The link between health technology assessment and decision making for the allocation of health resources in Latin America

2020 ◽  
Vol 36 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Andrés Pichon-Riviere ◽  
Federico Augustovski ◽  
Sebastián García Martí ◽  
Verónica Alfie ◽  
Laura Sampietro-Colom
Keyword(s):  
Decision Making ◽  
Latin America ◽  
Health Technology Assessment ◽  
Latin American ◽  
Technology Assessment ◽  
Design Thinking ◽  
Good Practice ◽  
Health Resources ◽  
Health Technology ◽  
Assessment Process

AbstractObjectiveOne of the good practice principles for health technology assessment (HTA) is having a clear link between the assessment and decision making. The objective of the 2019 Latin American Policy Forum (LatamPF) of Health Technology Assessment International was to explore different models of connection between HTA and decision making and to discuss the potential applicability of such models in Latin America.MethodsThis paper is based on a background document and the deliberations of the members of the LatamPF (fifty-four participants from twelve countries) where a design-thinking methodology was used.ResultsThe participants agreed that insufficient links between HTA and decision making undermine the legitimacy of decisions, expose the HTA process to excessive political and judicial influence, and promote the exclusion of some stakeholders from participating in the assessment process and decision making. High priority aspects of the HTA process that could feasibly be improved and which hold the greatest potential to generate positive changes in the health systems in the region were identified. The majority of these aspects were associated with the appropriate institutionalization of HTA, a greater degree of participation by different stakeholders, and improved transparency in the HTA process.ConclusionsThe LatamPF identified barriers and recommended actions to strengthen the link between HTA and decision making. Participants emphasized that there is now a window of opportunity in the region as many societal actors see this as a priority. For this reason, health system stakeholders must take this opportunity to increase efforts toward strengthening the link between HTA and decision making.

scholarly journals HEALTH TECHNOLOGY ASSESSMENT FOR DECISION MAKING IN LATIN AMERICA: GOOD PRACTICE PRINCIPLES

2018 ◽  
Vol 34 (3) ◽  
pp. 241-247 ◽  
Author(s):  
Andrés Pichon-Riviere ◽  
Natalie C. Soto ◽  
Federico Ariel Augustovski ◽  
Sebastián García Martí ◽  
Laura Sampietro-Colom
Keyword(s):  
Decision Making ◽  
Latin America ◽  
Health Technology Assessment ◽  
Latin American ◽  
Technology Assessment ◽  
Good Practice ◽  
Health Technology ◽  
International Level ◽  
Deliberative Process ◽  
Main Challenge

Objectives:The aim of this study was to identify good practice principles for health technology assessment (HTA) that are the most relevant and of highest priority for application in Latin America and to identify potential barriers to their implementation in the region.Methods:HTA good practice principles proposed at the international level were identified and then explored during a deliberative process in a forum of assessors, funders, and product manufacturers.Results:Forty-two representatives from ten Latin American countries participated. Good practice principles proposed at the international level were considered valid and potentially relevant to Latin America. Five principles were identified as priority and with the greatest potential to be strengthened at this time: transparency in the production of HTA, involvement of relevant stakeholders in the HTA process, mechanisms to appeal decisions, clear priority-setting processes in HTA, and a clear link between HTA and decision making. The main challenge identified was to find a balance between the application of these principles and the available resources in a way that would not detract from the production of reports and adaptation to the needs of decision makers.Conclusions:The main recommendation was to progress gradually in strengthening HTA and its link to decision making by developing appropriate processes for each country, without trying to impose, in the short-term, standards taken from examples at the international level without adequate adaptation of these to local contexts.

scholarly journals Identification and selection of health technologies for assessment by agencies in support of reimbursement decisions in Latin America

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Andrés Pichon-Riviere ◽  
Federico Augustovski ◽  
Sebastián García Martí ◽  
Andrea Alcaraz ◽  
Verónica Alfie ◽  
...  
Keyword(s):  
Latin America ◽  
Health Technology Assessment ◽  
Latin American ◽  
Technology Assessment ◽  
Design Thinking ◽  
Burden Of Illness ◽  
Good Practice ◽  
Health Technology ◽  
Health Priorities ◽  
Health Technologies

Abstract Objective There is no health system that has the resources to evaluate all technologies. The presence of a clear process to prioritize health technologies for assessment by health technology assessment (HTA) agencies is a good practice principle recognized at the international level. The objective of Health Technology Assessment International's 2020 Latin American Policy Forum (LatamPF) was to explore how to improve the way HTA agencies in Latin America identify and prioritize technologies for assessment. Methods This paper is based on a background document, a survey, and the deliberations of the members of the LatamPF (forty-six participants from eleven countries) using a design thinking methodology. Results Participants agreed that a lack of clear prioritization mechanisms results in HTA processes and decisions that are perceived to be of low transparency and overly exposed to political or interest group pressures. The LatamPF identified barriers and recommended actions to improve HTA prioritization mechanisms in Latin America. The criteria identified as the most important to be taken into consideration by HTA agencies in the region when prioritizing a technology for assessment were: the burden of illness, the potential clinical benefit, the alignment with national health priorities, the potential impact on equity, a lack of treatment alternatives for patients, and the potential economic impact. Conclusions Forum participants agreed that the establishment of transparent prioritization processes is a key element for all health systems. Improvements in these processes will strengthen HTA and provide greater legitimacy to decision making.

STAKEHOLDER INVOLVEMENT IN THE HEALTH TECHNOLOGY ASSESSMENT PROCESS IN LATIN AMERICA

2018 ◽  
Vol 34 (3) ◽  
pp. 248-253 ◽  
Author(s):  
Andres Pichon-Riviere ◽  
Natalie Soto ◽  
Federico Augustovski ◽  
Laura Sampietro-Colom
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Latin American ◽  
Technology Assessment ◽  
Private Insurance ◽  
Stakeholder Involvement ◽  
Health Technology ◽  
Assessment Process ◽  
Health Coverage ◽  
Key Issues

Objectives:Latin American countries are taking important steps to expand and strengthen universal health coverage, and health technology assessment (HTA) has an increasingly prominent role in this process. Participation of all relevant stakeholders has become a priority in this effort. Key issues in this area were discussed during the 2017 Latin American Health Technology Assessment International (HTAi) Policy Forum.Methods:The Forum included forty-one participants from Latin American HTA agencies; public, social security, and private insurance sectors; and the pharmaceutical and medical device industry. A background paper and presentations by invited experts and Forum members supported discussions. This study presents a summary of these discussions.Results:Stakeholder involvement in HTA remains inconsistently implemented in the region and few countries have established formal processes. Participants agreed that stakeholder involvement is key to improve the HTA process, but the form and timing of such improvements must be adapted to local contexts. The legitimization of both HTA and decision-making processes was identified as one of the main reasons to promote stakeholder involvement; but to be successful, the entire system of assessment and decision making must be properly staffed and organized, and certain basic conditions must be met, including transparency in the HTA process and a clear link between HTA and decision making.Conclusions:Participants suggested a need for establishing clear rules of participation in HTA that would protect HTA producers and decision makers from potentially distorting external influences. Such rules and mechanisms could help foster trust and credibility among stakeholders, supporting actual involvement in HTA processes.

GUIDING PRINCIPLES FOR GOOD PRACTICES IN HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT UNITS

2015 ◽  
Vol 31 (6) ◽  
pp. 457-465 ◽  
Author(s):  
Laura Sampietro-Colom ◽  
Krzysztof Lach ◽  
Iris Pasternack ◽  
Jean-Blaise Wasserfallen ◽  
Americo Cicchetti ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Large Scale ◽  
Good Practice ◽  
Policy Decision ◽  
Health Technology ◽  
Assessment Process ◽  
Local Context ◽  
Good Practices ◽  
Guiding Principles

Objectives: Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA units.Methods: A framework for good practice criteria was built inspired by the EFQM excellence business model and information from six literature reviews, 107 face-to-face interviews, forty case studies, large-scale survey, focus group, Delphi survey, as well as local and international validation. In total, 385 people from twenty countries have participated in defining the principles for good practices in HB-HTA units.Results: Fifteen guiding principles for good practices in HB-HTA units are grouped in four dimensions. Dimension 1 deals with principles of the assessment process aimed at providing contextualized information for hospital decision makers. Dimension 2 describes leadership, strategy and partnerships of HB-HTA units which govern and facilitate the assessment process. Dimension 3 focuses on adequate resources that ensure the operation of HB-HTA units. Dimension 4 deals with measuring the short- and long-term impact of the overall performance of HB-HTA units. Finally, nine core guiding principles were selected as essential requirements for HB-HTA units based on the expertise of the HB-HTA units participating in the project.Conclusions: Guiding principles for good practices set up a benchmark for HB-HTA because they represent the ideal performance of HB-HTA units; nevertheless, when performing HTA at hospital level, context also matters; therefore, they should be adapted to ensure their applicability in the local context.

scholarly journals Multi-criteria Decision Analysis for Health Technology Assessment of Intensive Care Ventilators for Pediatric Patients.

2021 ◽  
Author(s):  
Martina Andellini ◽  
Francesco Faggiano ◽  
Sergio Giuseppe Picardo ◽  
Giuseppina Testa ◽  
Daniela Perrotta ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Pediatric Patients ◽  
Healthcare Setting ◽  
Health Technology ◽  
Assessment Process ◽  
Decision Making Process ◽  
Support Tool

Abstract BackgroundThe technological complexity and heterogeneity of intensive care ventilator models currently available on the market together with the heterogeneity in pediatric patients (0 to 18 years old), make the choice of the best machine for pediatric healthcare setting crucial.This paper is aimed at addressing all the critical aspects linked to the implementation of intensive care ventilators in a pediatric setting, highlighting the most relevant technical features and describing the methodology to conduct health technology assessment (HTA) for supporting the decision-making process.Four ventilators models were included in the assessment process. A decision-making support tool (DoHTA method) based on Analytic Hierarchy Process, was applied. 28 Key Performance Indicators (KPIs) were identified, defining the safety, clinical effectiveness, organizational, technical, and economic aspects. The Performance scores of each ventilator have been measured with respect to KPIs integrated with the total cost of ownership (TCO) analysis, leading to a final rank of the four possible technological solutions. ResultsThe final technologies’ performance scores reflected a deliver valued, contextualized, and shared outputs, detecting the most performant technological solution for the specific hospital context. HTA results had informed and supported the pediatric hospital decision-making process. ConclusionsThis study, identifying and discussing the pros and cons of innovative features of ventilators and all the evaluation criteria and aspects to be taken into account during the evaluation process, can be considered as a valuable proof of evidence as well as a reliable and transferable method for conducting a decision making process in a hospital context.

Are Key Principles for improved health technology assessment supported and used by health technology assessment organizations?

2010 ◽  
Vol 26 (1) ◽  
pp. 71-78 ◽  
Author(s):  
◽  
Peter J. Neumann ◽  
Michael F. Drummond ◽  
Bengt Jönsson ◽  
Bryan R. Luce ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Societal Perspective ◽  
Technology Assessment ◽  
Working Group ◽  
Good Practice ◽  
Health Technology ◽  
Wide Range ◽  
Decision Making Processes

Previously, our group—the International Working Group for HTA Advancement—proposed a set of fifteen Key Principles that could be applied to health technology assessment (HTA) programs in different jurisdictions and across a range of organizations and perspectives. In this commentary, we investigate the extent to which these principles are supported and used by fourteen selected HTA organizations worldwide. We find that some principles are broadly supported: examples include being explicit about HTA goals and scope; considering a wide range of evidence and outcomes; and being unbiased and transparent. Other principles receive less widespread support: examples are addressing issues of generalizability and transferability; being transparent on the link between HTA findings and decision-making processes; considering a full societal perspective; and monitoring the implementation of HTA findings. The analysis also suggests a lack of consensus in the field about some principles—for example, considering a societal perspective. Our study highlights differences in the uptake of key principles for HTA and indicates considerable room for improvement for HTA organizations to adopt principles identified to reflect good HTA practices. Most HTA organizations espouse certain general concepts of good practice—for example, assessments should be unbiased and transparent. However, principles that require more intensive follow-up—for example, monitoring the implementation of HTA findings—have received little support and execution.

VP30 Research And Analysis Of European Health Technology Assessment Processes

2017 ◽  
Vol 33 (S1) ◽  
pp. 161-161
Author(s):  
Julia Sus ◽  
Zoe Garrett
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Medical Devices ◽  
Technology Assessment ◽  
Health Technology ◽  
General Information ◽  
Assessment Process ◽  
Joint Production ◽  
Member States ◽  
Horizon Scanning

INTRODUCTION:As part of the European Network for Health Technology Assessment (EUnetHTA) Joint Action 3, the National Institute for Health and Care Excellence (NICE) in collaboration with forty-nine Health Technology Assessment (HTA) agencies and payer organizations, is leading on research to gain a high level understanding of HTA processes across Europe. This will help to facilitate improved collaboration and use of EUnetHTA HTA reports and tools across member states and decrease the duplication of work.To analyze the similarities and differences in HTA processes and decision making on the reimbursement of pharmaceuticals and medical devices across Europe.METHODS:National agencies involved in the HTA and reimbursement processes shared data on HTA and decision-making processes. Data provided was extracted into an excel workbook including information relating to pharmaceuticals, medical devices, inpatient and outpatient care and assessments that inform reimbursement, pricing and other processes.RESULTS:Thirty-one countries provided fifty-eight sets of HTA process and procedural documents for both medical devices and pharmaceuticals. This information was translated into the workbook which consisted of eleven sections (general information, capacity, overview of the process, topic selection, assessment process, advice and decision making, legal and procedural issues, reassessment, stakeholders engagement, HTA information used and HTA information held).The first stage of data analysis is a descriptive write up of existing processes from horizon scanning and topic selection up to decision making. The second stage is an analysis showing how collaboration and use of EUnetHTA outputs can be implemented into existing processes. An additional questionnaire will be developed to gain further understanding of EUnetHTA partners views on national engagement in the EUnetHTA procedures, implications of joint production, what EUnetHTA products are most valued and what mechanism might support better information sharing and more efficient use of HTA reports between jurisdictions.CONCLUSIONS:The analysis of the above data will provide detailed information on how EUnetHTA products or HTA products from other jurisdictions could be introduced into HTA and reimbursement processes across member states and at what point could EUnetHTA partners best engage in joint and cooperative work.

scholarly journals Health Technology Assessment of Intensive Care Ventilators for Pediatric Patients

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 986
Author(s):  
Martina Andellini ◽  
Francesco Faggiano ◽  
Sergio Giuseppe Picardo ◽  
Giuseppina Testa ◽  
Daniela Perrotta ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Evaluation Criteria ◽  
Clinical Effectiveness ◽  
Health Technology ◽  
Assessment Process ◽  
Decision Making Process ◽  
Support Tool

This paper is aimed at addressing all the critical aspects linked to the implementation of intensive care ventilators in a pediatric setting, highlighting the most relevant technical features and describing the methodology to conduct health technology assessment (HTA) for supporting the decision-making process. Four ventilator models were included in the assessment process. A decision-making support tool (DoHTA method) was applied. Twenty-eight Key Performance Indicators (KPIs) were identified, defining the safety, clinical effectiveness, organizational, technical, and economic aspects. The Performance scores of each ventilator have been measured with respect to KPIs integrated with the total cost of ownership analysis, leading to a final rank of the four possible technological solutions. The final technologies’ performance scores reflected a deliver valued, contextualized, and shared outputs, detecting the most performant technological solution for the specific hospital context. HTA results had informed and supported the pediatric hospital decision-making process. This study, critically identifying the pros and cons of innovative features of ventilators and the evaluation criteria and aspects to be taken into account during HTA, can be considered as a valuable proof of evidence as well as a reliable and transferable method for conducting decision-making processes in a hospital context.

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