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Accelerating the uptake of proven innovations through the Innovation Technology Payment
Accelerating the uptake of proven
innovations through the Innovation
Technology Payment
Welcome
Dr Samantha Roberts
Director
Innovation and Life Sciences
Rob Chesters
Senior Innovation and Research Manager
Innovation, Research and Life Sciences Group
ITP was introduced to incentivise the adoption and spread of transformational innovation in the NHS. It builds on the Innovation and Technology Tariff (ITT) launched in 2017.
It aims to remove the need for multiple local price negotiations and guarantee automatic reimbursement when an approved innovation is used. At the same time the ITP allows NHS England to optimise its purchasing power and negotiate national “bulk buy” price discounts where applicable on behalf of the NHS.
For 2018-19 four innovations have been identified which could provide innovation benefits to the NHS at scale:
• HeartFlow
• SecurAcath
• Endocuff
• Plus Sutures
The ITP is available until the 31st March 2019
Product Description
Plus Sutures Triclosan-coated absorbable sutures that inhibit colonisation of the suture by bacteria commonly
associated with surgical site infection (SSI). The technology had been shown to reduce the
prevalence of SSI by 30% across all surgical areas.
SecurAcath SecurAcath provides subcutaneous attachment of PICC lines without the need for sutures or
adhesives. SecurAcath provides continuous securement from catheter placement through to line
removal, allowing improved site cleaning with less catheter manipulation.
Endocuff Vision Endocuff Vision is a distal device which attaches to the end of the colonoscope . It provides an
optimal view by smoothing out the folds in the colon and increasing visibility. This technology has
demonstrated a statistically significant increase in detection of adenomas (relative increase 21%)
and cancer (relative increase 78%) when compared to standard colonoscopy.
Heartflow Rapid diagnosis of patients with suspected Coronary Heart Disease (CAD) using advance image
analysis, reducing overutilization of invasive diagnostic procedures, their associated risks and
increased costs
See:- https://www.england.nhs.uk/ourwork/innovation/innovation-and-technology-payment-201819
ITT and ITP current status
• In use in 170 NHS organisations• Reaching over 107,000 patients• Starting to gather valuable data on
outcomes
Introducing ITP’s 2018/19 Innovations
Dr Keri Torney
Deputy Director
Innovation, Research and Life Sciences Group
HeartFlow
Gina McDonald Main
Vice President and General Manager UK & Ireland
HeartFlow FFRCT
September 2018
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15597589 v.2
HeartFlow: Advancing Cardiovascular Disease Diagnosis and Treatment
ITP – Innovation and Technology
Payment
200+ peer-reviewed publications
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CE Mark: 2011
FDA Clearance: 2014
Commercially available in the
United States, Canada, Europe
and Japan
4 multi-center studies completed
CG95: Nov 2016
MTG32: Feb 2017
15597589 v.2
HeartFlow FFRCT Process
Proprietary software and certified analysts create a
personalised, digital 3D model of the coronary arteries.
Powerful computer algorithms solve millions of complex
equations to assess the impact that blockages have on blood
flow.
Physicians interrogate the model and interpret the FFRCT
values to assess, vessel-by-vessel, if sufficient blood is
reaching the heart.
A standard cardiac CT scan is performed and the data is
uploaded to HeartFlow.
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15597589 v.2
HeartFlow Analysis Interactive Viewer
Refer to product Instructions For Use for patient populations in which FFRCT has been clinically evaluated, relevant clinical data, and product warnings.
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Gina McDonald Main
Vice President & General Manager, UK & Ireland
15597589 v.2
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HeartFlow ITP Experience to Date
Referral Decision by Month
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31
59
126
160*
0
20
40
60
80
100
120
140
160
180
May June July August
*Forecast August volume
ICA26%
Medical Therapy
74%
Overall Referral Decision
15597589 v.2
Growing Support for HeartFlow
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Papworth
Liverpool Heart & Chest
Blackpool Victoria
Countess of Chester
Russells Hall
Sandwell
QE Birmingham
New Cross
Wythenshawe
MRI
Warrington
Royal Devon & Exeter
Musgrove Park
Glenfield
Royal Stoke
Lincoln
Leighton
Crewe
Northern General
Leeds General Infirmary
Castle Hill
Bristol Royal Infirmary
Royal Bath
Great Western
North Tees
Newcastle Upon Tyne NHS Trust
North Tyneside
St. Barts
Watford
St Thomas
Croydon
KingstonRoyal Bournemouth
Southampton
QA Portsmouth
Hammersmith
Harefield
Frimley
Wexham
Heatherwood
Royal Surrey
Royal Sussex
Western Sussex
J R Oxford
Gina McDonald Main
Vice President & General Manager, UK & Ireland [email protected]
SecurAcath
Scott Baker
Director, Market & Clinical Development - EMEA
Interrad Medical, Inc
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• Medical device manufacturer based in
Plymouth, MN USA
• Founded by an Interventional Radiologist
• Frustrated by complications caused by
sutures and adhesives
• Sought to improve catheter securement
• SecurAcath device was developed
Interrad Medical, Inc.
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Subcutaneous Engineered Catheter
Stabilization Device
• Can be added onto any catheter
• Securement feet placed just beneath skin at
insertion site
• No sutures or adhesives needed
• Allows 360 degree site cleaning while secured
• Secures catheter right where it enters the skin
• Minimizes or eliminates catheter movement,
migration and dislodgement
• Remains in place for life of catheter
• NICE Guidance received June 2017
• Backed by clinical evidence
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Changing the Standards of Practice
Issues with Adhesive Securement
• Must be replaced with each dressing change
• Does not secure right at insertion site
• During dressing changes - securement device is removed, leading to catheter
migration and dislodgements
• During dwell time - movement, including dislodgements, migration and pistoning
is common
• Can cause skin injury (MARSI)
Benefits of SecurAcath
• Dramatically reduces catheter dislodgements
• Decreased catheter replacement costs
• Decreased catheter movement or migration
• Increased stability and efficiency
• 360 degree site cleaning while secured
• Decreased skin irritation
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• Reducing the barriers
• Working with AHSN’s
• Positivity around the project
Innovation Technology Program Progression
Trusts Ordering
131%
Units Increase
100%
120k PICCs
55%-70%
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SecurAcath - Contact details
Scott BakerDirectorMarket & Clinical Development - EMEAInterrad Medical, Inc.181 Cheshire Lane, Suite 100, Plymouth, MN55441mobile +44 (0) 7468 493406 | main +1 763-225-6699 | fax +1 [email protected] | www.securAcath.com
Endocuff Vision
Sandra Smith
Commercial Manager
Norgine
Norgine: The ‘go to’ European specialist pharma company
• Norgine is a leading European specialist pharmaceutical company with over 110 years of expertise and apresence in all major European markets.
• Our vision is to be the ‘go to’ European specialist pharma company, which means that we want to be theorganisation that other companies come to in order to develop and commercialise their products in Europe.
• Our vision is intended to ensure that we bring specialist and transformative products to Europe that addvalue and benefits to healthcare systems and patients.
• In the UK & Ireland Norgine has 26 office staff.
• 45 field staff including 2 x Medical Scientific Liaison (MSLs), 5 x Healthcare Partnership Manager (HPMs).
• 25 Hospital Specialists covering NHS E.
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• Bowel cancer remains the second largest cause of cancer related mortality in the UK.
• Improving Adenoma Detection Rate (ADR) and cancer detection through increased colonoscopy performance has the potential to deliver improved outcomes for patients and the NHS.
• Analyses have demonstrated that a 1% improvement in ADR is associated with a 3% reduction in Colorectal Cancer (CRC) and a higher ADR is linked with lower CRC mortality1 .
• In addition to the patient benefits of improved detection, earlier diagnosis of cancer is associated with reduced costs to health care payers2.
• There is a need for innovations that can improve colonoscopy performance in order to improve outcomes for patients across theUK. Increasing cancer detection and reducing costs addresses both the cancer and efficiency priorities of the NHS Five Year Forward View.
• ENDOCUFF VISION® has been developed to address this unmet need.
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References:1. Corley DA et al. Adenoma detection rate and risk of colorectal cancer and death. New Engl J Med. 20142. https://www.incisivehealth.com/uploads/Saving%20lives%20averting%20costs.pdf
Background
ENDOCUFF VISION® is a Class 1, sterile, single-use medical device
• During insertion of the
colonoscope, the arms of
the device lie flat against
the colonoscope to
enable easy passage of
the instrument through
the colon.
• During withdrawal, the
arms fan out
straightening and
flattening the colon.
Qualitative Feedback from Norgine Hospital Specialists
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Key Account South East
• 7 District General Hospitals, 2 of whichoperate over multiple sites.
• Despite being interested in orderingENDOCUFF VISION® in the past, they couldnot progress as no budget available.
• As a result of ITP, 5 out of 7 Hospitals arenow ordering with the last 2 receivingtraining before placing an order.
Key Account North West
• 4 Hospitals within this trust.
• Order for ENDOCUFF VISION® was placed 2 yearsago and rejected by Procurement due to cost.
• With ITP, the Endoscopy lead has e-mailedEndoscopy sister, who e-mailed Procurement.
• Procurement manager has requested moreinformation.
• Order is now imminent .
Summary• Bowel cancer remains the second largest cause of cancer related mortality in the UK.
• Improving Adenoma Detection Rate (ADR) and cancer detection through increased colonoscopy performance has the potential todeliver improved outcomes for patients and the NHS.
• There is a need for innovations that can improve colonoscopy performance in order to improve outcomes for patients across the UK.
• ENDOCUFF VISION® has been developed to address this unmet need.
• Norgine is happy to be present where deemed appropriate to ensure proficiency in using the device and will provide suitable andappropriate samples to ensure proficiency and safety of operators.
• Norgine will provide appropriate training to all units and there are two training videos are available.
• More information can be found on the ENDOCUFF VISION® website: http://endocuff.com/products/endocuff-vision/
For further information please visit the Norgine stand No.89 or contact:
– Sandra Smith, Commercial Manager at Norgine
– Email: [email protected]
– Tel: 07771931619
References:1. Ngu WS, Bevan R, Tsiamoulos ZP, et al. Improved adenoma detection with Endocuff Vision: the ADENOMA randomised controlled trial. Gut Published Online First: 23 January 2018. doi: 10.1136/gutjnl-2017-314889
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Plus Sutures
Chloe Symes
UK & IRE Platform Manager – Wound Closure
Ethicon
The Status Quo of Surgical Site lnfections
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Patients are 2X as likely to spend time in an intensive
care unit II32% of hospital acquired infections are
surgical site infections I
Patients with an SSI are 5X more likely to be readmitted
after discharge II2X as likely to die II
40-60% of surgical site infections may be preventable III
The Concept of Antibacterial Sutures
29Legal Entity / Enter date in Footer dialogue box /
Coating suture material with antiseptic
IRGACARE®* MP (triclosan) approach to
SSI prevention is by:
• Reducing the suture being a risk factor
for infection, by significantly decreasing
the adherence of bacteria to the suture I
Contact:
Chloe Symes, UK&IRE Platform Manager, Wound Closure
07768852382
I: Justinger C et a l. Antibiotic coating of abdominal closure sutures and wound infection. Surgery. 2009; 145: 330–334
"8 out of 8 meta-analyses support Plus usage for prevention of SSls"
The WHO Global Guidelines for the Prevention of SSIs now include a
recommendation for the use of triclosan coated sutures (2016).
Trusts to adopt Plus sutures ITP so far in 2018
What has worked well for Plus sutures with the ITP?
• Intense focus on targeted hospitals – fund is timed and limited.
• Make sure to include key surgeons and procurement in all discussions.
• Get trusts to talk to NHSE if they are unsure/worried about re-imbursement.
• Positive PR from Heartlands – featuring in the UHB Patient and Staff Newsletter.
• Worked with GIRFT General Surgery report messaging relating to reducing SSI as well.
Questions
Closing Remarks
Dr Keri Torney
@NHS_Innovation
https://www.england.nhs.uk/ourwork/innovation
