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Health Economics for Dermatologists Prof Olle Larkö

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Health Economics for Dermatologists Prof Olle Larkö NewsWINTER 2014-2015 – N°53 Health economics for dermatologists Prof Olle Larkö or many years, dermatology has these diseases are best taken care of Fbeen at the forefront of efficient by dermatologists. It is both better and management of resources for healthcare. cheaper for society to have direct access to We have managed to reduce the number dermatologists for skin cancer compared of beds in clinics due to scientific progress to visiting a general practitioner first. with new medicines. One such example In Germany, for example, a big proportion is the way we treat psoriasis on an of the population was screened for skin outpatient basis, already for decades now. cancer. Several years later, the mortality of malignant melanoma has decreased Recently, the introduction of biologicals for significantly. The health economic effect psoriasis has revolutionised treatment of of such an intervention is immense. this chronic disease. Although expensive, In this issue the total cost to society is probably lower Better use of resources than before. Furthermore, clinical efficacy is In the near future, we can expect the better. In the coming years, the introduction Editorial ......................................................................... 3 introduction of several new drugs of biosimilars may reduce costs even more. for treating metastasising malignant President's Perspective ............................................. 4 However, clinical studies are needed. The melanoma. Keeping such treatments in Melanoma Screening in Estonia ............................ 5 spectrum of dermatologic diseases is the hands of dermatologists will ensure changing rapidly. The incidence of atopic Swim for Psoriasis Campaign ................................. 6 efficient use of resources. However, it dermatitis has increased substantially in Feedback from the 23rd EADV Congress .............. 8 is very important to carry out clinical recent years. Prophylactic measures to research and follow the outcome of Celebrating EADV Scholarship Winners ............ 11 minimise symptoms are important for the patients by quality registries. In Europe, 12th EADV Spring Symposium - Valencia ......... 12 patient but also to reduce costs. we have unique possibilities to conduct Statistics from the Belgrade Symposium ........ 14 such studies. Delivering better outcomes Fostering Course Report: Also, the incidence of skin cancer is New, interesting devices are introduced Dermatopathology .................................................. 15 increasing rapidly. In many countries on the market to help us in the diagnosis Update from the Membership Committee ...... 16 of melanoma. As some of them have a we see no levelling-off of this disease. Call for Nominations – Recent studies have demonstrated that EADV Committee Chairs and Members ............ 17 continued on page 3 ss Update from the CME-CPD Committee ........... 19 Board Member Profiles .......................................... 20 Swim for Psoriasis 12th EADV Spring EADV Committees EADV Committee Member Updates .................... 21 Campaign Symposium Call for nomimations Upcoming Fostering Courses ............................... 22 Report from the Media 5-8 March 2015 Calendar of Events.................................................. 23 & PR Committee Valencia, Spain See pages 6-7 ss See pages 12-13 ss See pages 17-18 ss EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY ACADEMIE EUROPÉENNE DE DERMATOLOGIE ET VÉNÉRÉOLOGIE EADV NEWS N°53 • WiNtEr 2014-2015 Editorial ww continued from page 1 high sensitivity but moderate specificity it is important that Prof Gregor Jemec these devices are kept in the hands of dermatologists to minimise the risk of unnecessary removal of pigmented skin Personalised medicine – lesions, which would do harm not only to the patients but getting the balance would also be expensive. right Individualised medicine has always been the goal of patients. Which unique individual would want to be treated in a standardised regimen? In our rational age, the therapeutic choices that physicians make should, however, also be evidence-based, and evidence ideally indicates that there is one solution that is better than another. Usually there are, however, many approaches to solving a patient’s problems and this combination of individualised medicine and evidence-based medicine can therefore pose a significant challenge. The combination carries the inherent choice between being either too attentive to detail or too normative and, therefore, physicians have to balance their view of reality Calculating value every day. The argument that good evidence can allow Value-based healthcare has been introduced in some freedom of clinical choice because specific choices have hospitals in the US and Europe. It estimates value for money been compared and found equivalent is theoretically true, by the quotient value for patients/cost for treatment. By but generally not available. The combination of a fertile doing this you get an approximation of clinical efficacy therapeutic fantasy and the real burden of providing versus cost. The theory was developed by Michael Porter evidence for any given choice effectively prevents a at Harvard Business School. In short, it not only appreciates completely rational approach to the problem. the cost but also the value of the treatment. Several other Practising clinical medicine well is probably the best way specialties, including psychiatry, have been enthusiastic of meeting this challenge. It is not easy. We classically concerning this new development. It has been developed describe diseases in standardised terms such as papules or in cooperation with private enterprises in the healthcare plaques, which get eroded over time until they lose their sector, such as the Boston Consulting Group (BCG). value and have to be defined again. To some extent the nomenclature of clinically descriptive terms is replaced Involving dermatologists by imaging techniques, biochemical and genetic testing, It is important that dermatologists engage in hospital but here again the magnitude of the problem is such that administration and university posts, such as prefects, deans these techniques are in reality usually only adjuncts to the or vice-chancellors. Laymen are usually interested in our clinical assessment. specialty and we certainly can get some help from the In the end, we have to learn the basics all over again and press. Such an example is springtime when newspapers are again. It is a regular and recurrent task for all of us. It is very keen to talk with us about the dangers of the summer perhaps also the real human condition that development sun. I think we also can work together with the press to happens incrementally through many reiterations. And encourage reasonable sun-awareness habits and hence deal every time we look at a patient closely, we see a unique with the skin cancer issue. Prophylactic measures may also individual. work out well in combating skin cancer. • Gregor Jemec Olle Larkö Editor Professor of Dermatology and Venereology Sahlgrenska Academy University of Gothenburg 3 President’s Perspective EADV is on the move Prof Erwin Tschachler Dr Pille Konno am honoured to write my first EADV Challenges for the future diseases with systemic involvement. News report as President. Dermatological oncology, infectious skin I However, major changes are taking place diseases, phlebology and allergology are in the status of medical congresses and While each EADV President makes his no longer integral parts of the dermato- serious questions concerning the future or her contribution to the growth of our venereological curriculum in several strategy of the Academy await answer: Academy I would like to register a special European countries. • How do we ensure that EADV has the thanks to the outgoing Past-President To stem this reductionist approach we capacity for continuing growth? Frank Powell for what he has done for need to convince political decision-makers EADV. Throughout his tenure he was a • Does our current status as a charitable that the broad diagnostic and therapeutic guarantor of transparency, democratic organisation allow us to develop in an skills of dermato-venereologists are of progress and collegiality, and, in difficult uncertain future with financial stability? great value for patients and of economic times, he was the rock in a stormy advantage for the healthcare system. sea. I feel privileged to have had the • Will the implementation of new During my presidency our Academy will opportunity to work with him, first as European legislation (that regulates spearhead “lobbying for dermatology”. Secretary General and for the past two the interaction of the pharmaceutical industry with medical doctors) affect In this endeavour we will strengthen our years as President-Elect. I am determined the viability of our future congresses? co-operation with our sister European to keep up his legacy. For example in Amsterdam there were societies, the European Dermatology Landmark congress already major restrictions on non- Forum (EDF), the European Society of Dermatological Research (ESDR) and rd prescriber access to industrial exhibits. The 23 EADV Congress in Amsterdam the dermatology section of the Union was a landmark in our history. It was the To address these important issues we Européenne des Médecins Spécialistes first congress that was organised entirely need to analyse our options and review (UEMS). by EADV. The lecture halls were packed in depth the strengths and
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