Medical Devices for The Non-Communicable Diseases Agenda Nicole - PowerPoint PPT Presentation

Medical Devices for The Non-Communicable Diseases Agenda Nicole Denjoy DITTA Chair COCIR Secretary General 2 nd WHO Global Forum on Medical Devices Geneva, Switzerland Plenary session 3 on Sunday 24 November 2013

DITTA - the Global Diagnostic Imaging, Healthcare IT, and Radiation Therapy Trade Association • DITTA is a global organization representing Industry Associations of Manufacturers around the world • DITTA was officially incorporated in 2012 as a non-profit trade association in the United States after more than 12 years of existence

DITTA: 6 Operational Groups DITTA Task Forces MDSAP RPS UDI MSW ENVI GRP

Our Technology: a Greater role to play at Global Level! Our Industry leads in state-of-art advanced technology and provides integrated solutions covering the complete care cycle

Challenges 1 36 million deaths from chronic disease in 2008 2 60% of all deaths result from chronic disease Deaths from chronic disease will increase by 17% by 2015 3 2 17.5mm Chronic disease deaths Worldwide 7.6mm 4.1mm 1.4mm Cardiovascular diseases Cancer Chronic Diabetes respiratory disease

Why the focus on Non-Communicable Diseases? 1. NCDs are contributing to 50% of global disability 2. In 119 out of 165 countries analyzed coronary heath disease are in the Top 3 leading causes of death  Economic implications: Over the next 2 decades NCDs will represent 48% of the global GDP  Policy developments will be required

Innovation in Medical Devices Diagnostics Biotech & Genomics IT & bioengineering • Faster, accurate imaging • Targeted therapy • eHealth/Telemedicine • Molecular imaging • Proteomics/DNA • Mobile solutions • Miniaturisation/portability • Biomarkers • BioSensors • Point of Care diagnostics • Rapid screening tools • Computer Aided Diagnostics • Therapy selection/monitor • Vaccine development • Patient monitoring

Innovation in Medical Devices … support improving outcomes in Cardiology US Life Expectancy at Birth 1950-2000 80 75 70 Heart Cancer 65 1950 1960 1970 1980 1990 2000 Disease 5 out 7 years gained due Cancer Heart to better heart care Disease Sources: NCHS, Cutler 2006 “Around 70% of the survival improvement in heart attack mortality is a result of changes in technology.” Cutler & McClellan, 2001 June 17, 2009, page 8

Innovation in Medical Devices … support improving outcomes in Oncology Prostate cancer deaths Breast cancer deaths Colorectal cancer deaths 60 45 45 Per 100K females Per 100K males Per 100K pop Deaths down 4.9% 40 30 30 Breast Male Prostate 20 15 15 Female Deaths down 4.1% Deaths down 3.5% Deaths down 4.5% 0 0 0 1975 2003 2008 1975 2003 2008 1975 2003 2008 • Prostate cancer mortality continues to fall: screening, PSA • Breast cancer mortality decreased 3.5%: first drop in 20 years • Colorectal cancer 5yr survival: 10% late stage; 90% early detection “The decline in cancer has little to do with improvements in late stage treatment...but more to do with screening, earlier detection and treatment." Prof. Gordon McVie, European Institute of Oncology, Milan June 17, 2009, page 9

Breast Cancer Care Cycle Diagnosis of Recurrence Detection of Residual Disease PET/CT New markers Therapy Evaluation Mammography In-vitro test Therapy Selection F-Angiogenesis PET Staging CTMRI Radiation Treatment Diagnosis Optical Functional Marker Screening PET/CT Microarray Predisposition Functional PACS marker Microarray Electronic Health Record CT Proteomics Medication Management MR Mammography PET/CT Genomics Ultrasound Nuclear Med Exist Today BRCA 1,2 MR Risk Profiling Emerging Research and Technologies

Changing Role of Healthcare Imaging • Trend: Minimal invasive procedures (i.e. more gentle methods for the elderly)  more images for guiding Therapies than Diagnostic procedures • Trend: Increasing number of IVD tests  Imaging tells the ‘where’ • Request for Screening : One-third of all cancers could be cured if detected and treated early  earlier detection followed by less costly treatment / therapy • Trend: Personalized Medicine  Biomarker research & imaging to characterize disease fundamentals

Medical Imaging Evolution ‘80s ‘90s ‘00s Next Mainstream Mainstream Mainstream Mainstream Molecular Imaging X-Ray-based Anatomical Positioning + • CT, MR, US Anatomical (Registration) of Molecular Anatomical Imaging: XR, CT Functional Imaging: Therapeutics Imaging PET/CT, MR + Ultrasound • Digital Xray Molecular Diagnostics Emerging Emerging Emerging Emerging MR Anatomical Functional Imaging Anatomical Registration Image-guided Gene Imaging (Tissue MR, PET of Molecular Imaging Therapy Visualization) MR Spectroscopy Molecular Therapeutics, (Characterization) Diagnostics & DI

Leverage the Power of Healthcare IT 1. Healthcare IT and eHealth  proven high Hospital Government Polyclinic clinical and societal value Home 2. Telehealth  linking patients with care Central Patient’s Pharmacy providers EHR Laboratory 3. IT infrastructure  ensure that systems derive maximal value from medical technology (Cloud computing) 4. IT connectivity  improving quality and reducing cost

Driving better access to healthcare, with maximum safety and quality in a cost-efficient and affordable way Better Access Affordability & Safety & To Cost Efficiency Quality Healthcare 1. Use integrated 1. Avoid medical errors solutions and use 2. Drive CT dose Optimisation Smart use of technology to connect 3. Provide Excellent image through center of technology to provide quality excellence better access to 4. Ensure reliability 2. Maximize use healthcare and avoid equipment through its 5. Expand life cycle of inequalities entire life cycle equipment through smart  Next page, see an maintenance 3. Taylored solutions example of use of based on country Health ICT environment

Better access to healthcare – e.g. Telehealth solutions Home Repository Care Provider Bluetooth connectio DSL / Secure n POTS / databas Blood 3G Pressur e e Device • Monitor and review patient data Scale • Analyse data Manual • Careplan delivery measureme nt entry

Innovative technology enables a shift in care • Focus on acute conditions  Focus on acute & long term conditions • Hospital centred  Community centred • Physician dependent  Team based • Episodic, reactive care  Integrated preventive care • Passive patient  Knowledgeable patient • Slow uptake of technology  Localised integrated high tech solutions • Budget silos  Fund continuum of care Hospital Community Home clinic Utilization FUTURE PRESENT Low High Intermediate

Technology affordability everywhere: A Concrete Initiative for Medical Imaging Equipments GOOD REFURBISHMENT PRACTICE (GRP) Extending Life of Medical Devices and Contributing to Recycling Economy

GRP – a GLOBALLY accepted Golden Standard GRP PROCESS GRP and RESOURCE EFFICIENCY • GRP is currently a Refurbishment is a form of re-use of whole equipment. It extend the synonym for lifetime of the medical equipment, ensuring at the same time that safety ‘manufacturer and performances when the equipment was new are maintained (or even refurbishment’. improved). • Used medical Refurbishment prevents equipment to be wasted, saves resources and devices re-shipped energy needed for the manufacturing of new equipment. to the manufacturer and processed to INDUSTRY INITIATIVE restore safety and Recognizing the importance of performances as refurbishment from the perspective of when new business and environment and as a tool (including all to meet up-coming requirements on relevant updates) energy and resource efficiency COCIR, • GRP is not JIRA and MITA published in 2009 the touching the GRP paper. regulatory scope GRP is now a globally accepted for medical approch to access to affordable imaging devices. technology

Call for attention to public authorities to benefit from innovation 1. Innovative technology and healthcare has to be seen as long-term investment 2. Member States with support of WHO can drive implementation and uptake of innovative and essential technology 3. Healthcare authorities should translate faster innovation from research to market 4. Public procurement and reimbursement systems should incentivise innovative technologies and IT connectivity

Besides Technology, crucial elements for success: 1. Constant education to ensure proper use of evolving technologies 2. Appropriate Healthcare Workforce and combined with technology (e.g. telehealth) 3. Invest in technology for sustainable healthcare systems through long term investment 4. Don’t forget equipment maintenance to ensure maximum safety and performance over time

7 Recommendations to tackle NCDs 1. Proactive steps should be taken by all governments to implement a monitoring framework 2. Prevention strategies and implementation of early diagnosis and treatment should be prioritized 3. Active promotion of educational and public health awareness of the modified risks associated with NCDs 4. Provision of universal health coverage should be the global norm 5. Developmment of clinical guidelines and public policies 6. Increase investment of primary care infrastructure 7. « Invest to save » would save more lives and improve health outcomes