• A decision support system for cyclic master surgery scheduling with multiple objectives

      Beliën, Jeroen; Demeulemeester, Erik; Cardoen, Brecht (Journal of Scheduling, 2009)
    • A decision support system for surgery sequencing at UZ Leuven's day-care department

      Cardoen, Brecht; Demeulemeester, Erik (International Journal of Information Technology & Decision Making, 2011)
    • A typology-based decisional framework to support market access and reimbursement decisions for personalised medicines

      Govaerts, Laurenz; Geldof, Tine; Simoens, Steven; Huys, Isabelle (Value in Health. The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 2017)
      New co-development approaches in personalized medicine challenge current decisional frameworks of health-technology access and reimbursement procedures. We aim to conceptualize an efficient typology-based decisional framework which takes into account the development and market access synchronism between therapeutic (Tx) and diagnostic (Dx) components of personalized medicines.
    • A typology-based decisional framework to support market access and reimbursement decisions for personalized medicines

      Govaerts, Laurenz; Geldof, Tine; Simoens, Steven; Huys, Isabelle; Van Dyck, Walter (2017)
    • Access blocking at Ghent University Hospital

      Gemmel, Paul; De Raedt, Lieven (2009)
      In the summer of 2006, some conflicts arose between the emergency department (ED) and some of the internal nursing departments (INDs) of Ghent University Hospital. The ED staff did not understand why the CEO had communicated a message about the low occupancy rate of the beds in the hospital, because he had been confronted for some years with the phenomenon of access blocking in the ED. Furthermore, the ED staff had evidence of the fact that the access of patients from the ED to the INDs was being blocked even though there were free beds in these nursing departments. As a consequence, the ED regularly became overcrowded, which led to an unacceptable workload for the ED staff. Therefore, the CEO and the hospital's chief of medicine invited Dr Paul De Meester - Professor of Health Care Management - to discuss the matter. Dr De Meester understood that this issue was not only an 'ED' problem, but a complex hospital-wide problem. Nevertheless, Dr De Meester was asked to come up with a solution. Fortunately, a lot of data had been gathered, which allowed Paul De Meester to make several well-founded recommendations.
    • Access decision-making in the Belgian Commission for reimbursement of medicines 2010-2017: Investigating the readiness for value-based pricing

      Van Dyck, Walter; Schoonaert, Lies; Geldof, Tine; Govaerts, Laurenz (2018)
      To balance the societal need for affordability of medicines with the industrial need for sustained innovation, the present pharmaceutical technology supply-driven system needs to become a societal demand-driven system. Value-based pricing is considered to be a key component of such a system, next to the conditional dialogue between payer and industry we proposed in previous work (Van Dyck, De Grève et al. 2016) in which it should be embedded. To find out how far Belgian pharmaceutical healthcare-related decision-making has evolved within this paradigm, we empirically investigated the access and reimbursement decision-making of the Belgian Commission for Reimbursement of Medicines (CRM) for the period 2010 – 2017. We combined this investigation with previous work in a meta-analysis in order to have the most complete picture possible of the present factors influencing decision-making in the Belgian system.
    • Acting with foresight in times of budget austerity

      Van Dyck, Walter; Schoonaert, Lies (2019)
      Horizon scanning is acknowledged to be one of the key components of a demand-driven healthcare system. We propose it to be a dynamic collaborative process driven by national unmet need matched with continued insight into the innovative pharmaceutical industry medicinal pipeline. Summer 2019 an international agreement was reached between payers to set up and commission an international horizon scanning initiative (IHSI), which is the international front-end of such a system. In this Policy Paper we propose a two-stage structure and organisation of the back-end national part of the horizon scanning process still to be implemented. This will lead to healthcare budgets managed with better foresight, a necessity in the face of breakthrough, some potentially curing therapies coming at a high cost. Taking the Belgian national component of the proposed horizon scanning system to implementation will require a pilot to be carried out. This to test the internal and external validity of the proposed design.
    • Acute coronary syndrome: What is the cost-effectiveness of prevention, point-of-care technology and telemonitoring?

      Van Dyck, Walter; Gassull, Daniel; Vértes, Gergely; Jain, Prateek; Palaniappan, Muhilan; Schulthess, Duane; Tambuyzer, Erik; Hudson, Richard; Moran, Nuala (Health Policy and Technology, 2012)
      This study is a cost-analysis that calculates the impact of three interventions for patients identified as ‘at risk’ for Acute Coronary Syndrome - a cardio-vascular exercise programme, point-of-care digital diagnostics, and telemonitoring adherence tools. The methodology utilizes a model of the annualized costs of ACS for the entire treatment value chain, and measures the impact of the three interventions by the change in treatment cost, incremental net benefit, and QALY. The results demonstrate that the largest impact is measured when all three interventions are utilized simultaneously producing a cumulative savings of €4424 and 0.126 QALY per patient. We also find a significant decrease in Emergency Room visits by 15% and changes in rates of utilization of Catharization (−59%), Angioplasty (−59%), Bypass (−17%), Medication (−14%) and Rehabilitation (−13%).
    • Admission scheduling in acute care hospitals: Does the practice fit with the theory?

      Gemmel, Paul; Van Dierdonck, Roland (International Journal of Operations and Production Management, 1999)
    • Barco implements platform-based product development in its healthcare division

      Boute, Robert; Van den Broeke, Maud; Deneire, Kristof (Interfaces, 2018)
      In this article, we present how Barco, a global technology company, used an operations research optimization model, which was supported by an efficient solution method, to implement platforms—common structures from which sets of products could be made—for the design and production of its high-tech medical displays. Our optimization model captures all cost aspects related to the use of platforms, thus, it is an objective tool that considers the input from marketing, sales, research and development (R&D), operations, and the supply chain. This comprehensive view allowed Barco to avoid the excessive costs that may result from the implementation of an incorrect platform. Our model supported Barco in determining the elements that should comprise each platform, the number of platforms to develop, and the products to derive from each platform. The results of the project led to reductions in safety stock and increased flexibility due to the use of platforms: R&D can now introduce twice as many products using the same resources, thus increasing Barco's earnings by over 5 million euros annually and reducing product introduction time by nearly 50 percent.
    • Barriers and opportunities for implementation of outcome-based spread payments for high-cost, one-shot curative therapies

      Michelsen, Sissel; Nachi, Salma; Van Dyck, Walter; Simoens, Steven; Huys, Isabelle (Frontiers in Pharmacology, 2020)
      Background: The challenging market access of high-cost, one-time curative therapies has inspired the development of alternative reimbursement structures, such as outcome-based spread payments, to mitigate their unaffordability and answer remaining uncertainties. This study aimed to provide a broad overview of barriers and possible opportunities for the practical implementation of outcome-based spread payments for the reimbursement of one-shot therapies in European healthcare systems. Methods: A systematic literature review was performed investigating published literature and publicly available documents to identify barriers and implementation opportunities for both spreading payments and for implementing outcome-based agreements. Data was analyzed via qualitative content analysis by extracting data with a reporting template. Results: A total of 1503 publications were screened and 174 were included. Main identified barriers for the implementation of spread payments are reaching an agreement on financial terms while considering 12-month budget cycles and the possible violation of corresponding (inter)national accounting rules. Furthermore, outcome correction of payments is currently hindered by the need for additional data collection, the lack of clear governance structures and the resulting administrative burden and cost. The use of spread payments adjusted by population- or individual-level data collected within automated registries and overseen by a governance committee and external advisory board may alleviate several barriers and may support the reimbursement of highly innovative therapies. Conclusion: High-cost advanced therapy medicinal products pose a substantial affordability challenge on healthcare systems worldwide. Outcome-based spread payments may mitigate the initial budget impact and alleviate existing uncertainties; however, their effective implementation still faces several barriers and will be facilitated by realizing the required organizational changes.
    • Characterisation and generation of nurse scheduling problem instances

      Vanhoucke, Mario; Maenhout, Broos (2005)
      In this paper, we propose different complexity indicators for the well-known nurse scheduling problem (NSP). The NSP assigns nurses to shifts per day taking both hard and soft constraints into account. The objective is to maximize the nurses' preferences and to minimize the total penalty cost from violations of the soft constraints. The problem is known to be NP-hard. Due to its complexity and relevance in practice, the operations research literature has been overwhelmed by different procedures to solve the problem. The complexity has resulted in the development of several (meta-)heuristic procedures, able to solve a NSP instance heuristically in an acceptable time limit. The practical relevance has resulted in a never-ending amount of different NSP versions, taking practical, case-specific constraints into account. The contribution of this paper is threefold. First, we describe our complexity indicators to characterize a nurse scheduling problem instance. Secondly, we develop a NSP generator to generate benchmark instances to facilitate the evaluation of existing and future research techniques. Finally, we perform some preliminary tests on a simple IP model to illustrate that the proposed indicators can be used as predictors of problem complexity. Keywords: Nurse scheduling, Benchmark instances, Problem classification
    • Clusters in the biopharmaceutical industry: Toward a new method of analysis

      Erden, Zeynep; von Krogh, Georg (Drug Discovery Today, 2011)
      Clusters are groups of co-located and interconnected firms and institutions linked by commonalities in their strategies and complementarities in their activities and resources. There are several reasons for the geographical clustering of firms in the biopharmaceutical industry. This review unpacks some advantages and disadvantages of cluster participation, and proposes a new method to enable managers and researchers to identify clusters in the biopharmaceutical industry.
    • Comparative and combined effectiveness of innovative therapies in cancer: A literature review

      Geldof, Tine; Rawal, Smita; Van Dyck, Walter; Huys, Isabelle (Journal of Comparative Effectiveness Research, 2019)
      To achieve therapeutic innovation in oncology, already expensive novel medicines are often concomitantly combined to potentially enhance effectiveness. While this aggravates the pricing problem, comparing effectiveness of novel yet expensive (concomitant) treatments is much needed for healthcare decision-making to deliver effective but affordable treatments. This study reviewed published clinical trials and real-world studies of targeted and immune therapies. In total, 48 studies compared and/or combined multiple novel products on breast, colorectal, lung and melanoma cancers. To a great extent, products evaluated in each study were owned by one manufacturer. However, cross-manufacturer assessments are also needed. Next to costs and intensive market competition, the absence of a regulatory framework enforcing real-world multiproduct studies prevents these from being conducted. Trusted third parties could facilitate such real-world studies, for which appropriate and efficient data access is needed.