Horizon Scanning in Denmark: Amgros. Providing the Health Care System with an Overview and Impact Estimation of New Medicines

Key Contextual Factors

• Amgros is a part of the Danish health care system and secures the supply of medicines and hearing aids to all public hospitals and hearing clinics across Denmark. This is done through efficient procurement and tendering procedures. This creates economies of scale and savings, and the five health care regions in Denmark can deploy resources differently in the health care system. Estimates and forecasts from Horizon Scanning in Amgros provide a qualified foundation for assessing how much the health care regions should allocate for budget for medicines in the future. Danish Regions, the interest organization for the health care regions, use the estimates in their annual negotiations with the Government on finances and the individual five regions use them in their own budgets. Sources for verifying and validating the data inputs are primarily European Medical Agency (EMA), complemented with commercial databases and a niche group of other sources, e.g. global newsletters selected for the purpose. Horizon Scanning assigns all medicines applied to EMA an impact score using a scoring system and a number of criteria, in order to create an easy accessible overview on which medicines can affect the health care system the most. Other important sources of information are the meetings with the pharmaceutical industry. These meetings provide in-depth knowledge on pipelines and bring insights to access plans for both parties in the coming years.

Key Components/Steps

• Decision to establish an early awareness system in 2016.
• Input from internal and external Danish stakeholders regarding their needs and expectations.
• Decision on first outputs was established in December 2016.
• Horizon Scanning in Amgros was established in January 2017.
• First deliveries of overviews in February 2017.
• First version of the Danish Horizon Scanning database February 2018.
• First High Impact report April 2017.
• Horizon Scanning launch website and Newsletter June 2017.
• Continuous development of the database ongoing.
• Staff resources: 3 FTE for the provider and support from the IT team and the International advisor.

Main Impacts / Added Value

• The outputs consist of estimates of increased costs for new expensive medicines as well as possible savings, for example if there are cheaper biosimilar drugs on the market and an overview of medicines that are about to enter the market.  We also assess potential patient population and clinical settings. This is done in close cooperation with a number of Danish clinicians.
• These outputs from Horizon Scanning, Amgros, enables our stakeholders to better plan the introduction of new medicines and this helps to secure more cost-effective health solutions for everyone.
• So far, we have published:

• 14 overviews, lists and summaries showing status for medicines on their way through EMA.
• 275 orientations with extended information on a specific medicine or extension of indication.
• 4 annual high impact reports.
• Ongoing identification of high impact medicines.
• 269 ad hoc questions from stakeholders.
• 11 surveillance for stakeholders, i.e. notifications on specific subjects.

Lessons Learned

• One of the key success factors in implementing the Horizon scanning-unit, has been the open dialog with all our stakeholders within the health care system. We want to enable their work in providing health care to the Danish citizens, so we are continuously adjusting our outputs to meet their needs. We are also geographically located close to one another, which facilitates a close dialog.

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