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Forum “For Healthy Life” December 9-10, 2013, Moscow. The Value Of In-vitro Diagnostics. Healthcare challenges in the 21 st century for governments & hospitals & how in-vitro diagnostics can contribute to overcoming these. Regina Kloss-Wolf
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Forum “For Healthy Life” December 9-10, 2013, Moscow The Value Of In-vitro Diagnostics Healthcare challenges in the 21st century for governments& hospitals & how in-vitro diagnostics can contributeto overcoming these Regina Kloss-Wolf Director Global Strategic Health Initiatives, Abbott Laboratories
The Healthcare World In The 21st Century:Having To Do More With Less Demographic change reinforces rise of NCDs • Economic • Reality: • Decreased healthcare budget • Healthcare • Reality: • Increased • healthcare demand Challenge #1 Challenge #2 Ageing population Rise of NCDs Healthcare reality: increased demand for healthcare
Healthcare Reality - Challenge 1:Population Ageing 60+yrs Russia 2050: 37% 2025: 26% 2000: 18% Sources: United Nations, Population Facts, Population Ageing and the non-communicable diseases, April 2012, accessed 25 November 2013. United Nations, World Population Ageing 1950-2050, accessed 25 November 2013. http://www.un.org/esa/population/publications/worldageing19502050/pdf/173russi.pdf
Healthcare Reality - Challenge 2:Non Communicable Diseases - Key Facts “Non Communicable diseases (chronic diseases) are not passed from person to person. They are of long duration & generally slow progression” Between 70% & 80% of Europe’s healthcare costs are spent on chronic care, amounting to €700bn NCDs cause more than 36 million deaths worldwide – 63% of all mortality Early intervention may enable early detection & hence contribute to cost-reduction Sources: WHO, factsheet on Chronic Diseases, accessed 25 November 2013. WHO, factsheet on Noncommunicable diseases, accessed 25 November 2013. EPHA, Extend healthy years by tackling chronic diseases in a life-course approach, accessed 25 November 2013.
Healthcare Reality - Challenge 2Rise Of Cardio Vascular Diseases & Associated Costs CVDs 23.3 million of people dying of CVDs Cost of CVDs:$1,044bn Cost of CVDs: $863bn 17.3 million people dying of CVDs CVDS 2008 2008 2010 2010 2030 2030 Sources; AIHW, Why are mortality data important?, accessed 25 November 2013. World Economic Forum, Non-communicable Diseases to cost $47 trillion by 2030, New Study Released Today, accessed 25 November 2013. World Heart Federation, The cost of CVD, accessed 25 November 2013. WHO, factsheet on Cardiovascular Diseases,, accessed 25 November 2013.
Healthcare Reality - Challenge 2Rise Of Cardio Vascular Diseases & Associated Costs Russia • CVDs account for 57% of all deaths • NCDs account for 90% of all deaths • Cost of CVDs: • 3% of GDP CVDs NCDs RUR 2012 2006-2009 2012 • Source: Petrukhin IS, Lunina EY. Cardiovascular disease risk factors and mortality in Russia: challenges and barriers. Public Health Reviews. 2012;33:436-49
So What Does The Rise Of NCDs Mean? The worldwide rise of chronicNon Communicable Diseases:a slow-motion catastrophe Margaret Chan WHO Director General
Increasing use of Clinical Guidelines and Quality Measurements Globally How Do IVDs Fit Into This ? Cost-effectiveness Clinical outcomes Hospital bed occupancy rate Mortality rates Unplanned readmission Cost per discharge Average waiting time for patient Length of stay
IVD Case Studies How can IVDs contribute to overcoming this challenge?
The Diagnostics Paradox:Recognised Important Role, but Low Investment 70% Early diagnosis & treatment stops NCDs progressing into costly, crippling complications & premature death Medical decisions are based on IVDs Healthcare budget spent on IVD’s 2% NCD Alliance 10 Sources: NCD Alliance, Discussion Paper No. 3 Geneva 2011, accessed 25 November 2013. EDMA answer to the European Commission consultation on Community Action on Health Services, 31 January 2007, p.2
IVDs: One Of The Key Tools In Diagnostics Disease prevention& Population screening Monitoring of prescribed treatments In Vitro Diagnostics are usedalongside the healthcare pathway Assessment of medical interventions Diagnosis, treatment selection & Prognosis
Biomarker helpsto diagnose congestive heart failure Case1: Early diagnosis of heart failure and differentiation from other diseases causing dyspnoea The impact on quality measurements • The challengeManagement of patients with acute Dyspnoea BNP (B-type NatriureticPeptide) HF is the most frequent diagnosis associated with 30 day readmission -10% Admission rate 30 Treatment cost Cost per discharge Cost per patient Length of stay Mortality $-1.854 -2.2 12
Earlier triage of patients, already after 2-4 hrs. with hsTroponin vs. 6-12 hrs. Case 2: Taking The Right Decision In Case Of Heart Attack In Patients With Acute Chest Pain The impact on quality measurements The challengeCorrect triaging hs Troponin 7-20% Only 7-20% of patients who present with chest pain in the ED are confirmed for diagnosis of myocardial infarct 40% More confident rule out for up to 40 % with suspected acute coronary syndrome Waiting times Cost per discharge Waiting times Cost per discharge Better allocation 13
Conclusion • The burden of the ageing world population and NCDs will continue to rise. • IVDs play an important role in optimizing care and minimizing cost • IVDs are critical to the successful implementation of clinical guidelines and quality measures.