ASSESSING VALUE, BUDGET IMPACT, AND AFFORDABILITY IN ASIA

2017 ◽  
Vol 33 (2) ◽  
pp. 315-322
Author(s):  
Grace Hampson ◽  
Chris Henshall ◽  
Adrian Towse
Keyword(s):  
Decision Making ◽  
Technology Assessment ◽  
Budget Impact ◽  
Health Benefit ◽  
Health Technology ◽  
Unintended Consequences ◽  
Decision Makers ◽  
Asian Countries ◽  
Equitable Access ◽  
Policy Forum

Objectives: The aim of this study was to explore definitions of value and the use of budget impact and affordability considerations in health technology assessment (HTA) in the Asia region, particularly in relation to high cost technologies.Methods: Issues were debated by senior representatives from HTA and payer systems in Asian countries, delegates from industry, and invited experts at the 2016 meeting of the HTAi Asia Policy Forum (HAPF). A premeeting survey was used to gather data on how value is assessed and budget impact calculations are used within current processes, as well as current approaches to managing affordability.Results: All systems consider health benefit to be the key component of value. There is little consensus around “wider” elements of value that should be included. All systems use budget impact in decision making, although meeting attendees noted the challenges in making accurate estimates. The most common strategies used to address affordability concerns to date have been: restricting coverage, for example, to patients who are likely to get the highest value; discounts; and revenue caps. It was noted that these “solutions” may have unintended consequences of creating inequitable access to therapies and failing to provide adequate rewards for innovation.Conclusions: Decision makers, HTA agencies, and industry need to continue to work together to find mutually agreeable solutions to ensure that patients continue to get equitable access to effective therapies at costs that can be afforded throughout the Asia region.

OP12 2017 Health Technology Assessment International Asia Policy Forum: The Importance Of Universal Health Care

2018 ◽  
Vol 34 (S1) ◽  
pp. 5-6
Author(s):  
Andrew Rintoul ◽  
Rebecca Trowman
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Inappropriate Prescribing ◽  
Health Technology ◽  
World Health ◽  
Universal Health Care ◽  
Policy Forum ◽  
Universal Health

Introduction:The fifth Health Technology Assessment International (HTAi) Asia Policy Forum (APF) was held in Beijing, November 2017. The topic of the meeting was ‘Universal Health Care in the Asia Region: Overcoming the Barriers using HTA and Real World Data’. This presentation will focus on the goal of achieving universal health care (UHC) in the Asia region, and specifically the perspective of the World Health Organization (WHO).Methods:The 2017 HTAi APF had senior representatives from HTA agencies, academia, industry active in the region plus representatives from the WHO Geneva office and the Western Pacific Regional Office. A keynote presentation was delivered by the WHO representative and there were guided breakout group discussions.Results:UHC is a key component of the overall aims and objectives of the WHO; universal access to safe, effective, quality and affordable medicines and vaccines for all is at the heart of this. Pharmaceutical spending varies widely across the Asia region and all countries in the region share common problems in attaining UHC. These include inadequate financing, inefficiencies in procurement and supply chain management, limited use of effective pricing policies and negotiations, substandard quality of medicines and widespread inappropriate prescribing and use.Conclusions:HTA can be used to help countries in the Asia region to achieve UHC; it is a tool to support good decision making and hence can help promote more efficient allocation of limited resources. Affordability, however, needs to be at the center of any decision to invest or disinvest, and incremental cost effectiveness ratios should not be used as the sole basis for decision making.

scholarly journals Breaking up is hard to do: why disinvestment in medical technology is harder than investment

2012 ◽  
Vol 36 (2) ◽  
pp. 148 ◽  
Author(s):  
Marion Haas ◽  
Jane Hall ◽  
Rosalie Viney ◽  
Gisselle Gallego
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Policy Makers ◽  
Healthcare Interventions ◽  
Practice Variations ◽  
The Right

Healthcare technology is a two-edged sword - it offers new and better treatment to a wider range of people and, at the same time, is a major driver of increasing costs in health systems. Many countries have developed sophisticated systems of health technology assessment (HTA) to inform decisions about new investments in new healthcare interventions. In this paper, we question whether HTA is also the appropriate framework for guiding or informing disinvestment decisions. In exploring the issues related to disinvestment, we first discuss the various HTA frameworks which have been suggested as a means of encouraging or facilitating disinvestment. We then describe available means of identifying candidates for disinvestment (comparative effectiveness research, clinical practice variations, clinical practice guidelines) and for implementing the disinvestment process (program budgeting and marginal analysis (PBMA) and related techniques). In considering the possible reasons for the lack of progress in active disinvestment, we suggest that HTA is not the right framework as disinvestment involves a different decision making context. The key to disinvestment is not just what to stop doing but how to make it happen - that is, decision makers need to be aware of funding disincentives. What is known about this topic? Disinvestment is an increasingly popular topic amongst academics and policy makers. Most discussions focus on the need to increase disinvestment as a corollary of investment, the lack of overt disinvestment decisions and the use of a framework based on health technology assessment (HTA) to implement disinvestment. What does this paper add? This paper focusses on the difficulties associated with deciding which technologies to disinvest in, and the problems in using an HTA framework to make such decisions, when disinvestment involves a different decision making context from that of investment. What are the implications for practitioners? The key to disinvestment is not just what to stop doing but how to implement such decisions. Making it happen means being aware of funding disincentives.

OP318 Health Technology Assessment And Decision-Making Processes: The Purchase Of Magnetic Resonance Imaging Technology

2021 ◽  
Vol 37 (S1) ◽  
pp. 13-13
Author(s):  
Maria Maia
Keyword(s):  
Magnetic Resonance Imaging ◽  
Decision Making ◽  
Magnetic Resonance ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Decision Making Process ◽  
Resonance Imaging ◽  
Decision Making Processes

IntroductionMedical devices play an essential role in health care, but they are also a leading causes of increasing healthcare expenditures. The purchase of technologies and the determination of how and when they should be used are among the most important decisions made by decision-makers, at the institutional level.The present research focuses on the Portuguese health system and sheds light on the characterization of decision-making process by those involved in Magnetic Resonance Imaging (MRI) purchases.MethodsTo characterize the decision-making process, results from forty questionnaires and twenty-seven semi-structured interviews with key decision-makers were merged, using a mixed method approach. To assess competences for decision-making, a questionnaire was applied, and Exploratory and Confirmatory Factorial Analysis conducted.ResultsCost and suppliers’ characteristics are seen as the most important indicators to guide decisions. The decision is undertaken by a committee, in a bottom-up process, characterized by a bounded rationality, influenced by intuition and a consultant decision-maker. The reasoning and justification for selection of the committee members is unclear. The decision process is considered to be bureaucratic, time-consuming and long. Patients are negatively perceived as stakeholders in the process. Few studies were performed (mostly related to the workload of the Radiology Department) to support the decision and no national or international health technology assessment (HTA) study was used in the process, to guide decisions. Decision-makers have limited knowledge and training in areas of decision-making in the areas of health informatics, health economics and especially HTA. This may limit their ability to truly understand the future implications of their purchase decisions.ConclusionsTo foster HTA in decision-making processes, recommendations are made, in particular, to: (i) establish an HTA in-house unit, able to carry out studies considering the hospital context and aiming to inform managerial local decisions (ii) promote a team comprised of technology assessment multidisciplinary researchers but also professionals from the health institution able to carry out HTA studies (iii) foster common languages and values to increase uptake of HTA studies.

OP102 Multiple Criteria Decision Analysis In The Field Of Hospital-Based Health Technology Assessment

2018 ◽  
Vol 34 (S1) ◽  
pp. 38-38 ◽  
Author(s):  
Andrey Avdeyev ◽  
Adlet Tabarov ◽  
Amir Akhetov ◽  
Nasrulla Shanazarov ◽  
Aigul Kaptagayeva ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Multiple Criteria ◽  
Decision Makers ◽  
Multiple Criteria Decision Analysis ◽  
Managerial Decision ◽  
Managerial Decision Making ◽  
Health Technologies

Introduction:One of the main tools for Hospital-Based Health Technology Assessment (HB HTA) is the preparation of a mini-health technology assessment (HTA) report. Despite the high value of the results of mini-HTA reports for hospital decision-makers, the classical mini-HTA report does not allow a direct comparison of several health technologies among themselves.Methods:Based on the analysis of international experience of using the principles of multiple-criteria decision analysis (MCDA) in the field of HB HTA, we created and approved our own managerial decision-making model which includes five standardized multiple criteria. The value (weight) of each criterion was defined as the arithmetic mean obtained as a result of interviewing hospital decision-makers and an HTA expert group.Results:Five standardized multiple criteria were included in the structure of our mini-HTA report. These criteria presented the main results of assessment of the viability of implementing new health technologies (HTs) in hospital practice and contain the following: i) Novelty/innovation; ii) Comparative clinical effectiveness and safety; iii) Relevance (demand); iv) Economic effectiveness; and, v) Payback period. We conducted the modeling of various options of HTA results by using multiple criteria, which allowed us to determine the threshold values of the evaluated HTs corresponding to their priority for implementation: i) High priority - HTs are recommended for implementation; ii) Medium priority - HTs can be recommended only if there are sufficient financial resources in hospital; and, iii) Low priority - HTs may be recommended only if there are strong reasons for their need.Conclusions:Integration of the principles of MCDA in the structure of mini-HTA reports gives the opportunity to i) make comparative assessments of implementing new health technologies based on standardized criteria; ii) determine the priority for implementation of newly evaluated health technologies; iii) avoid the influence of subjective factors on the managerial decision-making in hospitals.

PP159 Making Health Technology Assessment A Common Language In Controversies: A Hidden Role For The National Evidence-Based Healthcare Collaborating Agency

2018 ◽  
Vol 34 (S1) ◽  
pp. 128-129
Author(s):  
Jeong-eun Park ◽  
Min Ji Lee ◽  
Eunkyo Park ◽  
Miseong Kim ◽  
Jooyeon Park
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Rapid Review ◽  
Evidence Based ◽  
Common Language ◽  
Deliberative Process ◽  
Evidence Based Healthcare

Introduction:In order to improve research planning it is critical to understand how decision makers have used previous health technology assessment (HTA) results, and what expectations policy makers and health professionals have in HTA programs. In this study, we aimed to examine how HTA results have been used by decision makers, and explore complex relationships between the National Evidence-based Healthcare Collaborating Agency (NECA) and various decision-making bodies in Korea.Methods:Three areas of healthcare decision in which NECA has been extensively involved were selected: prevention programs, single technology reimbursement, and clinical guidelines. We conducted in-depth interviews with two or three key informants from decision making bodies in each selected area. The interview participants included clinicians and government officials. We also conducted interviews with the researchers who participated in the related research to better capture the context. The interviews were analyzed using qualitative content analysis.Results:Eight interviews with decision makers and five interviews with researchers were conducted and analyzed. Three main themes were revealed in the data. Firstly, it was revealed that NECA was primarily expected to be an intermediary between clinicians and government. Both government and clinicians had referred to NECA's HTA results, which are expected to be scientific and impartial, when they need to reach one another on controversial topics. Secondly, there was a high need for deliberative process to resolve the conflicting interests regarding HTA results. Lastly, they wanted the HTA process to be more responsive to fast changing healthcare environments by introducing a form of rapid review.Conclusions:Lack of effective communication channels between government and healthcare providers in Korea has made a room for HTA to be a common language for both sides. It is time to give up the ‘one-size-fits-all’ approach to conducting HTA research and tailor the research process to various needs of decision makers.

VP66 Perception Of Decision Makers And Researchers Towards Health Technology Assessment In Ghana

2017 ◽  
Vol 33 (S1) ◽  
pp. 179-180 ◽  
Author(s):  
Rebecca Addo ◽  
Jane Hall ◽  
Stephen Goodall ◽  
Marion Haas
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Health System ◽  
Human Resource ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Research Approach ◽  
Human Data ◽  
Effective Manner

INTRODUCTION:In recent years, the Ghana health system has been faced with the challenge of financial sustainability. New ways of making decisions in a cost-effective manner that ensure efficient use of available resources is being explored. Consequently, Ghana has been pursuing the formal introduction of Health Technology Assessment (HTA) for decision making in the health system.However, the limited use and impact of HTA on health systems has been associated with reasons including, and not restricted to, the knowledge and perception of decision makers towards it (1-3). Therefore as Ghana gears towards using HTA formally, it is important to assess the knowledge and attitude of potential users and producers of HTA. This will provide useful information for the setting up of an HTA agency.METHODS:A qualitative research approach using in-depth interviews was utilized. Twenty-three decision makers both at the national and district levels, and four researchers were interviewed. Thematic analysis was conducted using NVivo software.RESULTS:Only seven respondents had knowledge about HTA. Respondents perceived HTA differently, and the word ‘technology’, was often misconstrued as a device for communication such as mobile phone. Two main barriers to the use of HTA emerged; lack of resources (human, data, and finance) and politico-cultural issues. To address these barriers respondents recommended that stakeholders be involved in decisions concerning the guidelines for its conduct, composition of the appraisal team, and the focus of HTA. Generating of human, data and financial resources were also indicated.CONCLUSIONS:There is paucity of knowledge about HTA in Ghana. For Ghana to successfully introduce HTA for health decision making and realize its expected benefits, there will be a need to address the perceived barriers in a comprehensive manner. Also, to mitigate data and human resource barrier, Ghana will have to examine the available local data and human resource to build on.

OP11 Findings From The 2017 Health Technology Assessment International Asia Policy Forum Survey

2018 ◽  
Vol 34 (S1) ◽  
pp. 5-5
Author(s):  
Linda Mundy ◽  
Rebecca Trowman ◽  
Brendon Kearney
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Real World ◽  
Health Technology ◽  
Quality Data ◽  
Political Agenda ◽  
Real World Data ◽  
World Data ◽  
Policy Forum

Introduction:Health systems in the Asia region seek to achieve universal health care (UHC) by increasing access to essential healthcare services, while reducing health inequalities and out-of-pocket expenditure. With this in mind, the discussion for the 2017 Health Technology Assessment International (HTAi) Asia Policy Forum (APF) centered around the topic of ‘Universal Healthcare in the Asia Region: Overcoming the Barriers using HTA and Real World Data’.Methods:As part of the background paper prepared to inform discussions at the APF, attendees from public sector HTA agencies from nine countries, and industry attendees from eight companies, were surveyed to explore issues on the barriers and challenges of establishing UHC in the region and use of real world data (RWD).Results:Most countries used evidence-based decision-making when considering which technologies to add to healthcare benefit packages; however, this was at times inconsistently applied. Prioritization criteria included burden of disease, unmet clinical need, clinical effectiveness, cost effectiveness and affordability. The political agenda and deference to expert opinion also played a role. Although all countries reported using RWD to inform decision-making, they also reported issues including lack of capacity, poor quality data and lack of collaboration between private and public sectors, as well as a conservative approach to data-linkage. It became apparent that a disconnect had been identified, as industry overwhelmingly identified access to RWD in the region as a major issue.Conclusions:Discussing the differences in opinion between HTA agencies and industry led to a greater understanding of issues in the Asia region, and will lead to increased dialogue and opportunities to collaborate in the future. Building capacity in the region will assist countries to deliver on their goal of achieving UHC.

OP303 Do You Get The Message? Making HTA Findings Easier For Decision-Makers To Implement

2021 ◽  
Vol 37 (S1) ◽  
pp. 11-11
Author(s):  
Jess Kandulu ◽  
Ed Clifton ◽  
Iain Robertson ◽  
Neil Smart ◽  
Karen Macpherson
Keyword(s):  
Decision Making ◽  
Technology Assessment ◽  
Health Technology ◽  
Evidence Base ◽  
Decision Makers ◽  
Appraisal Committee ◽  
Economic Modelling ◽  
Health Technologies ◽  
Patient Groups ◽  
The Impact

IntroductionOften health technology assessment (HTA) products developed by the Scottish Health Technologies Group (SHTG) did not reach clear directive conclusions because the evidence base for a technology was weak. Despite being methodologically robust, these products did not meet the needs of decision-makers and may have had negligible impact.MethodsSHTG set out to equip and empower the recommendation-making council (that is, appraisal committee) to reach clear conclusions. SHTG broadened the HTA components and types of evidence that could be considered. The increased breadth of evidence included: clinicians attending council meetings to respond to questions; patient groups making submissions and presenting at council meetings; Scotland-specific economic modelling; and consultation on draft recommendations. SHTG also restructured the council for improved deliberative decision-making.ResultsClear directive conclusions were reached in a substantially higher proportion of HTA products (eighty-eight percent in 2019 compared with eight percent in 2017). It became possible for decision-makers to implement findings. It also became feasible to assess the impact and implementation of recommendations.ConclusionsBroadening SHTG's consideration of HTA components has led to a clearer conclusion being reached and stronger messaging for decision makers. This positions SHTG to increase its influence in the use of health technologies in Scotland.

scholarly journals HEALTH TECHNOLOGY ASSESSMENT, VALUE-BASED DECISION MAKING, AND INNOVATION

2013 ◽  
Vol 29 (4) ◽  
pp. 353-359 ◽  
Author(s):  
Chris Henshall ◽  
Tara Schuller
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Health And Social Care ◽  
Patient Health ◽  
Care Systems ◽  
Technology Lifecycle ◽  
The Relationship ◽  
Policy Forum

Background: Identifying treatments that offer value and value for money is becoming increasingly important, with interest in how health technology assessment (HTA) and decision makers can take appropriate account of what is of value to patients and to society, and in the relationship between innovation and assessments of value.Methods: This study summarizes points from an Health Technology Assessment International (HTAi) Policy Forum discussion, drawing on presentations, discussions among attendees, and background papers.Results and Conclusions: Various perspectives on value were considered; most place patient health at the core of value. Wider elements of value comprise other benefits for: patients; caregivers; the health and social care systems; and society. Most decision-making systems seek to take account of similar elements of value, although they are assessed and combined in different ways. Judgment in decisions remains important and cannot be replaced by mathematical approaches. There was discussion of the value of innovation and of the effects of value assessments on innovation. Discussion also included moving toward “progressive health system decision making,” an ongoing process whereby evidence-based decisions on use would be made at various stages in the technology lifecycle. Five actions are identified: (i) development of a general framework for the definition and assessment of value; development by HTA/coverage bodies and regulators of (ii) disease-specific guidance and (iii) further joint scientific advice for industry on demonstrating value; (iv) development of a framework for progressive licensing, usage, and reimbursement; and (v) promoting work to better adapt HTA, coverage, and procurement approaches to medical devices.

scholarly journals Information or Evidence? Abandoning Imaginary Worlds for Blockchains in Health Technology Assessment

2018 ◽  
Vol 9 (3) ◽  
pp. 12
Author(s):  
Paul Langley
Keyword(s):  
Decision Making ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Product Performance ◽  
Sources Of Information ◽  
The Past ◽  
Blockchain Technology ◽  
Article Type ◽  
Recent Developments

Commentaries published in INNOVATIONS in Pharmacy over the past 2 years have made the case that, as a basis for formulary decision making, the construction of imaginary modeled worlds fails to meet the standards of normal science. As such, they should be rejected as a basis for decision-making. While their proponents argue that imaginary constructs are key sources of information for formulary decisions, the fact is that the claims made from those models are impossible to validate. Indeed, they were never intended to be validated. Claims for product performance should be presented in evidentiary terms. That is, they should be credible, evaluable and replicable. If the commitment to imaginary worlds in technology assessment is to be abandoned a key requirement is for platforms that allow claims to be assessed in real time and in a timeframe that is meaningful to decision makers. Recent developments in blockchain technology offer the prospects for platforms that meet criteria for claims assessment.   Article Type: Commentary

Sign in / Sign up

Export Citation Format

Share Document