Priority Setting for Systematic Reviews Drug Effectiveness Review Project     US Cochrane Center Conference Baltimore, Mar...
Drug Effectiveness Review Project  <ul><li>State of Oregon Medicaid had 60% increase in drug spending in the year 2000 </l...
Drug Effectiveness Review Project HISTORY Broader base desirable to increase number of reviews and provide for updating DE...
Drug Effectiveness Review Project <ul><li>Arkansas Missouri </li></ul><ul><li>Canadian Agency for Drugs/ Montana </li></ul...
Drug Effectiveness Review Project <ul><li>To obtain and synthesize global evidence on the comparative effectiveness, safet...
Drug Effectiveness Review Project <ul><li>Full systematic reviews with explanation by report authors </li></ul><ul><li>Abi...
Drug Effectiveness Review Project <ul><li>Center for Evidence-based Policy responsible for contracting, communication, mee...
Drug Effectiveness Review Project <ul><li>Considerations </li></ul><ul><li>Dollar and Prescription Volume </li></ul><ul><l...
Drug Effectiveness Review Project <ul><li>3 months before Governance conference: </li></ul><ul><li>Solicit the 5 most pres...
Drug Effectiveness Review Project <ul><li>1 month before Governance conference: </li></ul><ul><li>Center collates particip...
Drug Effectiveness Review Project <ul><li>Briefing Paper Elements </li></ul><ul><li>Disease Burden </li></ul><ul><li>Alter...
Drug Effectiveness Review Project <ul><li>Revisions to the Process  </li></ul><ul><li>Number of topics solicited varies ba...
Drug Effectiveness Review Project <ul><li>Revisions to the Process </li></ul><ul><li>Economic Impact eliminated </li></ul>...
Drug Effectiveness Review Project <ul><li>Originally, all reports updated continually or annually </li></ul><ul><li>In rea...
Drug Effectiveness Review Project <ul><li>Literature search of MEDLINE since date of last search </li></ul><ul><li>Include...
Drug Effectiveness Review Project <ul><li>DERP Topic Selection has evolved over time in response to: </li></ul><ul><li>Inc...
Drug Effectiveness Review Project <ul><li>  Alison Little, MD, MPH, Medical Director </li></ul><ul><li>Drug Effectiveness ...
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Drug Effectiveness Review Project

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Drug Effectiveness Review Project

  1. 1. Priority Setting for Systematic Reviews Drug Effectiveness Review Project US Cochrane Center Conference Baltimore, Maryland Presented by: Alison Little, MD, MPH Date: July 11, 2008
  2. 2. Drug Effectiveness Review Project <ul><li>State of Oregon Medicaid had 60% increase in drug spending in the year 2000 </li></ul><ul><li>PDL Legislation (Senate Bill 30) </li></ul><ul><ul><li>Consider effectiveness/safety first </li></ul></ul><ul><ul><li>Consider cost if effectiveness/safety equal </li></ul></ul><ul><li>Collaboration with OHSU EPC – 4 Reviews </li></ul><ul><li>Washington and Idaho join – 8 more Reviews </li></ul>HISTORY
  3. 3. Drug Effectiveness Review Project HISTORY Broader base desirable to increase number of reviews and provide for updating DERP officially begins in 2003 with 3 year contract Ultimately includes 15 states and 2 other organizations Phase 2 of project runs from 2006 to 2009
  4. 4. Drug Effectiveness Review Project <ul><li>Arkansas Missouri </li></ul><ul><li>Canadian Agency for Drugs/ Montana </li></ul><ul><li> Technologies in Health New York </li></ul><ul><li>Colorado North Carolina </li></ul><ul><li>Idaho Oregon </li></ul><ul><li>Kansas Washington </li></ul><ul><li>Michigan Wisconsin </li></ul><ul><li>Minnesota Wyoming </li></ul>CURRENT DERP MEMBERS
  5. 5. Drug Effectiveness Review Project <ul><li>To obtain and synthesize global evidence on the comparative effectiveness, safety and effects on subpopulations of drugs within classes, and to support policy makers in using that evidence to inform policy in local decision making </li></ul>MISSION
  6. 6. Drug Effectiveness Review Project <ul><li>Full systematic reviews with explanation by report authors </li></ul><ul><li>Ability to choose those reviews </li></ul><ul><li>Translational products (executive summaries, power point slides, P&T Committee briefs, P&T presentations) </li></ul><ul><li>Proprietary electronic report library </li></ul><ul><li>Monthly teleconferences </li></ul><ul><li>Biennial face to face conferences </li></ul>BENEFITS OF MEMBERSHIP
  7. 7. Drug Effectiveness Review Project <ul><li>Center for Evidence-based Policy responsible for contracting, communication, meetings </li></ul><ul><li>Oregon Evidence-based Practice Center either completes or oversees review work </li></ul><ul><li>Total of 34 reviews to date </li></ul><ul><li>Total of 60 updates of those reviews </li></ul>BENEFITS OF MEMBERSHIP
  8. 8. Drug Effectiveness Review Project <ul><li>Considerations </li></ul><ul><li>Dollar and Prescription Volume </li></ul><ul><li>Variation of Cost within a Class </li></ul><ul><li>Timing of New Releases and Changes to Generic/OTC Status </li></ul><ul><li>Likelihood of Good Quality Evidence </li></ul><ul><li>Expected Workload of the Review </li></ul><ul><li>Drugs in the Class </li></ul>TOPIC SELECTION - ORIGINAL
  9. 9. Drug Effectiveness Review Project <ul><li>3 months before Governance conference: </li></ul><ul><li>Solicit the 5 most pressing topics from each participating organization. </li></ul><ul><li>2 months before Governance conference: </li></ul><ul><li>Center collates and distributes list to all participants </li></ul><ul><li>List discussed at Governance call and narrowed to 10 topics </li></ul><ul><li>Participants analyze their data to determine answers to selected prioritization criteria and submit to Center </li></ul>TOPIC SELECTION – SECOND PHASE
  10. 10. Drug Effectiveness Review Project <ul><li>1 month before Governance conference: </li></ul><ul><li>Center collates participant’s answers to criteria as well as additional information on the topic to create a briefing paper. EPC provides review of evidence for each potential topic. </li></ul><ul><li>At Governance conference: Final discussion and vote for new topics </li></ul><ul><li>Post Governance conference: </li></ul><ul><li>Summary of the decision added to briefing paper, </li></ul><ul><li>Re-confirm relevancy of topic prior to onset of work </li></ul>TOPIC SELECTION – SECOND PHASE
  11. 11. Drug Effectiveness Review Project <ul><li>Briefing Paper Elements </li></ul><ul><li>Disease Burden </li></ul><ul><li>Alternatives </li></ul><ul><li>Clinical Impact </li></ul><ul><li>Budget Impact </li></ul><ul><li>Economic Impact </li></ul><ul><li>Evidence </li></ul><ul><li>Marketing </li></ul><ul><li>Benefit/ Policy Considerations </li></ul>TOPIC SELECTION – SECOND PHASE
  12. 12. Drug Effectiveness Review Project <ul><li>Revisions to the Process </li></ul><ul><li>Number of topics solicited varies based on number of reports to choose </li></ul><ul><li>List of solicited topics varies based on number of reports to choose </li></ul><ul><li>More elements of briefing paper to be completed by Center </li></ul>TOPIC SELECTION – REVISION
  13. 13. Drug Effectiveness Review Project <ul><li>Revisions to the Process </li></ul><ul><li>Economic Impact eliminated </li></ul><ul><li>Budget Impact reporting standardized </li></ul><ul><li>Evidence limited to last 3 years </li></ul><ul><li>Pros and Cons added </li></ul>TOPIC SELECTION – REVISION
  14. 14. Drug Effectiveness Review Project <ul><li>Originally, all reports updated continually or annually </li></ul><ul><li>In reality, some not updated for years </li></ul><ul><li>Second phase of DERP brings more formalized process – Annual Scanning </li></ul>TOPIC SELECTION – UPDATING
  15. 15. Drug Effectiveness Review Project <ul><li>Literature search of MEDLINE since date of last search </li></ul><ul><li>Include abstracts </li></ul><ul><li>New Drugs </li></ul><ul><li>New Indications </li></ul><ul><li>New Safety Alerts </li></ul>TOPIC SELECTION – SCANNING
  16. 16. Drug Effectiveness Review Project <ul><li>DERP Topic Selection has evolved over time in response to: </li></ul><ul><li>Increased project size </li></ul><ul><li>More limited resources </li></ul><ul><li>Need for fairness </li></ul>SUMMARY
  17. 17. Drug Effectiveness Review Project <ul><li> Alison Little, MD, MPH, Medical Director </li></ul><ul><li>Drug Effectiveness Review Project </li></ul><ul><li>Center for Evidence-based Policy </li></ul><ul><li>Oregon Health and Science University </li></ul><ul><li>503-494-7239 </li></ul><ul><li>[email_address] </li></ul><ul><li>www.ohsu.edu/policycenter </li></ul><ul><li>www.ohsu.edu/drugeffectiveness </li></ul>CONTACT INFORMATION

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