The Value Of In-vitro Diagnostics

Healthcare challenges in the 21st century for governments& hospitals & how in-vitro diagnostics can contributeto overcoming these

Regina Kloss-WolfDirector Global Strategic Health Initiatives, Abbott Laboratories

Forum “For Healthy Life”December 9-10, 2013, Moscow

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The Healthcare World In The 21st Century:Having To Do More With Less

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EconomicReality:

Decreased healthcare

budget

HealthcareReality:

Increasedhealthcare demand

Challenge #1

Ageingpopulation

Challenge #2

Riseof NCDs

Demographic change reinforces rise of NCDs

Healthcare reality: increased demand for

healthcare

Healthcare Reality - Challenge 1:Population Ageing

3Sources: United Nations, Population Facts, Population Ageing and the non-communicable diseases, April 2012, accessed 25 November 2013.United Nations, World Population Ageing 1950-2050, accessed 25 November 2013.

http://www.un.org/esa/population/publications/worldageing19502050/pdf/173russi.pdf

60+yrs

2000: 18%

2050: 37%

2025: 26%

Russia

Healthcare Reality - Challenge 2:Non Communicable Diseases - Key Facts

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“Non Communicable diseases(chronic diseases) are not

passed from person to person.They are of long duration &generally slow progression”

NCDs cause more than36 million deaths worldwide

– 63% of all mortality

Between 70% & 80% ofEurope’s healthcare costsare spent on chronic care,

amounting to €700bn

Early intervention mayenable early detection &

hence contribute to cost-reduction

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Sources: WHO, factsheet on Chronic Diseases, accessed 25 November 2013. WHO, factsheet on Noncommunicable diseases, accessed 25 November 2013.EPHA, Extend healthy years by tackling chronic diseases in a life-course approach, accessed 25 November 2013.

Healthcare Reality - Challenge 2Rise Of Cardio Vascular Diseases & Associated Costs

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2008 2010 2030

Sources; AIHW, Why are mortality data important?, accessed 25 November 2013. World Economic Forum, Non-communicable Diseases to cost $47 trillion by 2030, New Study Released Today, accessed 25 November 2013. World Heart Federation, The cost of CVD, accessed 25 November 2013. WHO, factsheet on Cardiovascular Diseases,, accessed 25 November 2013.

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2008 2010 2030

CVDS

17.3 million people dying of CVDs

Cost of CVDs: $863bn

CVDs 23.3 million of people dying of CVDs

Cost of CVDs:$1,044bn

Healthcare Reality - Challenge 2Rise Of Cardio Vascular Diseases & Associated Costs

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20122012

NCDs account for 90% of all deaths

CVDs account for 57% of all deaths

Russia

2006-2009

NCDs

Cost of CVDs: 3% of GDP

RUR

CVDs

Source: Petrukhin IS, Lunina EY. Cardiovascular disease risk factors and mortality in Russia: challenges and barriers. Public Health Reviews. 2012;33:436-49

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So What Does The Rise Of NCDs Mean?

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The worldwide rise of chronicNon Communicable Diseases:

a slow-motion catastrophe

Margaret ChanWHO Director General

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Increasing use of Clinical Guidelines and Quality Measurements Globally

Clinical outcomes

Cost-effectiveness

Mortalityrates

Hospital bed occupancy

rate

Cost per discharge

Length of stay

Unplanned readmission

Average waiting time for patient

How Do IVDs Fit Into This ?

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IVDCase

Studies

How can IVDs contribute to overcoming this

challenge?

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The Diagnostics Paradox:Recognised Important Role, but Low Investment

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Early diagnosis & treatment stops NCDs progressing into costly, crippling

complications & premature death

NCD Alliance

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Medical decisions are based on IVDs

70%

Healthcare budget spent on IVD’s

2%

Sources: NCD Alliance, Discussion Paper No. 3 Geneva 2011, accessed 25 November 2013.EDMA answer to the European Commission consultation on Community Action on Health Services, 31 January 2007, p.2

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IVDs: One Of The Key Tools In Diagnostics

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Monitoring of prescribed treatments

Disease prevention& Population screening

Assessmentof medical

interventions

Diagnosis, treatment selection

& Prognosis

In Vitro Diagnostics are usedalongside the healthcare pathway

Case1: Early diagnosis of heart failure and differentiation from other diseases causing dyspnoea

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The challengeManagement of patients

with acute Dyspnoea

The impact

on quality measurements

Biomarker helpsto diagnose

congestive heart failure

BNP(B-type Natriuretic

Peptide)

Cost per discharge

HF is the most frequent diagnosis associated with

30 day readmission30

Treatmentcost

Mortality

Cost per patient$-1.854

Admission rate-10%

Length of stay-2.2

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Case 2: Taking The Right Decision In Case Of Heart Attack In Patients With Acute Chest Pain

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The challengeCorrect triaging

The impact

on quality measurements

Earlier triage of patients, already

after 2-4 hrs.with hs Troponin

vs. 6-12 hrs.

hs Troponin

Cost per discharge

Only 7-20% of patients who present with chest pain in the

ED are confirmed for diagnosis of myocardial

infarct

7-20% More confident rule out

for up to 40 % with suspected acute coronary

syndrome

40%

Waiting times

Waiting times

Cost per discharge

Better allocation

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Conclusion

• The burden of the ageing world population and NCDs will continue to rise.

• IVDs play an important role in optimizing care and minimizing cost

• IVDs are critical to the successful implementation of clinical guidelines and quality measures.

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