scholarly journals INTELLIGENCE AND TRANSPARENCY IN HEALTH TECHNOLOGY ASSESSMENT

2016 ◽  
Vol 32 (1-2) ◽  
pp. 3-9 ◽  
Author(s):  
Henry S. Richardson
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Making ◽  
Health Technology ◽  
Quality Adjusted Life Years ◽  
Human Capabilities ◽  
Current Thinking ◽  
Life Years ◽  
Subjective Preference ◽  
Subjective Importance

Current thinking about the methodology of health technology assessment (HTA) seems to be dominated by two fundamental tensions: [1] between maintaining a tight focus on quality-adjusted life-years and broadening its concern out to pay attention to a broader range of factors, and [2] between thinking of the evaluative dimensions that matter as being objectively important factors or as ones that are ultimately of merely subjective importance. In this study, I will argue that health is a tremendously important all-purpose means to enjoying basic human capabilities, but a mere means, and not an end. The ends to which health is a means are manifold, requiring all those engaged in policy making to exercise intelligence in a continuing effort to identify them and to think through how they interrelate. Retreating to the subjective here would be at odds with the basic idea of HTA, which is to focus on certain objectively describable dimensions of what matters about health and to collect empirical evidence rigorously bearing on what produces improvements along those dimensions. To proceed intelligently in doing HTA, it is important to stay open to reframing and refashioning the ends we take to apply to that arena. The only way for that to happen, as an exercise of public, democratic policy making, is for the difficult value questions that arise when ends clash not to be buried in subjective preference information, but to be front-and-center in the analysis.

scholarly journals Health Technology Assessment: confronto tra HD ed HDF on-line secondo i QALYs

2018 ◽  
Vol 23 (2) ◽  
pp. 29-32
Author(s):  
U. Tulli ◽  
E. Valeri
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Quality Adjusted Life Years ◽  
Sono Stati ◽  
Life Years ◽  
On Line ◽  
Quality Adjusted Life

Lo scopo di questo studio è valutare la qualità di vita percepita dalle persone sottoposte a terapia dialitica in rapporto al costoutilità; I pazienti oggetto dello studio a Tivoli sono stati 28, mentre a Guidonia sono stati 82. In base alla ricerca bibliografica abbiamo scelto di utilizzare l'ACU (analisi costo/utilità), tecnica che massimizza il rapporto utilità/costo, due alternative (interventi tecnici) in cui l'utilità è espressa in termini fisici e, in particolare, in termini di QALYs (quality adjusted life years) cioè anni di vita guadagnati ponderati per la qualità della vita per due diverse tecniche dialitiche: emodialisi standard HD ed emodiafiltrazione HDF. Osservando i dati emersi dallo studio ci siamo resi conto che i due gruppi percepiscono la qualità della loro vita in maniera molto simile, nonostante i parametri dialitici ed ematologici, oggetto di studio, siano significativamente migliori nel gruppo in trattamento dialitico con la metodica deU'Emodiafiltrazione.

scholarly journals Health Technology Assessment for Policy Making in India: Current Scenario and Way Forward

2017 ◽  
Vol 2 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Shankar Prinja ◽  
Laura E. Downey ◽  
Vijay K. Gauba ◽  
Soumya Swaminathan
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Making ◽  
Health Technology ◽  
Current Scenario

scholarly journals CHALLENGES IN CONTEMPORARY HEALTH TECHNOLOGY ASSESSMENT: A VIEW FROM THE OUTSIDE

2016 ◽  
Vol 32 (1-2) ◽  
pp. 1-2 ◽  
Author(s):  
Wija Oortwijn ◽  
Gert Jan van der Wilt
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Making ◽  
Evidence Synthesis ◽  
Health Technology ◽  
Healthcare Policy ◽  
Economic Modeling ◽  
Harvard University ◽  
Norman Daniels

The Special Interest Group on Ethics and HTA (health technology assessment) has invited two renowned philosophers, Norman Daniels from Harvard University and Henry Richardson from Georgetown University to reflect on the role of HTA in healthcare policy making. Both acknowledge its importance, but at the same time warn against a too mechanistic deployment of HTA. In their view, the relevance of HTA to healthcare policy making would considerably be enhanced if it were subsumed within a broader deliberative framework. Why should this be so? What is there to deliberate on, who should do the deliberating, where and when, and how does this relate to the more technical elements of HTA such as evidence synthesis and economic modeling?

Health technology assessment and its influence on health-care priority setting

2004 ◽  
Vol 20 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Adam Oliver ◽  
Elias Mossialos ◽  
Ray Robinson
Keyword(s):  
Public Health ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Making ◽  
Clinical Medicine ◽  
Health Technology ◽  
The Past ◽  
Stakeholder Perspectives ◽  
Health Care Priority Setting ◽  
Perceived Relevance

In this article, we review the development of health technology assessment (HTA) in England and Wales, France, The Netherlands, and Sweden, and we summarize the reaction to these developments from a variety of different disciplinary and stakeholder perspectives (political science, sociology, economics, ethics, public health, general practice, clinical medicine, patients, and the pharmaceutical industry). We conclude that translating HTA into policy is a highly complex business and that, despite the growth of HTA over the past two decades, its influence on policy making, and its perceived relevance for people from a broad range of different perspectives, remains marginal.

scholarly journals Clinical trial metadata: defining and extracting metadata on the design, conduct, results and costs of 125 randomised clinical trials funded by the National Institute for Health Research Health Technology Assessment programme

2015 ◽  
Vol 19 (11) ◽  
pp. 1-138 ◽  
Author(s):  
James Raftery ◽  
Amanda Young ◽  
Louise Stanton ◽  
Ruairidh Milne ◽  
Andrew Cook ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Research ◽  
Health Technology ◽  
Classification Systems ◽  
Data Availability ◽  
Randomised Trials ◽  
Life Years ◽  
Randomised Controlled

BackgroundBy 2011, the Health Technology Assessment (HTA) programme had published the results of over 100 trials with another 220 in progress. The aim of the project was to develop and pilot ‘metadata’ on clinical trials funded by the HTA programme.ObjectivesThe aim of the project was to develop and pilot questions describing clinical trials funded by the HTA programme in terms of it meeting the needs of the NHS with scientifically robust studies. The objectives were to develop relevant classification systems and definitions for use in answering relevant questions and to assess their utility.Data sourcesPublished monographs and internal HTA documents.Review methodsA database was developed, ‘populated’ using retrospective data and used to answer questions under six prespecified themes. Questions were screened for feasibility in terms of data availability and/or ease of extraction. Answers were assessed by the authors in terms of completeness, success of the classification system used and resources required. Each question was scored to be retained, amended or dropped.ResultsOne hundred and twenty-five randomised trials were included in the database from 109 monographs. Neither the International Standard Randomised Controlled Trial Number nor the term ‘randomised trial’ in the title proved a reliable way of identifying randomised trials. Only limited data were available on how the trials aimed to meet the needs of the NHS. Most trials were shown to follow their protocols but updates were often necessary as hardly any trials recruited as planned. Details were often lacking on planned statistical analyses, but we did not have access to the relevant statistical plans. Almost all the trials reported on cost-effectiveness, often in terms of both the primary outcome and quality-adjusted life-years. The cost of trials was shown to depend on the number of centres and the duration of the trial. Of the 78 questions explored, 61 were well answered, 33 fully with 28 requiring amendment were the analysis updated. The other 17 could not be answered with readily available data.LimitationsThe study was limited by being confined to 125 randomised trials by one funder.ConclusionsMetadata on randomised controlled trials can be expanded to include aspects of design, performance, results and costs. The HTA programme should continue and extend the work reported here.FundingThe National Institute for Health Research HTA programme.

OP08 National Institute for Health Research Health Technology Assessment Programme Research Funding And United Kingdom Burden Of Disease

2017 ◽  
Vol 33 (S1) ◽  
pp. 5-6
Author(s):  
Fay Chinnery ◽  
Gemma Bashevoy ◽  
Amanda Blatch-Jones ◽  
Lisa Douet ◽  
Sarah Puddicombe ◽  
...  
Keyword(s):  
United Kingdom ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Burden Of Disease ◽  
Health Research ◽  
Data Exchange ◽  
Market Failure ◽  
Health Technology ◽  
Life Years ◽  
The Uk

INTRODUCTION:This study compared the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme portfolio of research with the united Kingdom (UK) burden of disease, as measured by Disability-Adjusted Life Years (DALYs).METHODS:Design: Cross-sectional study.Setting: The HTA Programme cohort included all funded applications (n = 363) received by the HTA Programme during the period 1 April 2011 to 31 March 2016. The sample contained primary research and evidence syntheses, all purely methodological studies were excluded since these are not comparable to the other study types.Main Outcome Measure: Proportion of spend for each of the twenty-one Health Research Classification System (HRCS) health categories were compared with burden of disease in the UK calculated using 2015 DALY data from the Institute for Health Metrics and Evaluation (IHME) Global Health Data Exchange (GHDx).RESULTS:The funded HTA Programme projects totalled about GBP397million research spend, which broadly reflected the UK DALY burden. Overall, there was less than 5 percent difference between the actual and predicted programme spend based on the burden of disease in the UK in most instances (seventeen out of the twenty-one HRCS Health Categories).The largest categories of apportioned spend were Cancer (accounting for 12.1 percent of portfolio), and Mental Health (11.8 percent of portfolio) which particularly reflected the 9.8 percent burden of disease to the UK. Most notable deviations from DALY, where spend was lower than disease burden, were in the Cancer, Cardiovascular and Musculoskeletal categories; which may reflect the importance of other, notably charity, funding.CONCLUSIONS:The HTA Programme spend broadly aligns with burden of disease as measured using DALYs. Discrepancies were expected owing to the programme remit and its approach to commissioning research to address market failure particularly in areas that are not already well supported by research charities or industry. Regular review of DALY data during research prioritisation and commissioning allows the HTA Programme to identify and address shortfalls in disease areas and to balance its portfolio.

scholarly journals Health technology assessment development in China

2009 ◽  
Vol 25 (S1) ◽  
pp. 202-209 ◽  
Author(s):  
Yingyao Chen ◽  
David Banta ◽  
Zhiliu Tang
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Making ◽  
Health Sector ◽  
Health Technology ◽  
Policy Makers ◽  
Great Opportunity ◽  
Assessment Development ◽  
The Past ◽  
Insurance Benefit

Objectives: This study is to review health technology assessment (HTA) development in China during the past two decades, and to facilitate further development of HTA and its integration into policy making.Methods: The study depends very much on the extensive experiences of the authors in involvement of HTA in China. In addition, literature review and Web site searching have been used to trace the process of growth of HTA in China.Results: With its rapid economic development, the Chinese health system has had many achievements in the past 30 years. However, there are some weaknesses that have developed during this period. HTA is traced back to the early 1990s in China. First, HTA knowledge transfer and establishment of HTA units were effective ways to develop HTA in China. By the end of 1990s, the policy makers of the Ministry of Health (MoH) made efforts to merge HTA with policy making to improve the quality and efficiency of health care. The main government authorities related to health technology are the State Food and Drug Administration, the Ministry of Labor and Social Security, and the MoH. Their involvements in HTA are varied.Conclusion: A technology licensure mechanism based on HTA, including technology permission for use, institution licensure, and workforce licensure, is being gradually carried out by the MoH in China. Moreover, HTA can play an important role in technology market entry, insurance benefit coverage, formulary, clinical pathway, reimbursement, and so on. There is a great opportunity for HTA to be an important part of health reform, especially to help policy makers within the health sector to make difficult decisions.

HEALTH TECHNOLOGY ASSESSMENT AND EVIDENCE-BASED POLICY MAKING: QUEENSLAND DEPARTMENT OF HEALTH EXPERIENCE

2014 ◽  
Vol 30 (6) ◽  
pp. 595-600 ◽  
Author(s):  
Hong Ju ◽  
Kaye Hewson
Keyword(s):  
Resource Allocation ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Making ◽  
Health Technology ◽  
Evidence Based ◽  
Health Technologies ◽  
Queensland Department ◽  
Department Of Health ◽  
Evidence Based Policy

Background: Evidence-based policy making is increasingly used for better resource allocation. Queensland Department of Health has developed a new model to introduce innovative health technologies through a health technology assessment (HTA) program.Structure: A state-wide committee and several sub-committees at health service district level were established to oversee the HTA program and to monitor the uptake of technologies. The committees are supported by a multidisciplinary secretariat comprising staff with key HTA skills.Process: The process starts with HTA applications, which are then shortlisted according to prespecified criteria. A due diligence process adopting a rapid evidence assessment approach is used to evaluate the applications. Based on the assessment, recommendations are made using a deliberative decision-making process guided by well-recognized tools. With positive recommendation, a technology is piloted in constrained local setting before its system-wide diffusion.Outcome: The HTA program has assisted health administrators in prioritizing their health technology agendas. It has gained trust and wide support from policy makers and is increasingly used to support funding allocations, indicating the increasing awareness of and confidence in the program.Conclusions: The HTA program is a valuable process to assist evidence-based policy development and to guide better resource allocation.

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