The role of Health Technology Assessment in pharmaceutical policy decision‐making in Greece. Findings from a qualitative study

2019 ◽  
Vol 10 (4) ◽  
pp. 439-441
Author(s):  
Christos Tsakalogiannis ◽  
Eleftheria Karampli ◽  
Kostas Athanasakis ◽  
John Kyriopoulos
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Decision ◽  
Health Technology ◽  
Pharmaceutical Policy ◽  
Policy Decision Making

Health Technology Assessment in Thailand: Institutionalization and Contribution to Healthcare Decision Making: Review of Literature

2019 ◽  
Vol 35 (6) ◽  
pp. 467-473 ◽  
Author(s):  
Pattara Leelahavarong ◽  
Suradech Doungthipsirikul ◽  
Suthasinee Kumluang ◽  
Akanittha Poonchai ◽  
Nitichen Kittiratchakool ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Decision ◽  
Health Technology ◽  
Systems Development ◽  
Healthcare Decision ◽  
Review Of Literature ◽  
Healthcare Decision Making ◽  
Policy Decision Making

AbstractObjectivesTo explore health technology assessment (HTA) in Thailand focusing on its institutionalization, key elements for HTA introduction, and HTA contribution to policy.MethodsA review of literature covered a wide range of topics, including the institutionalization of HTA, elements of HTA introduction, and the role of HTA in policy decision making in Thai context. Additional information from the authors’ involvement in the policy decision-making process in Thailand was also considered.ResultsHTA institutionalization comprises processes of introducing HTA, including evidence generation and use in policymaking, building capacity of HTA practitioners, organizations, system infrastructure, and collaborations. In Thailand, HTA has been formally integrated into coverage decisions, including in the development of the National List of Essential Medicines and the Universal Health Coverage Scheme benefits package. Contributing factors included political will and leadership, capacity building on HTA-related disciplines, adequate resources, technical expertise, and data. Conversely, challenges faced included the absence of a governing body and strategic plan for HTA systems development, a lack of formal mechanisms for mobilizing financial support, an inadequate number of HTA researchers in nonprofit institutes, and the rise in advanced biotechnologies.ConclusionsHTA plays an important role in evidence-based healthcare decision making. However, key elements of HTA institutionalization need to be strengthened, especially governance structure and policy for HTA systems development, building and retaining capacity of HTA practitioners to meet demand, addressing the challenges of complex and highly innovative health interventions. Lessons learned from the Thai experience may be used as guidance for HTA institutionalization in other developing countries.

INTRODUCTION: HEALTH TECHNOLOGY ASSESSMENT AND THE EUROPEAN UNION

2000 ◽  
Vol 16 (2) ◽  
pp. 299-302 ◽  
Author(s):  
David Banta ◽  
Wija Oortwijn
Keyword(s):  
Public Health ◽  
Decision Making ◽  
European Union ◽  
Health Technology Assessment ◽  
European Commission ◽  
Technology Assessment ◽  
Health Technology ◽  
The European Union ◽  
European Level

Health technology assessment (HTA) has become increasingly important in the European Union as an aid to decision making. As agencies and programs have been established, there is increasing attention to coordination of HTA at the European level, especially considering the growing role of the European Union in public health in Europe. This series of papers describes and analyzes the situation with regard to HTA in the 15 members of the European Union, plus Switzerland. The final paper draws some conclusions, especially concerning the future involvement of the European Commission in HTA.

VP138 Integration Of Ethics In Health Technology Assessment

2017 ◽  
Vol 33 (S1) ◽  
pp. 212-213
Author(s):  
Christian Bellemare ◽  
Suzanne Kocsis Bédard ◽  
Pierre Dagenais ◽  
Jean-Pierre Béland ◽  
Louise Bernier ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Decision ◽  
Practical Method ◽  
Health Technology ◽  
Social Needs ◽  
Operational Method ◽  
Ethics Assessment ◽  
Integrating Ethics

INTRODUCTION:The objective was to identify the conceptual and methodological issues surrounding integration of ethics in Health Technology Assessment (HTA). We conducted a systematic review examining: (i) social needs, (ii) methodological and procedural barriers, (iii) concepts or processes of ethics assessment used and (iv) results of experimentations for integrating ethics in HTA.METHODS:Search criteria included ‘ethic’, ‘technology assessment’ and ‘HTA’. The literature search was done up to 21 November 2016 in Medline/Ovid, SCOPUS, CINAHL, PsycINFO and international HTA Database. Screening of citations, screening of full-text and data extraction were performed by two subgroups of two independent reviewers. The first group was constituted of HTA experts, and the second of ethics and philosophy experts. Data extracted from articles were regrouped in categories for each objective.RESULTS:A list of 2,420 citations was obtained while 1,646 remained after the removal of duplicates. Of these, 132 were fully reviewed, yielding 67 eligible articles for analysis. Eight categories were identified within the social needs. The mostly evoked were ‘Informed policy decision making’ (n = 16) and 'Informed public/patient decision making’ (n = 12). Ten categories of methodological and procedural barriers were identified. The most mentioned were 'Lack of standardized and recognized proceedings for ethical analysis’ (n = 28) and ‘Lack of shared consensus on the role of ethical theory and ethical expertise’ (n = 17). Within the concepts or processes of ethics assessment, thirteen categories were identified. The most mentioned were ‘Fairness and Equity’ (n = 12), ‘Beneficence and Non-maleficence’ (n = 10) and, ‘Autonomy’ (n = 10). Within results of experimentations, five categories were identified. The most mentioned was ‘Usefulness of ethics for identifying relevant problems’ (n = 3). While few experimentations were identified, no clear operational method was found in our research.CONCLUSIONS:This study confirms the necessity to design an operational method integrating ethics and addressing social needs of HTA. Our results constitute the basis for developing a new theoretical and practical method.

scholarly journals Ethical and Social Values for Paediatric Health Technology Assessment and Drug Policy

2020 ◽  
Author(s):  
Avram E. Denburg ◽  
Mita Giacomini ◽  
Wendy Ungar ◽  
Julia Abelson
Keyword(s):  
Decision Making ◽  
Child Health ◽  
Health Technology Assessment ◽  
Health Systems ◽  
Technology Assessment ◽  
Drug Policy ◽  
Social Values ◽  
Policy Decision ◽  
Health Technology ◽  
Structured Interviews

Background: Public policy approaches to funding paediatric medicines in advanced health systems remain understudied. In particular, the ethical and social values dimensions of health technology assessment (HTA) and drug coverage decisions for children have received almost no attention in research or policy. Methods: To elicit and understand the social values that influence decision-making for public funding of paediatric drugs, we undertook a series of in-depth, semi-structured interviews with a stratified purposive sample (n = 22) of stakeholders involved with or affected by drug funding decisions for children at the provincial (Ontario) and national levels in Canada. Constructivist grounded theory methodology guided data collection and thematic analysis. Results: Our study provides empirical evidence about the unique ethical and social values dimensions of HTA for children, and describes a novel social values typology for paediatric drug policy decision-making. Three principal categories of values emerged from stakeholder reflections on HTA and drug policy-making for children: procedural values, structural values, and sociocultural values. Key findings include the importance of attention to the procedural legitimacy of HTA for children, with emphasis on the inclusion of child health voices in processes of technology appraisal and policy uptake; a role for HTA institutions to consider the equity impacts of technologies, both in setting review priorities and in assessing the value of technologies for public coverage; and the potential benefits of a distinct national framework to guide drug policy for children. Conclusion: Current approaches to HTA are not well designed for the realities of child health and illness, nor the societal priorities regarding children that our study identified. This research generates new knowledge to inform decision-making on paediatric drugs by HTA institutions and government payers in Canada and other publicly-funded health systems, through insights into the relevant social values for child drug funding decisions from varied stakeholder groups.

scholarly journals Health Technology Assessment Development in Vietnam: A Qualitative Study of Current Progress, Barriers, Facilitators, and Future Strategies

2021 ◽  
Vol 18 (16) ◽  
pp. 8846
Author(s):  
Hwa-Young Lee ◽  
Thuy Thi-Thu Nguyen ◽  
Saeun Park ◽  
Van Minh Hoang ◽  
Woong-Han Kim
Keyword(s):  
Decision Making ◽  
Health Insurance ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Clinical Decision Making ◽  
Policy Decision ◽  
Health Technology ◽  
Scientific Integrity ◽  
Data Repository ◽  
The Government

Introduction: To make more efficient use of limited resources, Vietnam incorporated health technology assessment (HTA) into the decision-making process for the health insurance benefit package in 2014. We evaluated progress in HTA institutionalization in Vietnam based on the theoretical framework developed by the National Institute for Health and Care Excellence and the Health Intervention and Technology Assessment Program, identified negative and conducive factors for HTA development, and finally suggested policy recommendations that fit the Vietnamese context. Methods: Semi-structured in-depth qualitative interviews were conducted between December 2017 and March and April 2018 with a purposive sample of 24 stakeholders involved in decision-making for health insurance reimbursement. We employed thematic analysis to examine themes within the data. Results: Despite a variety of activities (e.g., training and advising/mentoring) and a substantial level of output (e.g., policy statements, focal points assigned, and case studies/demonstration projects), Vietnam has not yet reached the policy decision stage based on HTA with scientific integrity and active stakeholder participation. Most respondents, except some clinicians, supported the use of HTA. The lack of capacity of human resources in the government sector and academia, the limited data infrastructure, the absence of guidelines, the government’s interest in immediate budget-saving, and public resistance were identified as barriers to the advancement of HTA. Conclusions: A structured data repository, guidelines based on the Vietnamese context for both policy decision-making at the central level and daily clinical decision-making at the micro-level, and integration of a participatory process into HTA are suggested as priorities for HTA institutionalization in Vietnam.

Methods, procedures, and contextual characteristics of health technology assessment and health policy decision making: Comparison of health technology assessment agencies in Germany, United Kingdom, France, and Sweden

2009 ◽  
Vol 25 (03) ◽  
pp. 305-314 ◽  
Author(s):  
Ruth Schwarzer ◽  
Uwe Siebert
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Research Policy ◽  
Policy Decision ◽  
Health Technology ◽  
Policy And Practice ◽  
Health Policy Decision ◽  
Policy Decision Making ◽  
Similarities And Differences ◽  
Domain Similarity

Objectives:The objectives of this study were (i) to develop a systematic framework for describing and comparing different features of health technology assessment (HTA) agencies, (ii) to identify and describe similarities and differences between the agencies, and (iii) to draw conclusions both for producers and users of HTA in research, policy, and practice.Methods:We performed a systematic literature search, added information from HTA agencies, and developed a conceptual framework comprising eight main domains: organization, scope, processes, methods, dissemination, decision, implementation, and impact. We grouped relevant items of these domains in an evidence table and chose five HTA agencies to test our framework:DAHTA@DIMDI, HAS, IQWiG, NICE, and SBU. Item and domain similarity was assessed using the percentage of identical characteristics in pairwise comparisons across agencies. Results were interpreted across agencies by demonstrating similarities and differences.Results:Based on 306 included documents, we identified 90 characteristics of eight main domains appropriate for our framework. After applying the framework to the five agencies, we were able to show 40 percent similarities in “dissemination,” 38 percent in “scope,” 35 percent in “organization,” 29 percent in “methods,” 26 percent in “processes,” 23 percent in “impact,” 19 percent in “decision,” and 17 percent in “implementation.”Conclusion:We found considerably more differences than similarities of HTA features across agencies and countries. Our framework and comparison provides insights and clarification into the need for harmonization. Our findings could serve as descriptive database facilitating communication between producers and users.

OVERVIEW ON THE CURRENT IMPLEMENTATION OF HEALTH TECHNOLOGY ASSESSMENT IN THE HEALTHCARE SYSTEM IN HUNGARY

2017 ◽  
Vol 33 (3) ◽  
pp. 333-338 ◽  
Author(s):  
Bertalan Németh ◽  
Marcell Csanádi ◽  
Zoltán Kaló
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Relevant Literature ◽  
Health Technology ◽  
Scientific Basis ◽  
Complex Process ◽  
Current Implementation ◽  
Country Specific

Objectives:Our objectives were to assess the current implementation of health technology assessment (HTA) in Hungary and to identify country-specific patterns of challenges and potential improvements.Methods:We applied a structure that can be used to create HTA implementation roadmaps to evaluate various issues regarding HTA implementation. A comprehensive description of the Hungarian HTA system is presented according to relevant literature and experiences of the authors.Results:By investigating eight components of HTA implementation, we identified the most important strengths and weaknesses of the Hungarian system. More specifically, we were mainly focusing on the emergence of HTA capacity, the establishment and current role of Department of HTA, the complex process of decision making, the quality elements developed in the near past, and the activity of Hungarian experts at international collaborations.Conclusions:We concluded that there is a sophisticated methodological and educational basis for HTA in Hungary. A permanent focus on capacity building and changes to the reimbursement procedure can further improve transparency and the scientific basis of decision making in the country.

scholarly journals Defining the role of the public in Health Technology Assessment (HTA) and HTA-informed decision-making processes

2020 ◽  
Vol 36 (2) ◽  
pp. 87-95
Author(s):  
Jackie Street ◽  
Tania Stafinski ◽  
Edilene Lopes ◽  
Devidas Menon
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Public Involvement ◽  
Health Technology ◽  
Operational Definition ◽  
Patient And Public Involvement ◽  
The Public ◽  
The World

ObjectivesThe terminology used to describe community participation in Health Technology Assessment (HTA) is contested and frequently confusing. The terms patients, consumers, public, lay members, customers, users, citizens, and others have been variously used, sometimes interchangeably. Clarity in the use of terms and goals for including the different groups is needed to mitigate existing inconsistencies in the application of patient and public involvement (PPI) across HTA processes around the world.MethodsWe drew from a range of literature sources in order to conceptualize (i) an operational definition for the “public” and other stakeholders in the context of HTA and (ii) possible goals for their involvement. Draft definitions were tested and refined in an iterative consensus-building process with stakeholders from around the world.ResultsThe goals, terminology, interests, and roles for PPI in HTA processes were clarified. The research provides rationales for why the role of the public should be distinguished from that of patients, their families, and caregivers. A definition for the public in the context of HTA was developed: A community member who holds the public interest and has no commercial, personal, or professional interest in the HTA processConclusionsThere are two distinct aspects to the interests held by the public which should be explicitly included in the HTA process: the first lies in ensuring democratic accountability and the second in recognising the importance of including public values in decision making.

PP020 Decision-Making Beyond Evidence Alone – Topic Prioritization For Health Technology Assessment

2017 ◽  
Vol 33 (S1) ◽  
pp. 77-78
Author(s):  
Hong Ju ◽  
Kwong Ng ◽  
Elaine Teo ◽  
Daphne Khoo
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Budget Impact ◽  
Policy Decision ◽  
Health Technology ◽  
Left Ventricular ◽  
Health Technologies ◽  
Potential Impact ◽  
The Impact

INTRODUCTION:The number of health technologies needing evaluation far outweighs available resources, and most Health Technology Assessment (HTA) agencies use criteria-based frameworks for topic prioritization (1,2). Despite variability, most frameworks include clinical, economic and budget impact. Some limitations of current frameworks lack mentioning of any explicit political/ethical deliberation and an evaluation on the potential impact of the HTAs (1).METHODS:During a topic prioritization for HTA, Left Ventricular Assist Device (LVAD) as destination therapy for adults with end-stage heart failure was submitted. The prioritization criteria used were largely in line with those described above. We also included criteria on ethical/equity consideration and the potential impact of an HTA on decision making. A literature search was conducted to gather clinical and economic evidence on LVAD for the target population, supplemented by local data on potential need for and budget impact of providing a LVAD service.RESULTS:LVAD was scored high on clinical, economic and budget impact with a moderately high need, which would generally subject it to an HTA in order to inform a policy decision. However LVAD was also considered as a technology with a high impact on ethical and political grounds, given that it is a technology offering survival and quality-of-life benefits for a small group of patients for whom effective treatment is otherwise lacking. Through deliberation, the prioritization panel concluded that the impact of an HTA would be low, as a policy decision on whether a LVAD program should be funded would go beyond evidence. Therefore an HTA was not recommended for LVAD.CONCLUSIONS:To inform decision making, an evaluation on the potential impact of the HTA itself taking into account of the ethical/political consideration of funding a technology is of equal importance as the evidence alone. Subsequently, limited HTA resources can be reserved for technologies where an HTA can truly make a difference.

WHAT IS THE ROLE OF COMMUNITY PREFERENCE INFORMATION IN HEALTH TECHNOLOGY ASSESSMENT DECISION MAKING? A CASE STUDY OF COLORECTAL CANCER SCREENING

2015 ◽  
Vol 31 (4) ◽  
pp. 241-248
Author(s):  
Sally Wortley ◽  
Kathy Flitcroft ◽  
Kirsten Howard
Keyword(s):  
Colorectal Cancer ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Discrete Choice ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Making Process ◽  
Preference Information ◽  
Crc Screening

Objectives:The aim of this study was to determine the role of community preference information from discrete choice studies of colorectal cancer (CRC) screening in health technology assessment (HTA) reports and subsequent policy decisions.Methods:We undertook a systematic review of discrete choice studies of CRC screening. Included studies were reviewed to assess the policy context of the research. For those studies that cited a recent or pending review of CRC screening, further searches were undertaken to determine the extent to which community preference information was incorporated into the HTA decision-making process.Results:Eight discrete choice studies that evaluated preferences for CRC screening were identified. Four of these studies referred to a national or local review of CRC screening in three countries: Australia, Canada, and the Netherlands. Our review of subsequently released health policy documents showed that while consideration was given to community views on CRC, policy was not informed by discrete choice evidence.Conclusions:Preferences and values of patients are increasingly being considered “evidence” to be incorporated into HTA reports. Discrete choice methodology is a rigorous quantitative method for eliciting preferences and while as a methodology it is growing in profile, it would appear that the results of such research are not being systematically translated or integrated into HTA reports. A formalized approach is needed to incorporate preference literature into the HTA decision-making process.

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