Regularly checking what’s on the horizon is an important tactic for planning in many areas of life. It can forewarn us about potential dangers or risks, changes in the environment or good things to come.
In healthcare, this means following research and new health technology developments to help us respond to innovations in the way we diagnose, treat and manage disease. Such technologies include precision medicines, immunotherapies, potentially curative cell and gene therapies and digital therapeutics.
These developments not only challenge clinical approaches to disease management, but also the traditional pathways of therapeutic development, from the clinical trial stage through regulatory approval to health technology assessment (HTA), and reimbursement. New technologies may offer significant value to patients, but also have resourcing impacts that must be managed within the healthcare system and budgets.
Horizon Scanning in Australian Healthcare
In October 2021, pharmaceutical company, Bristol Myers Squibb (BMS) convened the Shaping Healthcare Together Roundtable, under the Broadening the Evidence project, online with representatives of 25 Australian patient advocacy organisations (including CreakyJoints Australia). The roundtable explored horizon scanning activities and opportunities in the Australian healthcare system.
BMS, together with strategic planning and commercialisation firm Biointelect, recently launched the Strengthening Horizon Scanning in Australia Report, which presents the findings of the roundtable, combined with desk research and interviews with a range of international experts involved in horizon scanning processes. It makes recommendations for an efficient, effective and inclusive horizon scanning process for the Australian healthcare system.
Australia should aim for a gold standard approach to horizon scanning for new health technologies. Key components of this system should include:
- Broad scope that includes medicines, vaccines, devices, diagnostics and cell and gene therapies that are in development. Inclusion criteria should be agreed by stakeholders and subject to regular review to keep pace with technological advances. This may include, for example, technologies that are expected to address areas of high unmet need, and that may present complexities in evaluation and/or implementation.
- Commonwealth Government driven and funded process, conducted via an independent third party, with the appropriate expertise to effectively identify and impartially document relevant products and technologies and apply filtering criteria.
- Process conducted in consultation with a broad range of relevant stakeholders from throughout the health ecosystem, including government, payers, patients and patient advocacy organisations, clinicians, industry and researchers.
- Support healthcare system capabilities and preparedness for new therapies and technologies. This should include alignment with relevant steps in the path to market for medicines in Australia such as regulatory and reimbursement processes.
- Ensure appropriate outputs of the horizon scanning research are developed to support dissemination amongst a broad range of relevant stakeholders. This may require outputs that are tailored to the needs of different stakeholders. For example, reports and online resources.
Though horizon scanning has the potential to positively shape the healthcare landscape and patients’ access to innovative therapies, existing processes and systems are associated with a number of limitations.
Of particular concern is the highly fragmented nature of horizon scanning, both at a local and international level. At present, there are many systems in place, all with various goals and different approaches to horizon scanning. This results in significant duplication of effort and poor utilisation of limited resources – with many organisations conducting their own horizon scanning without interacting with others undertaking the same work.
This could be better addressed with a higher level of collaboration and transparency between those who are already conducting horizon scanning.
Australia does not currently have a formalised, comprehensive horizon scanning program, however, an annual horizon scanning forum will begin in 2022 under the Strategic Agreement between the Australian Government and Medicines Australia.
The Strengthening Horizon Scanning in Australia Report highlights five critical areas for progressing towards an optimal horizon scanning approach in Australia.
- Inclusion of key stakeholders (including patient organisations) in the upcoming Medicines Australia – Department of Health horizon scanning forum.
- Mapping of horizon scanning activities already being undertaken by stakeholders in Australia.
- Appointment of an independent third party to research and develop a public report that draws on a broad range of sources to inform the annual horizon scanning forum.
- Exploration of potential opportunities to leverage horizon scanning that is conducted in other countries and organisations with a similar purpose.
- Provision of a single source of easy-to-access and interpret information for Australian patients and other healthcare system stakeholders regarding both clinical trials and emerging health technologies – for example, via a searchable online database.
How Horizon Scanning Activities Can Help You
We know that many of you have experienced difficulties in areas such as:
- Getting a timely and accurate diagnosis.
- Finding treatments targeted for your condition that suit your lifestyle and have a reduced risk of side-effects.
- Facing restrictions and delays in accessing life-changing medicines.
- Accessing reliable information in easy-to-follow language that can help you actively participate in your own healthcare.
Bringing all relevant stakeholders (including patients and patient organisations) together to identify and analyse the issues behind such barriers will go a long way towards removing them. When we work together, we achieve more.
What CreakyJoints Australia is doing to help
CreakyJoints Australia has participated in events leading up to the development of this report over several years. We will continue to present the voice of Australians with arthritis at the annual horizon scanning forums and related events and will share the outcomes of our advocacy activities with you.