scholarly journals Development of health technology assessment in Lithuania

2009 ◽  
Vol 25 (S1) ◽  
pp. 140-142 ◽  
Author(s):  
Jankauskiene Danguole

Objectives: To describe how Lithuania is attempting to develop health technology assessment (HTA) structures.Methods: The case study of the history of development of HTA in Lithuania is presented.Results: Historical steps of HTA development are as follows: in 1993, a few conferences on HTA; eight people were trained in Sweden at SBU; the book First Steps of HTA in Lithuania (5) was issued together with SBU in 1993; participation in the International Society of Technology Assessment in Health Care (ISTAHC) conferences; participation in development of training courses and European networks of HTA; new people in HTA were trained in health accreditation service, Sickness Fund, and Ministry of Health. The major step was establishment of an evidence-based medicine library.In 1994, Article 54 in the Health Care System Law, which declares that the use of healthcare technologies that have not been assessed or approved shall be prohibited, except in cases provided by law, was passed. The procedure of healthcare technologies assessment and approval was to be established by the Ministry of Health Care. A policy of HTA was approved with the program for HTA in 1999 in the Ministry of Health. Currently, enthusiasts of HTA fully realize that technology assessment is a developing frontier for creative and constructive thinking from all disciplinary view points.Conclusions: Unfortunately, in this country, there is still a very small demand for HTA reports from the decision-maker's side. Hopefully joining the network of European Union Network for Health Technology Assessment (EUnetHTA) will give a new challenge for further policy development.

2009 ◽  
Vol 25 (S1) ◽  
pp. 82-87 ◽  
Author(s):  
Irina Cleemput ◽  
Philippe Van Wilder

Objectives: This paper gives an overview of health technology assessment (HTA) in Belgium.Methods: The information included in the overview is based on legal documents and publicly available year reports of the Belgian Health Care Knowledge Centre (KCE).Results: Belgium has a relatively young history in HTA. The principle of evidence-based medicine (EBM) was introduced in the drug reimbursement procedure in 2001, with the establishment of the Drug Reimbursement Committee (DRC). The DRC assesses the efficacy, safety, convenience, applicability, and effectiveness of a drug relative to existing treatment alternatives. For some drugs, relative cost-effectiveness is also evaluated. The activities of the DRC can, therefore, be considered to be the first official HTA activities in Belgium. Later, in 2003, KCE was established. Its mission was to perform policy preparing research in the healthcare and health insurance sector and to give advice to policy makers about how they can obtain an efficient allocation of limited healthcare resources that optimizes the quality and accessibility of health care. This broad mission has been operationalized by activities in three domains of research: HTA, health services research, and good clinical practice. KCE is independent from the policy maker. Its HTAs contain policy recommendations that may inform policy decisions but are not binding.Conclusions: Although the Belgian history of HTA is relatively short, its foundations are strong and the impact of HTA increasing. Nevertheless KCE has many challenges for the future, including continued quality assurance, further development of international collaboration, and further development of methodological guidance for HTA.


2009 ◽  
Vol 25 (S1) ◽  
pp. 156-162 ◽  
Author(s):  
Rafał Niżankowski ◽  
Norbert Wilk

In 1989, Poland started to slowly release itself not only from the burden of a half-century of communist indoctrination and soviet exploitation, but also from the consequences of the Semashko model of healthcare organization: low doctors' salaries, primary care based on multispecialty groups, overdeveloped hospital infrastructure, and limited access to sophisticated interventions overcome by patients' unofficial payments.A few years after the 1998 workshop on health technology assessment (HTA) in Budapest, the first HTA reports were elaborated in the National Center for Quality Assessment in Health Care, which could mark the beginning of HTA in Poland. Several individuals and organizations have been involved in developing HTA, both from noncommercial and commercial standpoints.A goal to establish a national HTA agency appeared among the priorities of the Polish Ministry of Health in 2004 and was realized a year later. The Agency for HTA in Poland published guidelines on HTA and established a sound and transparent two-step (assessment-appraisal) process for preparing recommendations on public financing of both drugs and nondrug technologies. The recommendations of the Agency's Consultative Council were warmly welcomed by the public payer. However, the recent major restructuring of the Agency and new drug reimbursement decisions aroused doubts as to keeping transparency of the decision-making processes.


Author(s):  
David Banta ◽  
Egon Jonsson

For the past several years, we have discussed the idea of producing a publication on the history of health technology assessment (HTA). It seemed important to us to develop this history now, while those who lived it can give their own accounts. An exception is Seymour Perry, the first president of ISTAHC and the Director of the first national public program in HTA, the U.S. National Center for Health Care Technology (NCHCT). See the In Memoriam in this issue.


2002 ◽  
Vol 18 (2) ◽  
pp. 171-183 ◽  
Author(s):  
Egon Jonsson

Health technology assessment (HTA) grew from a need recognized by researchers concerned about the effectiveness of health services. They were later joined by policy makers in search of valid information about the costs and benefits of investments in health care. The history of HTA shows that this need appeared in many countries at nearly the same time.


2009 ◽  
Vol 25 (S1) ◽  
pp. 42-52 ◽  
Author(s):  
Egon Jonsson

Sweden has a long history of using data as a basis to form policies in many sectors of society. The very first documented efforts to collect data and use some kind of evidence to judge health care began 350 years ago in Sweden. In 1663, theSwedish Collegium Medicorum(re-namedCollegium Medicumin 1688) was established; initially to distinguish quackery from medicine, to develop a pharmacopoeia, to control the trade of poisonous drugs, and banish all swindlers who “grease people with their fake, fraudulent, and harmful medicaments”(12;20;25;26).


2009 ◽  
Vol 25 (S1) ◽  
pp. 112-119 ◽  
Author(s):  
Matthias Perleth ◽  
Bernhard Gibis ◽  
Britta Göhlen

Objectives: To provide an overview of the development of health technology assessment (HTA) in Germany since the 1990s.Methods: Analysis of key documents (e.g. literature, laws, and other official documentation) and personal experiences.Results: Health technology assessment (HTA) entered the political agenda in Germany only in the mid-1990s, basically as the result of a top-down approach toward more efficiency in health care, but with a strong impetus of an evidence-based medicine movement. Accordingly, HTA became part of several healthcare reform laws since 1997, which led to the establishment of the Federal Joint Committee (G-BA) and the Institute for Quality and Efficiency in Health Care (IQWiG) in 2004. This tandem construction aims at using evidence in decision-making processes for coverage and other decisions.Conclusions: These developments have led to a considerable impact of HTA in Germany. In addition, a broad spectrum of activities at universities and in other organizations, such as the German Institute for Medical Documentation and Information (DIMDI), can be observed that contribute to both teaching and research in HTA. German researchers in the field of HTA are actively involved in international projects, such as EUNetHTA, and contribute to scientific conferences and journals.


2009 ◽  
Vol 25 (S1) ◽  
pp. 19-23 ◽  
Author(s):  
David Banta ◽  
Egon Jonsson ◽  
Paul Childs

The International Society for Technology Assessment in Health Care (ISTAHC) was formed in 1985. It grew out of the increasing awareness of the international dimensions of health technology assessment (HTA) and the need for new communication methods at the international level. The main function of ISTAHC was to present an annual conference, which gradually grew in size, and also to generally improve in quality from to year. ISTAHC overextended itself financially early in the first decade of the 2000s and had to cease its existence. A new society, Health Technology Assessment international (HTAi), based on many of the same ideas and people, grew up beginning in the year 2003. The two societies have played a large role in making the field of HTA visible to people around the world and providing a forum for discussion on the methods and role of HTA.


2009 ◽  
Vol 25 (S1) ◽  
pp. 270-275 ◽  
Author(s):  
Octavio Gómez-Dantés ◽  
Julio Frenk

Objectives: The history of health technology assessment (HTA) in Mexico is examined, starting with the efforts to incorporate this topic into the policy agenda and culminating with the recent creation of a specialized public agency.Methods: Information was gathered through a bibliographic search and interviews with actors involved in HTA in Mexico.Results: HTA efforts were developed in Mexico since the mid-1980s with the participation both of academics and of policy makers, a relationship that eventually led to the creation of the Center for Technological Excellence within the Ministry of Health.Conclusions: Institutionalization of HTA in resource-constrained settings requires the development of a critical mass of researchers involved in this field, the implementation of information efforts, and the establishment of strong relationships between HTA experts and policy makers.


Author(s):  
Jacques Orvain ◽  
Bertrand Xerri ◽  
Yves Matillon

Health technology assessment (HTA) in France covers a variety of activities performed for different customers (e.g., health professionals in the field and policy makers in government) for the benefit of patients. To promote the improvement of quality in health care, France has set up a series of distinct agencies that report to the Ministry of Health but are also accountable to their other customers. We place particular emphasis on ANAES (National Agency for Accreditation and Evaluation in Health) whose main remit is HTA. We show how the diversity of HTA activities and their decentralization suggests tight collaboration among all the different bodies which perform HTA or are closely involved with HTA, and we provide examples of such collaboration.


2020 ◽  
pp. 45-58
Author(s):  
O. B. Piniazhko ◽  
L. I. Kovtun ◽  
O. M. Zaliska ◽  
O. M. Oleshchuk ◽  
M. V. Leleka ◽  
...  

Market access for pharmaceuticals is a set of strategies, activities and processes developed by pharmaceutical companies to provide affordable medicines at appropriate fair prices in a particular health care system. Access to the pharmaceutical market covers main areas of stages, including the health technology assessment (HTA). The aim of the work was to analyze the stages of market access for pharmaceuticals in particular the implementation of HTA based on regulatory review, tasks and activities of the HTA Department of the State Expert Center of the Ministry of Health and the Expert Committee for Selection and Use of Essential Medicines and directions of HTA use in the health care system in Ukraine. Materials: legislation governing the conduction of HTA in Ukraine, international publications on the subject of the study. Research methods: system and content analysis, data synthesis and generalization of information, extrapolation, retrospective analysis. We have generalized the legislation for the introduction of HTA in Ukraine, the stages of institutionalization of the direction, the HTA roadmap, current state of financing of medicines using several regulatory lists from the perspective of state payer, including: National list of essential medicines, nomenclature of central procurement, insulin reimbursement. The mechanisms of selection of new medicines and evaluation with the use of HTA methods for inclusion on the regulatory lists, is in particular only for the National list, by criteria are presented: morbidity, disease prevalence and mortality; evidence of comparative efficacy (effectiveness), safety and cost-effectiveness; demand; the results of the budget impact analysis; pharmacokinetic properties of drugs; WHO recommendations on the use of essential medicines. In order to inform decisions on the rational allocation and use of financial resources in the health care system in January 2019, the HTA Department in Ukraine was established at SE "State Expert Center of the Ministry of Health of Ukraine" to conduct HTA and examination of applications for inclusion of medicines on National list. It is substantiated that the institutionalization of the direction with the establishment of the HTA Department is an important step in ensuring the ecosystem of decision-making based on HTA in the Ukrainian health care system. The developed methodological support, in particular the first HTA guidelines, the model of multicriteria decision analysis, experience in assessment of applications for inclusion of medicines on the National list indicate the feasibility of further expanding the use of HTA for other regulatory lists, including the list of central procurement programs and development of single positive list of medicines for public funding in Ukraine.


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