[PMH64] Health care organizations/services clustering: example of PCTS in England

[PMH64] Health care organizations/services clustering: example of PCTS in England

2010 Value in health

Millier, A. | Toumi, M. | Lamure, M. | Aballea, S. | Flostrand, S. | Hansen, K. | Volume: 13, Issue: 7, Pages: A457-A458, poster, England, innovative medicine, Medicine, Attitude, mental health, analysis, methods, database, Decision Making, M,

OBJECTIVES: England has 152 Primary Care Trust (PCT) each having its own
characteristics, and prescription patterns. As a consequence, PCT formulary lists
differ, creating an additional hurdle for patient access to innovative medicines, often
referred to as the post-code lottery. The objective of this study was to segment these
PCTs in groups with homogeneous attitudes towards patient access for innovative
drugs in Mental Health (MH) using a clustering analysis. METHODS: We collected
all available information about the PCTs through public sources and the OneKey +
database. We identifi ed 62 variables per PCT and classifi ed them in 5 groups: profile
of population, economic & fi nancial information, organization, prescription pattern
and patient management. We fi rst ran a principal component analysis on quantitative
variables and then a multiple correspondence analysis on qualitative variables, in order
to get individuals coordinates of PCTs on several axes on which they were projected.
We then merged the results, and ran an analysis to create PCTs clusters. RESULTS:
We identifi ed 5 clusters of PCTs with differentiated, homogeneous attitude towards
innovative drugs. Cluster 1 focused on MH disorders with GP-level decision-making,
cluster 2 focused on MH disorders and contained high-prescribing physicians, cluster
3 had low recognition of MH disorders, cluster 4 had low recognition but offered a
high level of care while cluster 5 was focused on cost containment. The clusters also
varied in population size from 1.2 M to 23.9 M. CONCLUSIONS: As this work was
rather innovative it was validated by local pharmaceutical sales and marketing organization.
The cluster approach proposed was endorsed by account managers’ pragmatic
experience in the fi eld and correlated well with their experience of obtaining
access for their innovative MH drugs. This study helped to improve our understanding
of the UK landscape in patient access for innovative drugs in MH