ECPM has been or is involved in several European Union-funded research projects (see below). We also take responsibility, since 2007, for the outcomes research and health economic evaluation activities of the Swiss Group for Clinical Cancer Research (SAKK), the leading Swiss collaborative study group in the field of oncology and haematology. In a growing atmosphere of reform of the national approach to Health Technology Assessment (HTA), we are engaged in discussion and are developing cooperation with relevant academic and non-academic players in the field, including health insurance companies. In cooperation with partner institutions from several Swiss universities, we perform HTAs for the Swiss Medical Board (SMB), a non-profit institution funded by e.g. the Swiss cantons and the Swiss Academy of Medical Sciences (SAMW). Projects with industrial partners continue to also play a relevant role, which gives us opportunities to work with raw data from large, multinational randomised clinical studies and to be involved in Health Technology Assessment activities abroad, e.g. in the UK. In cooperation with the Basel Pharmacoepidemiology Unit (BPU; Prof. Christoph Meier), and the Helsana Group, we publish reports on medication utilisation in Switzerland, based on health insurance claims data covering about 15% of the Swiss population (Helsana Arzneimittelreport).
European Union-funded Projects
Optimising PharmacothERApy in the Multimorbid elderly: OPERAM (ongoing). Many older adults have multiple chronic diseases (multi-morbidity) and multiple medications (polypharmacy). However, multi-morbid patients are often excluded from clinical trials and most guidelines address diseases in isolation. Inappropriate drug prescription and poor drug compliance are common and contribute to up to 30% of hospital admissions. OPERAM investigators developed STOPP/START criteria to detect inappropriate drug use, both over- and underuse. Applying these criteria limits unnecessary polypharmacy and reduces underuse of indicated medications, but it remains uncertain whether systematic pharmacotherapy optimisation can improve clinical outcomes and reduce costs. OPERAM performs a multicentre randomised controlled trial to assess the impact of a user-friendly software-assisted intervention to optimise pharmacotherapy and to enhance compliance in 1900 multi-morbid patients aged 75 years or older. Outcomes will include drug-related hospital admissions, health care utilisation, quality of life, patient preferences and cost-effectiveness. We will also perform several network meta-analyses (NMA) to provide new comparative evidence on the most effective and safest pharmacological and non-pharmacological interventions to reduce common causes of preventable hospital admissions (e.g. falls, fractures, bleeding). Therapy optimisation in the multi-morbid elderly, enhanced compliance and discontinuation of less effective interventions have the potential to improve clinical, quality of life and safety outcomes, while reducing costs. OPERAM ultimately aims at better healthcare delivery in primary and hospital care, based on effective, safe, personalised and cost-effective interventions that can be applied to the rapidly growing older population in Europe. Funding 2015-2020: EU (HORIZON 2020, Grant Agreement no. 634238) and Swiss State Secretariat for Education, Research and Innovation (contract number 15.0137)
Within OPERAM, ECPM is responsible for the work package devoted to health economics.
Genome-based biomarkers leading to validated molecular diagnostic tests for response prediction in breast cancer: RESPONSIFY (completed). RESPONSIFY has contributed to confirming the hypothesis that predictive biomarker approaches can distinguish responders from non-responders to breast cancer treatments, and will therefore spare patients from unnecessary treatment toxicities. This may help to significantly reduce costs in European healthcare systems and improve prognosis and quality of life for women diagnosed with breast cancer. Using new genome-wide based techniques, candidate biomarkers which have the potential to predict response to therapy and affect clinical outcome are selected and validated. From 2012-2015, it was funded by European Union's FP7 programme (Grant Agreement no. 278659).
ECPM has developed an existing decision-analytic framework further and applies it to biomarker-driven treatment decision making. On this basis, health economic characteristics are defined and an evidence base to sustain efficient decision making on novel test assays in breast cancer management is generated. Different treatment settings (adjuvant, neoadjuvant, metastatic) can be addressed as relevant.
Improvement in postoperative PAIN OUTcome: PAIN OUT (completed). PAIN OUT is a multi-national research project that provides a unique and user-friendly web-based information system to improve treatment of patients with post-operative pain. The project offers a system for measurement and feedback of outcome quality and supports the process of decision making in order to achieve an optimized treatment of patients. From 2009-2012, it was funded by European Union's FP7 programme (Grant Agreement no. 223590).
Since 2013, PAIN OUT is being continued in cooperation with professional societies, e.g. the International Association for the Study of Pain (IASP). Participating hospitals have to pay a moderate annual fee for the services provided by PAIN OUT.
ECPM has extensively contributed to the design and validation of a patient-reported outcome questionnaire (International Pain Outcome Questionnaire), which is completed by PAIN OUT patients on postoperative day 1. The second main contribution was an analysis of drivers of patient satisfaction with their operative pain Treatment, based on data from 17,000 PAIN OUT patients in three continents.