why is medical device technology moving abroad and how can we stop it?
TRANSCRIPT
Pharmaceutical/biotechnology industry perspective• why pharmaceutical/biotechnology companies
should collaborate• what the pharmaceutical/biotechnology company
can provideExamples of collaboration
• safety and efficacy studies• cost effectiveness studies• treatment and functional status studies• clinical outcome measurement studies• quality-of-life studies• development of registries• guideline implementation and evaluation studies
Collaboration with risk sharing
Barriers to PartnershipPharmaceuticallbiotechnology companyManaged care organization
Case StudyThe Kaiser approachKaiser Permanente Northern California Region
• size of membership• number of facilities• number of physicians/staff
Creation of the Permanente Medical Group Research Institute
• mission
• goals
Long Range Strategic Research Planning Process27 Research areas identifiedFour categories
• evaluate and contribute to community health• attract and retain customers• provide care/care delivery• evaluate care
Gap analysis
• importance• adequacy
Top six research areasExamples: models of care; cost models
2:05 pm
The Role of the Health Care FinancingAdministration in Funding Clinical StudiesSteven Sheingold
2:25 pm
Why is Medical Device Technology MovingAbroad and How Can We Stop It?
James s. Benson
Learning objectives: It is the speaker's intent to:proVide at least five primary reasons for the increasing movement of the u.s. medical device industry tooffshore locations; discuss at least four deleteriOUs effects caused by this escalating trend; and discuss waysin which the medical device industry is attemptinghalt this movement, which include: (1) legislative attempts to reform the Food and Drug Administration;
(2) legislative attempts to reform u.s. product liabilitylaws; and (3) attempts to effect FDA reform at the agencylevel.
THE medical device industry in the United States isundergoing radical changes. Numerous forces of boththe public and private sectors are dramatically increasingthe cost of product development and commercialization.Forces affecting the industry include a burdensomeregulatory process, increased pressure to contain healthcare costs, an increasingly litigious environment, morerestrictive reimbursement policies, and diminishing venture capital funds. These forces alter access to marketsand financing, and forces the industry to adapt, refocus,and reallocate its resources.
In the attempts to remain competitive, U.S. medicaldevice manufactures have made some significantchanges. Increasing numbers of companies are movingclinical trials and manufacturing facilities offshore. Research and development dollars, and new product introductions, are following in the wake.
Together, these public and private forces are threatening the high quality of health care long enjoyed bypatients in America. Patients in the U.S. often receive thelatest advances in medical technology months or evenyears after than patients in other countries. This reflectslost opportunities to save lives, reduce hospitalizationcosts, and improve patient quality of life.
2:45 pm
Clinical Trials for Medical Devices: Focus onCarotid StentsSusan Alpert, PhD, MD
Learning objectives: It is the speaker's intent to discussthe FDA's role in clnical investigation ofmedical deVicesseeking marketing approval in hte U.S.; to provide wxamples of significant risk and non-significant risk devices and the processes by which approval for studies ofthese devices are obtained; and to describe the role oftheFDA in the regulatino of medical device manufacturersas distinguished from physiians' fleXibility in the practice of medicine.
THE FDA's role in the conducting of trials is first oneof patient protection. The law provides a role both forthe FDA and for institutional review boards (IRB) in assessing protocols and consent forms for any investigation of medical devices that involves human subjects, asregulated in the Investigational Device Exemption (IDE).In this regulation, trials of medical devices are categorized as significant risk or non-Significant risk. Significantrisk studies require a full IDE with approval by both IREand FDA, whereas non-significant risk studies require anabbreviated IDE, which includes IRE approval but doesnot require review or approval at the FDA level.
Questions are often raised as to the need for an IDEfor a study of a device that is already in the marketplace.Although marketed devices may be used by a practitioner as appropriate for a patient according to the product's labeling or in ways that are considered off label, the
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