HIPER - Centre for Health Intervention and Policy Evaluation Research

📢 Course Registration: Simulation for Health Technology Assessment (HTA) Enhance your skills with our immersive 5-day course, designed to give you a deep understanding and hands-on experience in designing and building simulations for HTA. 📅 Event Details: 🗓 Date: 24–28 March 2025 🕒 Time: 9 am - 5:30 pm (SGT) 📍 Location: In-person at Saw Swee Hock School of Public Health (NUS MD1)   🌟 Course Highlights: Understand the purpose and limitations of simulations in healthcare Choose and apply probability distributions for patient trajectories Implement, validate, and analyze simulation results for insightful reporting Gain practical skills to enhance HTA decision-making 🔑 Prerequisites: Prior experience in economic evaluation A laptop with the latest version of Microsoft Excel and macro capabilities 📈 Don’t miss this chance to elevate your HTA expertise! 👉 More information and registration link are available on: https://lnkd.in/eBUM8VtU

📢 Dear MedTech Enthusiasts, are you ready to make an impact in 2025? Join us for the Market Access in MedTech Course from 5–9 May 2025, where you'll gain actionable insights to drive better patient access to medical devices, diagnostics, and digital health innovations! 🗓 Save the Dates and stay tuned for more details! For inquiries, reach out to us at hiper@nus.edu.sg #Medtech #MarketAccess Anh BOURCET Hwee-Lin Wee

🌟 HIPER Event Highlights: Course on the Methodology of Comprehensive Clinical Evaluation of Medicines in Beijing, China🌟 At the invitation from the Beijing Children’s Hospital, Capital Medical University, HIPER - Centre for Health Intervention and Policy Evaluation Research and HITAP_Thailand, Ministry of Public Health, Thailand recently conducted the Third Training Course on the Methodology of Comprehensive Clinical Evaluation of Medicines in Beijing, China. The hands-on training course was conducted over two days (20th – 21st September 2024) in Mandarin. Through the course, over 20 participants from various government, healthcare and private organizations were equipped with both theoretical knowledge and practical skills to perform Health Technology Assessments (HTA). The course covered techniques to construct deterministic Markov models as well as strategies to perform deterministic and probabilistic sensitivity analyses. In addition, participants were provided with an overview of the aspects of model validation, and key pointers on presenting economic evaluations in alignment with CHEERS and CNHDRC guidelines. The course lecturers included A/Prof Hwee-Lin Wee, Asst Prof YI WANG, Dr Jing Lou, and Dr Sharon Tan, and the other course instructors included Prof Yot Teerawattananon, Prof Alec Morton, Mr Manit Sittimart, Ms Waranya Rattanavipapong, and Ms Nitichen Kittiratchakool. On 22nd September 2024, the team from HIPER also participated in the Fourth Symposium on System Construction of National Medicine Evaluation in Belt and Road Countries. Prof Alec Morton shared on HTA of precision medicine, Prof Yot Teerawattananon presented on Developing HTA in Southeast Aisa: Lessons for China, while Asst Prof Wang Yi presented on early HTA. Through the workshop and symposium, close international collaborations and partnerships between NUS and HTA partners in China have been forged. 新加坡国立大学苏瑞福公共卫生学院卫生干预和政策评估研究中心（HIPER）与泰国卫生干预和技术评估项目中心 (HITAP) 在首都医科大学附属北京儿童医院主办单位的邀请下，在北京进行了第三届药品临床综合评价方法学培训班。这两天的课程以中文授课。超过20位来自各政府单位，医药部门以及企业的嘉宾参加了这次的培训班，并从中了解了卫生经济学的原理和卫生技术评估（HTA）的方法和实践技巧。课程包括了建设确定性和概率性的马尔可夫模型，敏感性分析，模型验证和依照CHEERS 和CNHDRC指南呈现经济评价研究结果的方式。除此之外，HIPER 也在9月22日参与了第四届“一带一路”国家药品临床综合评价体系建设交流会。通过这次的会议和培训班，HIPER 和中国北京儿童医院及其他HTA机构建立了友好关系，促进了更密切的交流，也进一步拓展了国际合作。

🌟 What's Brewing @ HIPER? 《Part 2》 🌟 We're excited to share our colleague's recent works on 🧬Beyond Lipid Profile: Enhancing Electronic Phenotyping with Unstructured Data🧬 The collaboration with National University Hospital, Tan Tock Seng Hospital, and Khoo Teck Puat Hospital, focuses on improving Familial Hypercholesterolemia (FH) identification using a mix of structured and unstructured electronic health record (EHR) data. 🔎 Objectives: Utilizing the ELPHA-FH framework to identify undiagnosed or probable FH cases and enhance the identification process for genetic testing. 🔎Study Design: Retrospective cohort study of 23,213 patients aged 21 to 100 with valid LDL-C tests conducted between 2015 to 2018, at NUH. Lab tests and diagnoses were analyzed to rule out secondary causes of elevated LDL-C levels, while dispensed drug data was used to account for prior statin treatment effects on LDL-C results. Clinical notes were also reviewed to identify any personal or family history of coronary artery disease or cardiovascular disease, along with relevant physical examination findings. 🔎 Results: 589 patients were identified with definite/probable FH, highlighting the value of integrating LDL-C levels with personal history for a more precise diagnosis. Cheers to another pivotal step toward automating FH identification and optimizing patient outcomes in cardiovascular disease management. Team: Meenakshi Dubey, Brandon Chong, Geok Teng Ng, Chester Drum M.D., Ph.D., Subramaniam Tavintharan, Sharon Pek, Fathima Ashna Nastar, E Shyong Tai and Hwee-Lin Wee. #FamilialHypercholesterolemia #EHR #HealthData #PrecisionHealth #CardiovascularDisease #FHPhenotyping #HealthcareInnovation

🌕 Happy Mid-Autumn Festival from HIPER! 🌕 Our team celebrated the occasion with a cozy pantry gathering last week, enjoying a potluck of mooncakes and festive treats. Traditionally a celebration of harvest and reunion, the Mid-Autumn Festival (中秋节) reminds us of the fruits of hard work, dedication, and teamwork. Wishing everyone health, happiness, and success this season! 🏮🥮🍊 #MidAutumnFestival #HIPER

🌟 What's Brewing @ HIPER? 🌟 We're excited to share our recent works on the cost-effectiveness of pre-emptive pharmacogenomic (PGx) panel testing! This study evaluates a multi-ethnic cohort and shows that a PGx panel test, focused on four selected drug-gene pairs, may potentially offer significant savings for health systems while improving patient outcomes. Key findings reveal: 💲 Potential cost-savings of SGD 37,600 and a gain of 9.32 QALYs 🧬 Potential for further improvement with higher variant allele prevalence 👍 Positive impact on reducing adverse drug reactions The results make a strong case for PGx panel testing in precision medicine, helping tailor treatments and optimize care. Project team: Jamaica B. , Jia Hui C., Yaroslava Zemlyanska, Elaine Lo, E Shyong Tai, Hwee-Lin Wee, Jaime Caro Stay tuned for exciting research updates on our publications and projects in our new "What's Brewing @ HIPER?" series! 💬 Let us know your thoughts on pre-emptive PGx panel testing in the comments ⬇ ⬇ #PrecisionMedicine #Pharmacogenomics #CostEffectiveness #HIPER #ValueBasedCare

🌟 Evaluating the Cost-Effectiveness of Dupilumab and Oral JAK Inhibitors for Atopic Dermatitis in Singapore 💊💉   Atopic dermatitis (AD) affects both adults and children, significantly impacting their quality of life and productivity. Traditional treatments like cyclosporine have limitations, but new systemic treatments such as monoclonal antibodies and Janus kinase (JAK) inhibitors are offering new hope.   🔍 Objective: This study assesses the cost-effectiveness of novel systemic treatments for moderate-to-severe AD in adults, comparing them with the best supportive care (BSC) in Singapore.   🧪 Methods: We applied a hybrid decision tree and Markov model. Outcomes from key trials of dupilumab, abrocitinib, baricitinib, and upadacitinib were used to inform the model over a 5-year time horizon.   📊Results: ◻     Cost-Effectiveness: Baricitinib 4 mg has the lowest incremental cost-effectiveness ratio of S$60,730 per quality-adjusted life-year (QALY). ◻     QALY Gains: Upadacitinib 30 mg offers the highest incremental QALY gain, whereas baricitinib 2 mg offers the least. ◻     Cost Proportion: Drug costs account for 68-93% of total expenses for patients in the maintenance state. ◻     Scenario Analysis: If drug costs were aligned with the lowest-priced option, the most cost-effective treatments would be dupilumab, upadacitinib 30 mg, and abrocitinib 200 mg.   📝 Conclusion: None of the treatments are currently deemed cost-effective compared to BSC at their existing prices. Future research should include treatment success and quality-of-life scores, as well as consider long-term outcomes and conditional discontinuation data.   🔗 Read the Full Study: https://lnkd.in/gQGWQRYB   Kudos to Clarence Ong, Amelia Lim Zhi Zhen, Dr Nisha Chandran, Dr Lee Haur Yueh, Benny Li, YIK WENG YEW, Jamaica B., Hwee-Lin Wee What are your thoughts on the cost-effectiveness of new AD treatments? How can we balance treatment costs with patient outcomes in AD management? Share your insights below! ⬇️   #AtopicDermatitis #CostEffectiveness #Pharmacoeconomics #JAKInhibitors #Dupilumab  

🔬 Advancing Colorectal cancer Detection with Blood-Based Tests: Qualitative Study and Discrete Choice Experiment to Elicit Population Preferences 🩸   ◾ Colorectal cancer (CRC) is the second most deadly cancer globally, with 1.9 million cases and 0.9 million deaths reported in 2020. Despite the availability of screening tests, uptake remains suboptimal. However, blood-based tests are emerging as a promising and less invasive alternative to traditional methods.   🔍 Study Objective: This research investigates public preferences for CRC screening tests, with a particular focus on blood-based tests, and explores factors influencing their uptake.   🧪 Methodology: We utilised semi-structured interviews and a discrete choice experiment (DCE) survey.   📊 Results: ◾ Preference: Participants showed a stronger preference for blood-based tests over a 2-day stool-based test. ◾ Segmentation: The DCE identified two groups: ◽ Strong Supporters for CRC screening: Generally preferred CRC screening regardless of the test type. ◽ Weak Supporters for CRC screening: Displayed a higher preference for blood-based tests. Women, ethnic Chinese, and individuals aged 40 to 60 years were more likely to be weak supporters. ◾ Influencing Factors: Cost and test sensitivity were major determinants of preferences. A transition to blood-based tests at SGD 5 (USD 3.75) could increase uptake by 5.9% (95% CI 3.6%-8.2%).   📝 Conclusions: The study highlights the advantages of blood-based tests and identifies areas of concern regarding their accuracy. These findings provide valuable insights for enhancing CRC screening programs and could lead to increased uptake if blood-based tests are more widely available.   🔗 Read the Full Study: https://lnkd.in/gd8Hd2dg   Congratulations to Clarence Ong, Alex Cook, Ker Kan Tan & YI WANG! What are your thoughts on integrating blood-based tests into our national screening programme? Share your insights below! ⬇️ #ColorectalCancer #CancerScreening #BloodTests #MedicalAdvancements #PublicHealth

🌟 Day 2 Afternoon Recap: Value-Based Care (VBC) Workshop 🌟 The afternoon sessions of Day 2 dived deep into practical strategies for implementation. Prof James Yip shared NUHS's journey with value-driven outcomes, emphasizing leadership's crucial role in change management and the use of peer comparisons on key indicators to drive improvement. Dr Chieh Suai Tan presented the CLEAR project, introducing a new community model for managing blocked catheters. He discussed the challenges faced, including medication costs, and how the team successfully overcame these hurdles. Mr Jordan Bai explored the role of theory of change mapping in program design and evaluation, highlighting strategies such as international benchmarking and performance-based payments to drive VBC. A/P Keith Lim provided insights from the private care perspective, discussing how VBC strategies can help maintain competitiveness amidst rising costs. He emphasized the use of data analysis, peer comparisons, and patient-reported outcome measures to track and improve patient outcomes. The afternoon sessions have been incredibly insightful, enhancing our understanding of practical applications in VBC. We’re looking forward to concluding the workshop with more key takeaways on Day 3!

🌟 Day 2 Morning Recap: Value-Based Care Workshop 🌟 Day 2 of our Value-Based Care (VBC) workshop provided an in-depth exploration of key topics in healthcare improvement. Prof Alec Morton kicked off the day by detailing the role of health technology assessment (HTA) in shaping reimbursement decisions. He broke down the components of economic evaluations and explained how HTA is operationalized in Singapore. Mr Sutowo Wong then addressed the critical need for accountability and effective resource allocation amidst slowing revenue and rising expenditures. He introduced the Programme Evaluation Framework, highlighting how it systematizes evaluation processes and enhances resource-performance feedback with practical case examples. Ms Farhana Nakhooda followed with a compelling discussion on data-driven outcome improvement. She emphasized reducing clinical variation using the 7-Step Health Catalyst Framework and the importance of activity-based costing for a clearer view of service delivery costs. Dr Chun Wei Yap introduced the National Healthcare Group’s "River of Life" framework, which segments care into five life stages. He discussed how data from this framework is used to monitor and prevent disease progression and highlighted the development of health indices using item response theory and computerized adaptive testing. Looking ahead, the afternoon sessions will build on these insights, diving into practical strategies for implementing VBC. Stay tuned for our recap of the afternoon’s key takeaways!