Across a broad range of diseases

In The Netherlands, about 10 percent of the adult population has asthma symptoms, while prevalence among children is almost twice as high. iMTA has studied costs, adherence, effectiveness and cost-effectiveness of disease management programs for asthma. iMTA was also the first institute to estimate cost-effectiveness of inhaled corticosteroids.

The treatment of cardiovascular diseases often involves highly technical medical equipment. Demonstrating effectiveness with top end study designs can be challenging in this field. For surgical procedures, for example, double-blinded RCTs are often not possible. As economic evaluations require input from these effectiveness studies, creative statistical procedures are required to model cost-effectiveness.

Prevalence estimates of COPD are as high as 11.4% to 26.1% for the population older than 40 years. The Global burden of disease study 2010 showed that COPD is the 3th leading cause of death and the 9th cause of DALYs worldwide. There are many pharmacological and non-pharmacological treatment options. iMTA has done trial-based, model-based as well as real-world economic evaluations of: medication (e.g. POET trial, BRONCUS trial), pulmonary rehabilitation (e.g. INTERCOM trial), nutritional counselling and supplements (NUTRAIN trial), integrated care (e.g. RECODE trial), smoking cessation, early assisted discharge (GO-AHEAD trial), etc.

Diabetes is a major public health issue across the globe. Lifestyle factors, although difficult to influence, are key drivers in the development of diabetes. In its integrated care research line, iMTA is very involved with addressing self-management of chronic conditions, including diabetes. Our core focus is on developing integrated care systems with a payment incentives. As we say at iMTA: integrated care requires integrated payment. This is one of the ways in which we help to design cost-effective ways to improve diabetes care and self-management strategies.

Medical devices are an umbrella term for all sorts of interventions, which can be within the body, outside the body, assist doctors or facilitate communcation, be part of the treatment or part of diagnosis. At iMTA we are involved in the development and economic evaluation of many medical devices. Our involvement in the development allows us to perform 'headroom ananalyses' for pricing strategies. In the economic evaluations we identify which stakeholder profits most from introduction of the device. For example we have worked with: CT scanners, MRI scanners, sleep position trainers, biomarkers, telemonitoring for cardiac care, stents, heart valves, light therapy, diabetes pumps.

Mental health is a fascinating research field, that aims to quantify the seemingly unquantifiable: how much health goes foregone when your ‘head doesn’t feel right’. iMTA is at the forefront of assessing cost-effectiveness in this field. We have worked on systemic interventions, drug treatments, collaborative care and integrated care.

Multiple Sclerosis treatment is improving, but do we capture these effects? iMTA developed novel ways to identify health outcomes suitable for economic evaluations ('utilities').

iMTA has been at the frontier of health technology assessment in cancer research for over 20 years, in close collaboration with (pharmaceutical) industry, government, medical professionals and patients. We have extensive expertise in economic evaluations of innovative medicines.

Orphan drugs are treatments for life threatening or chronically debilitating diseases with a patient population of 1 case per 2,000 inhabitants. The Netherlands is at the forefront of economic evaluations in orphan drugs. That is due to the fact that reimbursement policy required economic evaluations after a period conditional reimbursement of costly inpatient medicines.

Rheumatoid arthritis (RA) affects 0.5% to 1.0% of adults in industrialized societies, with 0.5 to 1% incident cases per 100,000 population each year. This chronic, systemic, inflammatory disorder causes erosive damage to articular cartilage and subchondral bone, with joint swelling, deformity, pain, stiffness, and fatigue. Many patients with RA experience diminished health-related quality of life as well as increased disability and cardiovascular and other forms of comorbidity.