فرهاد زرگری , Healthcare, pharma

1. 1
HealthcarePharmacoeconomy
FARHAD ZARGARI, MD, PHD
DECEMBER, 2013

2. Course Outline

Session One (92-9-25)

Introduction

Healthcare

Health System


2
Pharmaceuticals in Healthcare
Session Two




Session Three


NDP
R&D

Dr. Zargari

3. 1
Introduction

4. The Changing World
• “The period 2000-2025 will bring the single greatest worldwide change since
we came down from the trees.”
David Schneider & Grady Means, Meta Capitalism
4
4
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5. The Changing World
• “It used to be that the big ate the small. Now the fast eats the slow.”
Geoff Yang, (Institutional Venture Partners)
5
5
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6. The Changing World
Future
Present
Past
Where are
we ?
Where are we
going to be ?
Where
were we ?
6
6
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7. The Changing World
• There are THREE kinds of
people:
• 1- Those who Remember
• 2- Those who Think
• 3- Those who Dream
• Those who Remember
• Remember the Past
• Those who Think
• Try to Grasp the Present
• Those who Dream
• Dream about Future
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8. The Changing World
Future
Present
Past
Where
were we ?
8
Where are
we ?
Where are we
going to be?
8
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9. The Changing World
• There are three types of people in the world:
• Those who make things happen.
• Those who watch things happen.
• And those who ask - "What happened?"
9
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10. 1-Cognitive
2-Affective
3-Behavioral
You
Change Yourself First
Change
Process
Outputs
Impact
Outcomes
10
10
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11. 2
Healthcare

12. 12

UNDP
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13. 13


Increasing
Human
Physical and
Mental
Productivity
Three
Protecting
People’s
Health
Two
One
Healthcare Ultimate Objectives:
Safeguarding
“Human
Capital” as
the Core
Engine of
Development
Sustainable Development
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14. 14

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15. 15
Human Capital Theory
Aging

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16. 16

WHO
WHO
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17. 17

–
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18. 18

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19. 19
GDP
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20. 20


SDH
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21. 21


Personal Behavior



Living Conditions
Working Conditions
Community Behavior

Economic Resources

Social Resources
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22. Lists of Social Determinants
From World Health Organization
From Social Determinants of Health
National Conference

Income/Social Status

Early Life

Social Support Networks

Education

Education/Literacy

Employment/Work Conditions

Social Environment

Food Security
Gender

Physical Environment


Health Care Services

Life/Coping Skills

Housing

Personal Health Practices

Income and its Distribution

Child Development

Social Safety Net

Gender

Social Exclusion

Culture

Unemployment/
Employment Security
21

23. 22

24. 23

25. 24

26. 25

27. 27
“Social justice is a matter of life and
death.”
World Health Organization
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28. 50
50
40
30
20
10
0
25
15
10

29. 29
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30. 30
Illness
Orientation
Wellness
Orientation
Fragmented
Care
Comprehensive
Care
Independent
Systems
Integrated
Network

31. 31
1-Socioeconomic Factors 2-Psychological Factors
3-Environmental Factors 4-Biological Factors
1-Preventive Measures
2-Therapeutic Measures
3-Rehabilitative Measures
1-Modern Medicine
2-Complimentary Medicine
Both Sexes
All
Ages
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32. Sustainability
32
Value Creation
Health
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33. 3
Health System

34. Health System Definition

Health systems can be understood in many ways. The World Health
Organization (WHO) defines health systems as “all the
organizations, institutions, and resources that are devoted to producing
health actions.”
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35. Health System Definition

Health care system is that part of any state concerned with regulating access
to, financing, and organizing the delivery of health care to the population.
Moran, 1991
Access
Health
Delivery
Financing
Organizing
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36. Health System Definition

All the activities whose primary purpose is to promote, maintain, or restore
the health of the society.
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37. Health System Definition

Health systems encompass all levels:






central,
regional,
district,
community,
and household.
Health sector projects engage with all levels and elements of the health
system and frequently encounter constraints that limit their effectiveness.
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38. Health System Functions

The World Health Report 2000 (WHO 2000) identifies the four key functions
of the health system:





(1) stewardship (often referred to as governance or oversight),
(2) financing,
(3) human and physical resources,
(4) organization and management of service delivery,
Next slide illustrates the relationship between the four functions of health
systems.
Dr. Zargari 38

39. Relations Between Functions and Objectives of a Health
System
Stewardship
(oversight)
Creating resources
(investment
And training)
Responsiveness
(to non-medical
expectations)
Delivering services
(provision)
Financing
(collecting, pooling
And purchasing)
Functions of the System
Health
Fair (financial)
contribution
Objectives of the System
Source: Adapted with permission from WHO (2001)
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40. 4
Pharmaceuticals in Healthcare

41. • ANY CHEMICAL THAT AFFECTS THE PROCESSES OF A LIVING ORGANISM
• A MEDICINE OR OTHER SUBSTANCE WHICH HAS A PHYSIOLOGICAL EFFECT
WHEN INGESTED OR OTHERWISE INTRODUCED INTO THE BODY.
•
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42. • CHEMICAL NAME, THE DRUG’S CHEMICAL COMPOSITION AND MOLECULAR
STRUCTURE
• GENERIC NAME (NONPROPRIETARY NAME)
• TRADE NAME (PROPRIETARY NAME), THE DRUG HAS A REGISTERED
TRADEMARK
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43. Dr. Zargari 43

44. 19.8%
19.1%
Mining, Crude Oil Production
Pharmaceuticals
Tobacco
Food Consumer Products
Household and Personal Products
Telecommunications
Industrial Machinery
Building Materials, Glass
Aerospace and Defense
Shipping
Network and Other Communications Equipment
Banks: Commercial and Savings
Beverages
Metals
Health Care: Insurance and Managed Care
Energy
Chemicals
Specialty Retailers
Mail, Package, and Freight Delivery
Trading
Computers, Office Equiment
Food and Drug Stores
Food Production
Insurance: Property and Casualty (Stock)
Engineering, Construction
Source: Fortune Global 2010
12.3%
11.9%
9.9%
7.5%
7.1%
6.5%
6.2%
6.1%
5.4%
5.2%
4.2%
3.7%
3.7%
3.5%
3.2%
3.1%
2.8%
2.8%
2.5%
2.3%
2.3%
2.0%
1.9%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
22%
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45. 20.0
.
18.0
16.0
14.0
12.0
10.0
8.0
6.0
4.0
2.0
0.0
List by the United Nations (2011)
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46. 35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
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47. Dr. Zargari 47

48. GDP
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49. Dr. Zargari

50. -
-
-
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51. Loss of
Exclusivity
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52. .
2016
OTC
.
2011
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53. *
•
- •
- •
R&D
- •
- •
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54. *
COUNTRY
PHARMA SHARE OF GDP
TOTAL GDP(MILLION USD)
0.2-0.5
514,060
New Zeland
Japan
Australia
Solomon Islands
Korea Republic
Vietnam
Cambodia
Nepal
China
Fiji
LaoPDR
Malysia
India
Singapore
Iran
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