être supprimées. Plus la plus-value sociétale d'une intervention médicale est élevée, plus le ticket modérateur associé devrait être faible. Ceci devrait contribuer à des soins de santé efficaces et de meilleure qualité. Le KCE recommande donc de ne plus comptabiliser le ticket modérateur comme un pourcentage des honoraires médicaux ou du cout d'un médicament. Il importe d'élaborer une vision globale, dans laquelle les objectifs des tickets modérateurs seraient pris en compte. Contents note: SYNTHÈSE 9 -- 1. CONTEXTE 9 -- 2. DÉFINITION ET OBJECTIFS DE LA VALUE-BASED INSURANCE 10 -- 3. FORMES DE VALUE-BASED INSURANCE 11 -- 4. IMPACT DE LA VALUE-BASED INSURANCE 12 -- 5. PROBLÉMATIQUES DE LA VALUE-BASED INSURANCE 13 -- 5.1. CONDITIONS ET OBSTACLES À L’IMPLÉMENTATION D’UNE VBI 13 -- 5.2. « VALUE-BASED INSURANCE » VERSUS « VALUE-BASED PRICING » 14 -- 5.3. L’OPINION PUBLIQUE EST-ELLE FAVORABLE À UNE VBI ? 15 -- 5.4. VALUE-BASED INSURANCE ET TICKET MODÉRATEUR SOUS LA FORME D’UN MONTANT FIXE OU D’UN POURCENTAGE 15 -- 6. ILLUSTRATION D’UNE POSSIBLE APPLICATION DES PRINCIPES DE LA VALUE-BASED INSURANCE AUX MÉDICAMENTS ET IMPACT BUDGÉTAIRE 16 -- 7. CONCLUSION 18 -- SCIENTIFIC REPORT 19 -- 1. INTRODUCTION 19 -- 1.1. GENERAL BACKGROUND 19 -- 1.2. SCOPE AND RESEARCH QUESTIONS 20 -- 1.3. METHODS 20 -- 1.4. CONTENT OF THE REPORT 20 -- 2. THE ROLE OF DEMAND-SIDE COST SHARING IN A SOCIAL INSURANCE SYSTEM 21 -- 2.1. DIMENSIONS OF HEALTH INSURANCE COVERAGE 21 -- 2.1.1. Breadth of the coverage 21 -- 2.1.2. Depth of the coverage 21 -- 2.1.3. Height of the coverage 21 -- 2.2. A BRIEF INTRODUCTION ON OPTIMAL COST SHARING 22 -- 2.2.1. Cost shifting 22 -- 2.2.2. Fighting moral hazard... 22 -- 2.2.3. Steering behaviour of imperfectly informed patients 23 -- 2.3. HEALTH INSURANCE COVERAGE AND VALUE-BASED INSURANCE 23 -- 2.4. DIFFERENTIATED COST SHARING IN BELGIUM 23 -- 2.4.1. Disease management programme for type 2 diabetes 23 -- 2.4.2. Pharmaceuticals 24 -- 2.4.3. Healthcare services 27 -- 3. THE CONCEPT OF VALUE-BASED INSURANCE 27 -- 3.1. THE BASIC PRINCIPLE OF VALUE-BASED INSURANCE 27 -- 3.2. DEFINITION OF VALUE 28 -- 3.2.1. Value in value-based insurance 28 -- 3.2.2. Value-based pricing 29 -- 3.2.3. Value in value-based pricing 30 -- 3.2.4. Issues with value-based pricing in practice 30 -- 3.2.5. Value-based insurance when value-based pricing fails 31 -- 4. TYPES OF VALUE-BASED INSURANCE DESIGNS 35 -- 4.1. DESIGNS IN GENERAL 35 -- 4.2. VALUE-BASED INSURANCE DESIGNS IN FUNCTION OF THE TYPE OF SERVICE 39 -- 4.2.1. One size does not fit all 39 -- 4.2.2. Belgian examples 41 -- 5. ISSUES IN VALUE-BASED INSURANCE 43 -- 5.1. VALUE-BASED INSURANCE AND SOCIAL PROTECTION 43 -- 5.2. VALUE-BASED INSURANCE AND COINSURANCE VERSUS CO-PAYMENT 43 -- 5.3. CONDITIONS FOR IMPLEMENTING VALUE-BASED INSURANCE 45 -- 5.3.1. Evidence on the value of healthcare services 45 -- 5.3.2. Efficient targeting 46 -- 5.3.3. Data requirements 47 -- 5.3.4. Auditing 47 -- 5.3.5. Patient and physician information 47 -- 5.3.6. Integrated approach 48 -- 5.4. PUBLIC ACCEPTANCE AND SUPPORT FOR VALUE-BASED INSURANCE 48 -- 6. IMPACT OF VALUE-BASED INSURANCE 49 -- 6.1. EXPECTED BENEFITS OF VALUE-BASED INSURANCE 49 -- 6.1.1. Impact on adherence... 49 -- 6.1.2. Impact on healthcare expenditures 50 -- 6.1.3. Impact on access to healthcare 50 -- 6.2. REAL-LIFE EXPERIENCES IN THE US 51 -- 6.2.1. Value-based co-payment tiers for pharmaceuticals 51 -- 6.2.2. Costs and outcomes of value-based insurance designs 52 -- 6.3. EVALUATION OF VALUE-BASED INSURANCE DESIGNS IN BELGIUM 57 -- 7. ILLUSTRATION OF A POSSIBLE APPLICATION OF VALUE-BASED INSURANCE PRINCIPLES TO ANTIDEPRESSANTS... 58 -- 7.1. OBJECTIVE AND SCOPE 58 -- 7.2. INDICATIONS FOR ANTIDEPRESSANTS 59 -- 7.2.1. Severe depression 59 -- 7.2.2. Label extensions 59 -- 7.2.3. Off-label use 59 -- 7.3. USE OF ANTIDEPRESSANTS 60 -- 7.3.1. Volume increase 60 -- 7.3.2. Antidepressant treatment duration and non-persistence 60 -- 7.4. SIMULATION OF A VALUE-BASED INSURANCE DESIGN FOR ANTIDEPRESSANTS 61 -- 7.4.1. Microsimulation as a tool for the analysis of policy measures 61 -- 7.4.2. Description of the data 61 -- 7.4.3. Analysis sample 62 -- 7.4.4. Defining a treatment episode 64 -- 7.4.5. Social protection measures 65 -- 7.4.6. Simulation scenarios 65 -- 7.5. RESULTS OF THE BASELINE SITUATION 67 -- 7.6. RESULTS OF THE SIMULATED SCENARIOS 71 -- 7.7. DISCUSSION 76 -- 7.7.1. Appropriateness and feasibility of a higher patient cost sharing for a first prescription 76 -- 7.7.2. Shared responsibilities 77 -- 8. CONCLUSION 77 -- APPENDICES 79 -- REFERENCES 119 -- Link for e-copy: http://doi.org/10.57598/R186B Format of e-copy: PDF (1,3 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3063 Hold
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Barcode Call number Media type Location Section Status 10273-02612 W 74 / CLE Report KCE Library (10.124) Due for return by 12/31/2020 Readers who borrowed this document also borrowed:
Travail et revenu universel Manifeste pour une santé égalitaire et solidaire Equality of opportunity Roemer, John E. La vérité sur le cholestérol Even, Philippe Theories of distributive justice Roemer, John E. Les inégalités sociales de santé Lang, Thierry Un monde vulnérable Tronto, Joan L'État-providence en Europe Lefebvre, Mathieu Crise et figures de la démocratie Panorama de la santé 2007 Organisation for Economic Co-operation and Development (OECD) = Organisation de Coopération et de Développement Economiques (OCDE) Justice, Luck & Responsibility in Health Care Denier, Yvonne Détermination du ticket modérateur en fonction de la valeur sociétale de la prestation ou du produit / Irina Cleemput / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)
Détermination du ticket modérateur en fonction de la valeur sociétale de la prestation ou du produit : Synthèse [printed text] / Irina Cleemput , Author ; Carl Devos , Author ; Stephan Devriese , Author ; Maria-Isabel Farfan-Portet, Author ; Carine Van de Voorde, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2012 . - 12 p. : Ill, ; A4. - (KCE Reports B. Health Services Research (HSR); 186BS) .
ISSN : D/2012/10.273/65 : € 0,00
Languages : French (fre)
Descriptors: Classification
W 74 Medical economics. Health care costs (General)
Indexation
2010-19 ; Cost-sharing ; Deductibles and Coinsurance ; Health Care Reform ; Health Services Accessibility ; Insurance, Health ; R186Abstract: Les tickets modérateurs existent en Belgique depuis près de 50 ans, et ils sont fort différenciés et complexes. À la demande de l'INAMI, le Centre Fédéral d'Expertise des Soins de Santé (KCE) a étudié un nombre de points sensibles importants. Le système gagnerait à être simplifié. Ainsi, les différences de tickets modérateurs en fonction du nombre de patients examinés pour les visites à domicile du médecin généraliste ou le lieu de la visite pourraient être supprimées. Plus la plus-value sociétale d'une intervention médicale est élevée, plus le ticket modérateur associé devrait être faible. Ceci devrait contribuer à des soins de santé efficaces et de meilleure qualité. Le KCE recommande donc de ne plus comptabiliser le ticket modérateur comme un pourcentage des honoraires médicaux ou du cout d'un médicament. Il importe d'élaborer une vision globale, dans laquelle les objectifs des tickets modérateurs seraient pris en compte. Link for e-copy: https://doi.org/10.57598/R186BS Format of e-copy: PDF (317 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3064 Hold
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Barcode Call number Media type Location Section Status 10273-02611 W 74 / CLE Report KCE Library (10.124) Due for return by 12/31/2020 Readers who borrowed this document also borrowed:
Les valeurs des Européens Jouvenel de, Hugues Carol Gilligan et l'éthique du care Nurock, Vanessa Travail et revenu universel The economics of health care McGuire, Alistair Economic crisis, health systems and health in Europe Thomson, Sarah Le bouclier sanitaire Tabuteau, Didier Institution, alternatives: faut-il choisir? Leclercq, Colette Les inégalités sociales de santé Lang, Thierry Promoting healthy behavior Callahan, Daniel Biostatistics in clinical trials Redmond, Carol K., Colton, Theodore La place des usagers dans le système de santé Developing an agency's position with respect to patient involvement in health technology assessment / Irina Cleemput in International Journal of Technology Assessment in Health Care, 36(2020)6 ([10/01/2020])
[article] Developing an agency's position with respect to patient involvement in health technology assessment : the importance of the organizational culture [printed text] / Irina Cleemput , Author ; Marie Dauvrin , Author ; Laurence Kohn , Author ; Patriek Mistiaen , Author ; Wendy Christiaens , Author ; Christian Léonard , Author . - 2020 . - 210 pp.
Languages : English (eng)
in International Journal of Technology Assessment in Health Care > 36(2020)6 [10/01/2020] . - 210 pp.
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
Organizational Culture ; Organizational Policy ; Patient ParticipationAbstract: The Belgian Health Care Knowledge Centre (KCE) formally involves stakeholders in HTA since 2012. Patients are treated as one stakeholder amongst others, but it is recognized that patient involvement (PI) requires a different approach. The success of implementing PIdepends, however, on the organizational culture toward PI.
Objectives. The objective of this study was to map the PI culture at KCE in the context of the development of organization-wide supported position statements about PI. Methods. A nominal group technique was used to measure the PI culture at KCE. Arguments for and against PI and conditions for PI in different phases of the HTA process were collected. A literature review and interviews fed the draft position statements, for which support was assessed by means of a two-round Delphi process. Results. Arguments in favor of PI in HTA related to the relevance of the scope, expertise with data collection, bringing in fresh ideas for study design, access to survey participants, validation of data analyses, adherence to recommendations. Disadvantages and risks included the lack of scientific knowledge of involved patients, resources requirements, conflicts of interest, and heterogeneity within patient populations. Conditions for meaningful PI referred to measures mitigating the identified disadvantages. Eighteen position statements supported by KCE could be formulated. Conclusion. The KCE culture seems predominantly positive toward PI, although attitudes vary between HTA researchers. KCE recognizes the potential value of PI in HTA, but considers the level of involvement to be contingent on the topic and phase in the HTA process.
Link for e-copy: http://vdic.idm.oclc.org/login?url=http://journals.cambridge.org/action/displayB [...] Format of e-copy: VDIC IP recognition Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4725 [article]Developing the HTA core model for the online environment / Kristian Lampe in International Journal of Technology Assessment in Health Care, 30(2014)05 ([11/01/2014])
[article] Developing the HTA core model for the online environment [printed text] / Kristian Lampe, Author ; Iris Pastermack, Author ; Oskaris Saarekas, Author ; Leena Raustia, Author ; Irina Cleemput , Author ; Mirella Corio, Author ; Gottfried Endel, Author ; Katrine Frønsdal, Author ; Inaki Imaz, Author ; Sarah Kleijnen, Author ; Finn Kristensen, Author ; Alric Rüther, Author ; Sophie Werkö, Author ; Marina Cerbo, Author . - 2014 . - 478-487.
Languages : English (eng)
in International Journal of Technology Assessment in Health Care > 30(2014)05 [11/01/2014] . - 478-487
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
Health Care ; Health Care Economics and Organizations ; Health Policy ; Journal Article ; Medical Informatics ; Quality of Health Care ; Research DesignKeywords: EUnetHTA Abstract: BACKGROUND:
A framework for collaborative production and sharing of HTA information, the HTA Core Model, was originally developed within EUnetHTA in 2006-08. In this paper, we describe the further development of the Model to allow implementation and utilization of the Model online. The aim was to capture a generic HTA process that would allow effective use of the HTA Core Model and resulting HTA information while at the same time not interfering with HTA agencies' internal processes.
METHODS:
The work was coordinated by a development team in Finland, supported by an international expert group. Two pilot testing rounds were organized among EUnetHTA agencies and two extensive core HTA projects tested the tool in a real setting. The final work was also formally validated by a group of HTA agencies.
RESULTS:
The HTA Core Model Online--available at http://www.corehta.info--is a web site hosting a) a tool to allow electronic utilization of the HTA Core Model and b) a database of produced HTA information. While access to the HTA information is free to all, the production features are currently available to EUnetHTA member agencies only. A policy was crafted to steer the use of the Model and produced information.
CONCLUSIONS:
We have successfully enabled electronic use of the HTA Core Model and agreed on a policy for its utilization. The system is already being used in subsequent HTA projects within EUnetHTA Joint Action 2. Identified shortcomings and further needs will be addressed in subsequent development.
Link for e-copy: http://dx.doi.org/10.1017/S0266462314000646 Format of e-copy: PDF [Requires Subscription) / Pre-print version available in attachment Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3668 [article]E-copies
Pre-print version : Developing the HTA core model for the online environmentAdobe Acrobat PDF Drempelwaarden voor kosteneffectiviteit in de gezondheidszorg / Irina Cleemput ; Mattias Neyt ; Nancy Thiry ; Chris De Laet ; Mark Leys / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2008)
Drempelwaarden voor kosteneffectiviteit in de gezondheidszorg [printed text] / Irina Cleemput , Author ; Mattias Neyt , Author ; Nancy Thiry, Author ; Chris De Laet , Author ; Mark Leys, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2008 . - viii, 69 p. : ill. ; 30 cm.. - (KCE Reports A. Health Technology Assessment (HTA); 100A) .
ISSN : D/2008/10.273/94 : 0 €
Studie nr : 2008-38
Languages : Dutch (dut) English (eng)
Descriptors: Classification
WA 525 Health Administration and Organization - General works
Indexation
2008-38 ; Cost-Benefit Analysis ; Decision Making ; Health Care Costs ; Health Care Rationing ; Quality-Adjusted Life Years ; R100 ; Technology Assessment, BiomedicalLink for e-copy: https://doi.org/10.57598/R100A Format of e-copy: .PDF (577 KB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=1419 Copies(0)
Status No copy Drug reimbursement systems / Maïté le Polain / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2010)
PermalinkDwanglicenties voor dure geneesmiddelen / Esther Van Zimmeren / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2022)
PermalinkEconomic evaluation in cancer care / E. van der Schueren in European journal of cancer, 36(2000)1 ([01/01/2000])
PermalinkEconomic Evaluation in renal transplantation. Outcome assesment & cost-utility of non-compliance / Irina Cleemput / Leuven [Belgium] : Katholieke Universiteit Leuven (KUL) (2003)
PermalinkEconomic evaluation of the use of point-of-care devices in patients with long term oral anticoagulation / Sophie Gerkens in Journal of thrombosis and thrombolysis, 34(2012)03 ([10/01/2012])
PermalinkEconomic implications of non-compliance in health care / Irina Cleemput in Lancet (The), 359(2002)9324 ([06/01/2002])
PermalinkEen Belgische waardenset voor de EQ-5D-5L / Nicolas Bouckaert / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2021)
PermalinkEen procedure voor de beoordeling van nieuwe medische hulpmiddelen / Imgard Vinck / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2006)
PermalinkEffectiviteit en kosten-effectiviteit van behandelingen voor rookstop / Ann Van den Bruel / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2004)
PermalinkEfficacité et rentabilité des thérapies du sevrage tabagique / Ann Van den Bruel / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2004)
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