Member Article

The Danish Regions have proposed a new model for establishing a so-called Treatment Council which is to assess whether the price of treatments and health technology measure up to the effect for the patients. The model will now go out for consultation.

 

The purpose and scope 

In their proposal, the Danish Regions want to establish a Treatment Council which is to make recommendations regarding the use of medical devices and health technology. Health technology is understood as "(...) any use of procedures, treatments and systems - including any associated knowledge and competence - applied in order to solve a health problem or to improve the quality of life." This is very broadly worded and covers many various products and services, which means that it is rather unclear which products and services will be comprised by the authority of the new Treatment Council. The Treatment Council will not assess the use of medicinal products, though, which will be the responsibility of the Danish Medicines Council, among others, instead. The recommendations of the Treatment Council will be comprising new and upcoming items as well as existing items already in use in the Danish healthcare system. The new Treatment Council will be assessing between 15 and 25 cases a year according to the model.

The Danish Regions have drafted their proposal based on the Danish Parliament's seven general principles for prioritizing hospital medicines, which also apply to the already existing Danish Medicines Council also established by the Danish Regions. However, the Danish Regions propose that the Treatment Council will be operating within the scope of four established principles: 1) better health value for the money; 2) professionalism and keeping the political system at arm's length; 3) openness; and 4) equality. This means that the principles of putting something into use quickly and having access to treatment are not included in this connection. The Danish Regions do not explain the reason for this in the announcement. 

The set-up 

The Treatment Council will consist of a council, a secretariat and professional committees. 

The model proposes a council consisting of 14 members, including two patient representatives. The Danish Regions will appoint the council president. The council will be meeting with a reference group, including representatives from the Confederation of Danish Industry (Dansk Industri), the Danish Chamber of Commerce (Dansk Erhverv), Medicoindustrien, Danish Care and LIF, twice a year, in order to include the interested parties in the process wherever possible. This model seems to be inspired by the set-up in Norway

The professional committees are to be appointed temporarily in connection with the assessment of the individual items. Using temporary professional committees will be different from how the Danish Medicines Council works, as their professional committees are permanent within the individual disease areas. 

Further, the Danish Regions propose that patients having experienced the treatment in question are also to be included in the professional committees. The intention is to include the patients' experiences with the specific solution in the assessment of the Treatment Council. In this connection, it will be interesting to see how this patient involvement will take place in practice, including how the Treatment Council will ensure the participation of a representative segment of the relevant patient group.

The assessment process 

Hospital management, the regions as well as companies will be able to propose that devices and health technology be assessed by the Treatment Council. If a company wants an assessment, said company must be able to render probable that the product or the health technology will not entail additional costs for the healthcare system or would lead to inferior quality. It will also be possible once a year to implement more complex analyses of fundamental issues like, for instance, treatment regimens or how to organize treatments.

Once an item has been selected for assessment, the secretariat will have to establish a professional committee tasked with assessing the item and preparing the basis of the decision for the Council. According to the model, the professional committees will have about four to eight months to make this assessment. For the more complex analyses of treatment regimens or the like, it will take up to 12 months. Following the assessment of the professional committee, the Council will - similar to the practice of the Danish Medicines Council - make a recommendation in relation to the treatment in question to the regions. The Danish Regions state that the regions will have to comply with the recommendation of the Treatment Council. Presumably, this will lead to renewed discussions regarding the right to complaint. The industry has already asked for such a right in connection with the work of the Danish Medicines Council. 

Establishment of the Treatment Council

The consultation period regarding the Danish Regions' proposal for the new Treatment Council ends on 29 January 2020. Then in March 2020, the Supervisory Board of the Danish Regions will present the final model for the establishment of the Treatment Council. According to the plans, the Treatment Council will begin making recommendations in early 2021. 

Plesner will follow the future developments closely and we will provide updates regularly.