Technology Assessment for Health Systems Engineering

The TANGO project aims at expanding molecular profiling of tumours to improve immune- and targeted treatment selection in patients with advanced melanoma or non-small cell lung cancer (NSCLC). TANGO includes cost-effectiveness and budget impact analysis of whole genome sequencing (WGS) to facilitate responsible introduction. Our focus is on providing insight in the consequences of implementation of WGS in the Netherlands from a health systems perspective to support health services planning. Large scale facilities, which are required for WGS, can have a major impact on health outcomes and costs of clinical oncology services. Given the complexity of healthcare delivery systems, we use dynamic simulation models to analyse the various aspects (e.g. organizational, economic, and policy) that play a role in the nationwide implementation of WGS.

Although a large set of point-of-care tests is currently available, only few are used in current clinical practice. Therefore, we aim to get insight in factors that affect the implementation and use of these point-of-care tests, by means of interviews with stakeholders, multi-criteria decision analysis, and health economic modeling. In turn, this will likely contribute to efficient implementation of cost-effective point-of-care tests. Finally, we will assess the consequences of increased uptake of point-of-care tests, for example, by general practitioners from a health system level perspective.

The B3Care project aims to advance the technology readiness level of simultaneous, integrated assessment of early imaging biomarkers of lung cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) using low-dose computed tomography (CT). This so-called Big-3 (B3), combination screening is expected to have major advantages due to shared risk factors, B3 interdependence and health economic yield compared to single disease screening. Our focus is on evaluating the long-term health and economic potential of combined screening to support decision-making. A screening program aimed at high-risk individuals for three different diseases proves to be a complex system of multiple dependent factors. To capture this complexity, we use simulation models to estimate the long-term health and economic outcomes of society with different screening strategies versus no screening. More information about this project is available on b3care.nl

The UCAN CAN-DU project aims to provide the correct treatment to patients with childhood arthritis at the opportune time. While advanced biologic therapies are frequently used and can be highly effective, we are currently unable to accurately predict which children should start biologic therapies and which can discontinue treatment without having disease flares. The overarching goal of the UCAN CAN-DU project is to integrate such innovative precision medicine strategies into practice. All pediatric rheumatology care providers across Canada and the Netherlands participate in this project. We develop simulation models to evaluate the long-term health and economic impact of biologic treatment strategies. Integrating preferences of patients, parents and clinicians into decision-making further enhances the usability and impact of the results in clinical practice. More information about this project is available on www.ucancandu.com.