TOWARD A SHIFTING HEALTH TECHNOLOGY ASSESSMENT PARADIGM: REACTIONS TO POLICY FORUM DISCUSSIONS

Are we in a period of significant change? Is health technology assessment (HTA) undergoing a fundamental transformation? Or should it be? Are we in the middle of a paradigm shift? These are some of the questions the paper by Facey et al in this journal (1) raises about the future of HTA, based on discussions at the HTAi Policy Forum in February 2015. To further share the deliberations of the Forum and with a view to opening this debate among the wider HTA community, a panel within the HTAi 2015 Annual Meeting in Oslo was organized. Presentations at the panel included a summary of the HTAi Policy Forum deliberations and perspectives from a patient, a clinician, and representatives of an HTA organization, industry, and a health system. This letter presents issues and thoughts raised in the panel session.

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RETHINKING STAKEHOLDER ENGAGEMENT AND TECHNOLOGY ACCESS IN HEALTH TECHNOLOGY ASSESSMENT: REACTIONS TO POLICY FORUM DISCUSSIONS

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462316000325 ◽

2016 ◽

Vol 32 (4) ◽

pp. 200-202 ◽

Cited By ~ 3

Author(s):

Laura Sampietro-Colom ◽

Sarah Thomas

Keyword(s):

Health Technology Assessment ◽

Annual Meeting ◽

Healthcare System ◽

Technology Assessment ◽

Stakeholder Engagement ◽

Health Technology ◽

Careful Consideration ◽

Technology Access ◽

Panel Session ◽

Policy Forum

The need to progress and innovate in health technology assessment (HTA) is a must in a continuously changing environment. The HTAi Policy Forum reflected on two specific areas for development where it was thought there was need for careful consideration and deliberation during the main annual meeting in February 2016. The study by Husereau et al. (1) in this journal presents the discussions resulting from this Forum. To further share the deliberations of the Forum and with a view to opening this debate to the wider HTA community, a panel session during the HTAi Annual Meeting in Tokyo was organized. Presentations at the panel included a summary of the HTAi Policy Forum discussions and perspectives from a patient, a representative of healthcare system provider, and a representative from an HTA organization and industry. This letter presents the issues raised in the panel session.

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IMPROVING THE EFFECTIVENESS AND EFFICIENCY OF EVIDENCE PRODUCTION FOR HEALTH TECHNOLOGY ASSESSMENT

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462315000355 ◽

2015 ◽

Vol 31 (4) ◽

pp. 201-206 ◽

Cited By ~ 19

Author(s):

Karen Facey ◽

Chris Henshall ◽

Laura Sampietro-Colom ◽

Sarah Thomas

Keyword(s):

Life Cycle ◽

Health Technology Assessment ◽

Health System ◽

Technology Assessment ◽

Real World ◽

Innovation System ◽

Health Technology ◽

Real World Data ◽

Whole Life Cycle ◽

Policy Forum

Objectives: Health Technology Assessment (HTA) needs to address the challenges posed by high cost, effective technologies, expedited regulatory approaches, and the opportunities provided by collaborative real-world evaluation of technologies. The Health Technology Assessment International (HTAi) Policy Forum met to consider these issues and the implications for evidence production to inform HTA. This paper shares their discussion to stimulate further debate.Methods: A background paper, presentations, group discussions, and stakeholder role play at the 2015 HTAi Policy Forum meeting informed this paper.Results: HTA has an important role to play in helping improve evidence production and ensuring that the health service is ready to adopt effective technologies. It needs to move from simply informing health system decisions to also working actively to align stakeholder expectations about realistic evidence requirements. Processes to support dialogue over the health technology life cycle need to be developed that are mindful of limited resources, operate across jurisdictions and learn from past processes. Collaborations between health technology developers and health systems in different countries should be encouraged to develop evidence that will inform decision making. New analytical techniques emerging for real-world data should be harnessed to support modeling for HTA.Conclusions: A paradigm shift (to “Health Innovation System 2.0”) is suggested where HTA adopts a more central, proactive role to support alignment within and amongst stakeholders over the whole life cycle of the technology. This could help ensure that evidence production is better aligned with patient and health system needs and so is more effective and efficient.

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Health technology assessment to optimize health technology utilization: Using implementation initiatives and monitoring processes

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462310000309 ◽

2010 ◽

Vol 26 (3) ◽

pp. 309-316 ◽

Cited By ~ 28

Author(s):

Katrine B. Frønsdal ◽

Karen Facey ◽

Marianne Klemp ◽

Inger Natvig Norderhaug ◽

Berit Mørland ◽

...

Keyword(s):

Health Technology Assessment ◽

Health System ◽

Technology Assessment ◽

Health Technology ◽

Evidence Based ◽

Use Of Technology ◽

Monitoring Activities ◽

The Impact ◽

Policy Forum

Background: The way in which a health technology is used in any particular health system depends on the decisions and actions of a variety of stakeholders, the local culture, and context. In 2009, the HTAi Policy Forum considered how health technology assessment (HTA) could be improved to optimize the use of technologies (in terms of uptake, change in use, or disinvestment) in such complex systems.Methods: In scoping, it was agreed to focus on initiatives to implement evidence-based guidance and monitoring activities. A review identified systematic reviews of implementation initiatives and monitoring activities. A two-day deliberative workshop was held to discuss key papers, members’ experiences, and collectively address key questions. This consensus paper was developed by email and finalized at a postworkshop meeting.Results: Evidence suggests that the impact and use of HTA could be increased by ensuring timely delivery of relevant reports to clearly determined policy receptor (decision-making) points. To achieve this, the breadth of assessment, implementation initiatives such as incentives and targeted, intelligent dissemination of HTA result, needs to be considered. HTA stakeholders undertake a variety of monitoring activities, which could inform optimal use of a technology. However, the quality of these data varies and is often not submitted to an HTA.Conclusions: Monitoring data should be sufficiently robust so that they can be used in HTA to inform optimal use of technology. Evidence-based implementation initiatives should be developed for HTA, to better inform decision makers at all levels in a health system about the optimal use of technology.

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Survey on the involvement of consumers in health technology assessment programs

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462306051427 ◽

2006 ◽

Vol 22 (4) ◽

pp. 497-499 ◽

Cited By ~ 35

Author(s):

David Hailey ◽

Margareta Nordwall

Keyword(s):

Health Technology Assessment ◽

Technology Assessment ◽

Health Technology ◽

International Network ◽

The Future

Objectives: The aim of this study was to obtain information from members of the International Network of Agencies for Health Technology Assessment (INAHTA) on their involvement of consumers (patients, carers, and related organizations) in their programs.Methods: A questionnaire for a survey was developed and sent to member agencies in October 2005.Results: Of the thirty-seven agencies that provided responses, 57 percent involve consumers in some aspects of their HTA programs and 83 percent intend to involve consumers in the future. Summaries of HTA reports that are intended to be easily understood by consumers are prepared by 49 percent of the agencies, and 36 percent involve consumers in dissemination of HTA material.Conclusions: Most INAHTA members involve consumers in some aspects of their programs, although not always routinely. Involvement seems likely to increase in the future.

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HTA AND VALUE - A COMMENTARY

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646231300055x ◽

2013 ◽

Vol 29 (4) ◽

pp. 374-375

Author(s):

Michael D. Rawlins

Keyword(s):

Cost Effectiveness ◽

Health Technology Assessment ◽

Technology Assessment ◽

Health Technology ◽

Therapeutic Interventions ◽

Value Proposition ◽

Costs And Benefits ◽

Societal Costs ◽

The Subject ◽

Policy Forum

The notion of value, in the evaluation of the clinical and cost-effectiveness of therapeutic interventions, was the subject of discussion at the HTAi Policy Forum in February 2013. A summary of its discussions and conclusions is published in this issue of the journal. This commentary considers the implications of the proposal that health technology assessment (HTA) agencies should include, in the value proposition, wider societal costs and benefits as well as incorporating innovative promise.

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OP04 Lessons Learnt When Implementing A Health Technology Assessment Institution In Costa Rica

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462317001155 ◽

2017 ◽

Vol 33 (S1) ◽

pp. 3-4

Author(s):

Iñaki Gutiérrez-Ibarluzea ◽

James Cercone ◽

Daniel Bronstein ◽

Luis Tacsan ◽

Pablo Morales ◽

...

Keyword(s):

Health Care ◽

Costa Rica ◽

Social Security ◽

Health Technology Assessment ◽

Health System ◽

Technology Assessment ◽

Access To Health Care ◽

Health Technology ◽

Right To Health ◽

Independent Evidence

INTRODUCTION:Faced with increasing financial challenges to the single-payer social security system and constitutional challenges supporting all citizen's right to health, Costa Rica has endeavored to introduce Health Technology Assessment (HTA) to ensure sustainability and promote the timely introduction of technology innovations in the health system. The Ministry of Health initiated a process to establish an independent, external institution providing leadership in the process of HTA.METHODS:Based on a survey developed by REDETSA/PAHO (HTA Network of the Americas/Pan American Health Organization), an inclusive method of stakeholders participation was used to analyze the strengths, weaknesses, opportunities and threats regarding the implementation of an HTA entity. This was combined with qualitative research methods, market access situation analysis and the review of coverage and provision processes to define the elements for the new HTA institution. The “in-depth” interviews extended to manufacturers, ministry representatives, services providers, purchasers, patients and citizens representatives, judiciary court, professional colleges, academia and non-governmental organizations (NGOs). Analysis of the professional competencies required for the HTA institution was carried out based on best practice analysis of international HTA institutions.RESULTS:The implementation of an HTA unit in Costa Rica was identified by all the actors as crucial to ensuring the health system's sustainability. Costa Rica's health system is based on all citizens right to health and all inputs required delivering health services, judicialization and access to health care have become a big issue. Two main issues were identified as essential to implement an HTA institution: the establishment of a clear framework to provide legal and financial support and the need to have sufficient independence from the Ministry and the Social Security, including maximum transparency and methodological robustness.CONCLUSIONS:The business model for the new HTA institution should consider the participation of all the interested actors. The HTA institution should bridge the gap between technology regulation and health technology management and aim to improve both processes. It should also provide third party independent evidence to inform the constitutional court around health care claims.

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OP10 Key Messages From The 2018 Health Technology Assessment Latin America Policy Forum

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462318000752 ◽

2018 ◽

Vol 34 (S1) ◽

pp. 4-5

Author(s):

Laura Sampietro-Colom ◽

Rebecca Trowman

Keyword(s):

Latin America ◽

Health Technology Assessment ◽

Technology Assessment ◽

Health Technology ◽

The European Union ◽

Private Industry ◽

Great Opportunity ◽

Health Technologies ◽

Policy Forum ◽

Latin America Region

Introduction:The third Health Technology Assessment International (HTAi) Latin America Policy Forum (LAPF) will meet on 23 and 24 April 2018 in Montevideo, Uruguay. The format of the LAPF echoes that of the HTAi Global Policy Forum and provides a unique opportunity as a leadership meeting for senior people from public and private sector organizations using HTA. The aim of the LAPF is to provide an environment where senior people can engage in strategic discussions, informed by the perspectives of their different organizations, without the constraints associated with discussions of specific products or organizational policies.Methods:The HTAi LPF will convene around 50 senior representatives from HTA agencies and industry members active in the Latin America region. The topic that has been chosen by the organizing committee is ‘defining the value of health technologies in Latin America’ and this will be discussed over two days by attendees.Results:This presentation will focus on summarizing the key messages that resulted from the two days of discussions at the LAPF. The views reflected will balance those of the not-for-profit agencies and private industry sector attendees, while respecting the ‘Chatham House’ rule (whereby no quotes will be directly attributed to any attendee). It will draw out any conclusions from the plenary sessions and the guided breakout sessions from the event. Any actions that are resulting from the event will also be summarized.Conclusions:The presentation will provide a great opportunity for the wider HTAi membership to hear reflections on the key messages resulting from the event. This could provide an opportunity for further questions and debate surrounding the key issues to occur, such us any difference between valuing technologies in the Latin America Region with the approaches made in the European Union and North America.

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