scholarly journals COST, CONTEXT, AND DECISIONS IN HEALTH ECONOMICS AND HEALTH TECHNOLOGY ASSESSMENT

2018 ◽  
Vol 34 (5) ◽  
pp. 434-441 ◽  
Author(s):  
Anthony J. Culyer
Keyword(s):  
Health Economics ◽  
Health Technology Assessment ◽  
Decision Maker ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Negative Consequences ◽  
Middle Income ◽  
Middle Income Countries ◽  
Context Dependent

Objectives:This study is an attempt to demystify and clarify the idea of cost in health economics and health technology assessment (HTA).Methods:Its method draws on standard concepts in economics. Cost is a more elusive concept than is commonly thought and can be particularly elusive in multidisciplinary territory like HTA.Results:The article explains that cost is more completely defined as opportunity cost, why cost is necessarily associated with a decision, and that it will always vary according to the context of that decision: whether choice is about inputs or outputs, what the alternatives are, the timing of the consequences of the decision, the nature of the commitment to which a decision maker is committed, who the decision maker is, and the constraints and discretion limiting or liberating the decision maker. Distinctions between short and long runs and between fixed and variable inputs are matters of choice, not technology, and are similarly context-dependent. Harms or negative consequences are, in general, not costs. Whether so-called “clinically unrelated” future costs and benefits should be counted in current decisions again depends on context.Conclusions:The costs of entire health programs are context-dependent, relating to planned rates of activity, volumes, and timings. The implications for the methods of HTA are different in the contexts of low- and middle-income countries compared with high-income countries, and further differ contextually according to the budget constraints (fixed or variable) facing decision makers.

scholarly journals Adaptive health technology assessment to facilitate priority setting in low- and middle-income countries

2021 ◽  
Vol 6 (4) ◽  
pp. e004549
Author(s):  
Cassandra Nemzoff ◽  
Francis Ruiz ◽  
Kalipso Chalkidou ◽  
Abha Mehndiratta ◽  
Lorna Guinness ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Priority Setting ◽  
Technology Assessment ◽  
Health Technology ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Principles for deliberative processes in health technology assessment

2020 ◽  
Vol 36 (4) ◽  
pp. 445-452 ◽  
Author(s):  
Kenneth Bond ◽  
Rebecca Stiffell ◽  
Daniel A. Ollendorf
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Group Discussion ◽  
Health Technology ◽  
Deliberative Process ◽  
Middle Income ◽  
Context Sensitive ◽  
Middle Income Countries ◽  
Deliberative Processes ◽  
Large Group Discussion

Deliberative processes are a well-established part of health technology assessment (HTA) programs in a number of high- and middle-income countries, and serve to combine complex sets of evidence, perspectives, and values to support open, transparent, and accountable decision making. Nevertheless, there is little documentation and research to inform the development of effective and efficient deliberative processes, and to evaluate their quality. This article summarizes the 2020 HTAi Global Policy Forum (GPF) discussion on deliberative processes in HTA.Through a combination of small and large group discussion and successive rounds of polling, the GPF members reached strong agreement on three core principles for deliberative processes in HTA: transparency, inclusivity, and impartiality. In addition, discussions revealed other important principles, such as respect, reviewability, consistency, and reasonableness, that may supplement the core set. A number of associated supporting actions for each of the principles are also described in order to make each principle realizable in a given HTA setting. The relative importance of the principles and actions are context-sensitive and must be considered in light of the political, legislative, and operational factors that may influence the functioning of any particular HTA environment within which the deliberative process is situated. The paper ends with suggested concrete next steps that HTA agencies, researchers, and stakeholders might take to move the field forward. The proposed principles and actions, and the next steps, provide a springboard for further research and better documentation of important aspects of deliberation that have historically been infrequently studied.

Health technology assessment in low- and middle-income countries: a landscape assessment

2016 ◽  
Vol 7 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Joseph B. Babigumira ◽  
Alisa M. Jenny ◽  
Rebecca Bartlein ◽  
Andy Stergachis ◽  
Louis P. Garrison
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Landscape Assessment ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Health Technology Assessment in Health Economics

2011 ◽  
pp. 69-86
Author(s):  
Steven Simoens
Keyword(s):  
Health Economics ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Expenditure ◽  
Health Technology ◽  
Decision Makers ◽  
Added Value ◽  
Healthcare Sector ◽  
Scarce Resources ◽  
Health Technologies

This chapter introduces health technology assessment and health economics as tools for decision makers to allocate scarce resources in the healthcare sector. It argues that information about the safety, efficacy and effectiveness, organizational implications, social and ethical consequences, legal considerations, and health economic aspects of the application of a health technology needs to be taken into account with a view to informing decisions about the registration and reimbursement of a health technology. Also, the author hopes that understanding the methodology and use of health technology assessment and health economics will persuade the reader of the added value of such studies and promote the application of health technologies that support further health improvements, whilst containing health expenditure.

scholarly journals Health Technology Assessment capacity development in low- and middle-income countries: Experiences from the international units of HITAP and NICE

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2119 ◽  
Author(s):  
Sripen Tantivess ◽  
Kalipso Chalkidou ◽  
Nattha Tritasavit ◽  
Yot Teerawattananon
Keyword(s):  
Health Technology Assessment ◽  
Priority Setting ◽  
Technology Assessment ◽  
Policy Research ◽  
Health Technology ◽  
The Philippines ◽  
Health Coverage ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Health Technology Assessment (HTA) is policy research that aims to inform priority setting and resource allocation. HTA is increasingly recognized as a useful policy tool in low- and middle-income countries (LMICs), where there is a substantial need for evidence to guide Universal Health Coverage policies, such as benefit coverage, quality improvement interventions and quality standards, all of which aim at improving the efficiency and equity of the healthcare system. The Health Intervention and Technology Assessment Program (HITAP), Thailand, and the National Institute for Health and Care Excellence (NICE), UK, are national HTA organizations providing technical support to governments in LMICs to build up their priority setting capacity. This paper draws lessons from their capacity building programs in India, Colombia, Myanmar, the Philippines, and Vietnam. Such experiences suggest that it is not only technical capacity, for example analytical techniques for conducting economic evaluation, but also management, coordination and communication capacity that support the generation and use of HTA evidence in the respective settings. The learned lessons may help guide the development of HTA capacity in other LMICs.

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