Diabetes Care in The Netherlands: - Novo Nordisk

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But new medication could add a lot of value in boostingcomplianceMotivationBehaviouralchangeReasons of non -compliance• Motivation to change is typically limited: no sense of urgency– No feeling of illness (especially in early stages)– Acceptance of illness– Benefits of compliance are distant• Compliance creates a short–term risk of side effects– e.g. especially hypos• Far reaching change in daily routines– Sleep times,– Diet– Exercising• Requires an adjustment in social life– Social pressure to engage in social activities not congruent withtreatment– Environment may perceive the distance as an ‘excuse’ to avoidparticipation• Requires an advanced understanding of the disease– Complex intake schemes that are dependent on the context ofdaily activities– Need to develop a optimized personal routinePotential impact of easier-touse-medication• Inherent property of thedisease• Potentially less invasivetreatment schemes• Potentially less invasivetreatments schemes• Therapy may be easier andless time consuming-Source: Apotheke und krankenhaus Ursachen der Non-Compiance, Booz & Company AnalysisBooz & Company 14 November 2011Prepared for Novo Nordisk5360
CFH access criteria evaluate impact on compliance, howeverevidence is usually not generated by trialsCategory Argument MetricsCFHcriteriaCFH DocumentType of evidencefrom trialWould extracompliance lead tohigher score?CharacteristicsComposition, type ofadministration, dosage,Operational areaFarmacotherapeutischdossierNoMedicalImprovement vs currentmedicationSide effects vs currentmedicationRelevant end points interm of morbidity andmortality. Report utilitiesand survivalFarmacotherapeutischdossierFarmacotherapeutischdossierNoYesEase of use / ease ofadministrationQALY’sFarmacotherapeutischdossier?YesPatientQuality of lifeQALY’sFarmaco -economischdossier?YesLife expectancyIncrease in yearsFarmacotherapeutischdossierYesDirect treatment costper yearEURFarmacotherapeutischdossierNoEconomicsIndirect cost per yearLong term cost effect(medical)EUR?Farmacotherapeutischdossier?NoNoLoss of productivity??NoBooz & Company 14 November 2011Prepared for Novo Nordisk5461
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SummaryDiabetes is a serious and de
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diabetes care. Extra compensation w
Page 11 and 12: ContentsSummarized findings and rec
Page 13 and 14: 11Diabetes is a major and underesti
Page 15 and 16: 33Further improving health of of di
Page 17 and 18: 22Recommendation 2: Engage employer
Page 19 and 20: 44Recommendation 4: Introduce condi
Page 21 and 22: Already more than 1M diabetes patie
Page 23 and 24: Costs of of complications and treat
Page 25 and 26: Number of patients reaches ~1.4M in
Page 27 and 28: Increase in lost productivity is dr
Page 29 and 30: Diabetes care clearly improved in t
Page 31 and 32: Better compliance can be stimulated
Page 37 and 38: Delaying complications saves medica
Page 39 and 40: LimitedLimitedcollaborationcollabor
Page 41 and 42: Individual quality incentives are l
Page 43 and 44: Recommendation 1: Insurer should in
Page 47 and 48: Labour shortage from late nineties
Page 49 and 50: However, curative and participative
Page 53 and 54: Non-compliance leads to severe comp
Page 55: Facilitated patient networks are su
Page 58 and 59: Recommendation 3:Facilitate network
Page 66: Booz & Company is a global manageme
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Diabetes Care in The Netherlands: - Novo Nordisk

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