Innovative medical devices and hospital decision making: a study comparing the views of hospital pharmacists and physicians

2016 ◽  
Vol 40 (3) ◽  
pp. 257 ◽  
Author(s):  
Mathilde Billaux ◽  
Isabelle Borget ◽  
Patrice Prognon ◽  
Judith Pineau ◽  
Nicolas Martelli
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Medical Devices ◽  
Technology Assessment ◽  
Evaluation Criteria ◽  
Health Technology ◽  
Local Health ◽  
University Hospitals ◽  
Hospital Pharmacists ◽  
Current Practices

Objectives Many university hospitals have developed local health technology assessment processes to guide informed decisions about new medical devices. However, little is known about stakeholders’ perceptions and assessment of innovative devices. Herein, we investigated the perceptions regarding innovative medical devices of their chief users (physicians and surgeons), as well as those of hospital pharmacists, because they are responsible for the purchase and management of sterile medical devices. We noted the evaluation criteria used to assess and select new medical devices and suggestions for improving local health technology assessment processes indicated by the interviewees. Methods We randomly selected 18 physicians and surgeons (nine each) and 18 hospital pharmacists from 18 French university hospitals. Semistructured interviews were conducted between October 2012 and August 2013. Responses were coded separately by two researchers. Results Physicians and surgeons frequently described innovative medical devices as ‘new’, ‘safe’ and ‘effective’, whereas hospital pharmacists focused more on economic considerations and considered real innovative devices to be those for which no equivalent could be found on the market. No significant difference in evaluation criteria was found between these groups of professionals. Finally, hospital pharmacists considered the management of conflicts of interests in local health technology assessment processes to be an issue, whereas physicians and surgeons did not. Conclusions The present study highlights differences in perceptions related to professional affiliation. The findings suggest several ways in which current practices for local health technology assessment in French university hospitals could be improved and studied. What is known about the topic? Hospitals are faced with ever-growing demands for innovative and costly medical devices. To help hospital management deal with technology acquisition issues, hospital-based health technology assessment has been developed to support decisions. However, little is known about the different perceptions of innovative medical devices among practitioners and how different perceptions may affect decision making. What does this paper add? This paper compares and understands the perceptions of two groups of health professionals concerning innovative devices in the university hospital environment. What are the implications for practitioners? Such a comparison of viewpoints could facilitate improvements in current practices and decision-making processes in local health technology assessment for these medical products.

INTRODUCTION OF INNOVATIVE MEDICAL DEVICES AT FRENCH UNIVERSITY HOSPITALS: AN OVERVIEW OF HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT INITIATIVES

2015 ◽  
Vol 31 (1-2) ◽  
pp. 12-18 ◽  
Author(s):  
Nicolas Martelli ◽  
Mathilde Billaux ◽  
Isabelle Borget ◽  
Judith Pineau ◽  
Patrice Prognon ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Medical Device ◽  
Medical Devices ◽  
Technology Assessment ◽  
Health Technology ◽  
Local Health ◽  
University Hospitals ◽  
Health Technologies ◽  
Management Processes

Objectives: Local health technology assessment (HTA) to determine whether new health technologies should be adopted is now a common practice in many healthcare organizations worldwide. However, little is known about hospital-based HTA activities in France. The objective of this study was to explore hospital-based HTA activities in French university hospitals and to provide a picture of organizational approaches to the assessment of new and innovative medical devices.Methods: Eighteen semi-structured interviews with hospital pharmacists were conducted from October 2012 to April 2013. Six topics were discussed in depth: (i) the nature of the institution concerned; (ii) activities relating to innovative medical devices; (iii) the technology assessment and decision-making process; (iv) the methodology for technology assessment; (v) factors likely to influence decisions and (vi) suggestions for improving the current process. The interview data were coded, collated and analyzed statistically.Results: Three major types of hospital-based HTA processes were identified: medical device committees, innovation committees, and “pharmacy & management” processes. HTA units had been set up to support medical device and innovation committees for technology assessment. Slow decision making was the main limitation to both these committee-based approaches. As an alternative, “pharmacy & management” processes emerged as a means of rapidly obtaining a formal assessment.Conclusions: This study provides an overview of hospital-based HTA initiatives in France. We hope that it will help to promote hospital-based HTA activities in France and discussions about ways to improve and harmonize practices, through the development of national guidelines and/or a French mini-HTA tool, for example.

HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT FOR INNOVATIVE MEDICAL DEVICES IN UNIVERSITY HOSPITALS AND THE ROLE OF HOSPITAL PHARMACISTS: LEARNING FROM INTERNATIONAL EXPERIENCE

2013 ◽  
Vol 29 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Nicolas Martelli ◽  
Anne-Sophie Lelong ◽  
Patrice Prognon ◽  
Judith Pineau
Keyword(s):  
Health Technology Assessment ◽  
Medical Devices ◽  
Technology Assessment ◽  
Success Factors ◽  
Health Technology ◽  
University Hospitals ◽  
Hospital Pharmacists ◽  
New Perspective ◽  
Future Hospital

Objectives: Several models of hospital-based health technology assessment (HTA) have been developed worldwide, for the introduction of innovative medical devices and support evidence-based decision making in hospitals. Two such models, the HTA unit and mini-HTA models, are widespread in university hospitals and involve various stakeholders. The purpose of this work was to highlight the potential role of hospital pharmacists in hospital-based HTA activities.Methods: We searched for articles, reviews, and letters relating to hospital-based HTA, as defined by the Hospital-Based Health Technology Assessment Worldwide Surveypublished by the Health Technology Assessment International (HTAi) Society, in the Health Technology Assessment database, MEDLINE, EMBASE, and hospital pharmacyjournals.Results: The number of university hospitals performing hospital-based HTA has increased since the 2008 Hospital-Based Health Technology Assessment Worldwide Survey. Our own experience and international findings show that hospital pharmacists already contribute to hospital-based HTA activities and have developed study interpretation skills and a knowledge of medical devices.Conclusions: Promoting multidisciplinary approaches is one of the key success factors in hospital-based HTA. Hospital pharmacists occupy a position between hospital managers, clinicians, health economists, biomedical engineers, and patients and can provide a new perspective. In the future, hospital pharmacists are likely to become increasingly involved in hospital-based HTA activities.

HARMONIZING HEALTH TECHNOLOGY ASSESSMENT PRACTICES IN UNIVERSITY HOSPITALS: TO WHAT EXTENT IS THE MINI-HTA MODEL SUITABLE IN THE FRENCH CONTEXT?

2017 ◽  
Vol 33 (2) ◽  
pp. 307-314 ◽  
Author(s):  
Nicolas Martelli ◽  
Capucine Devaux ◽  
Hélène van den Brink ◽  
Mathilde Billaux ◽  
Judith Pineau ◽  
...  
Keyword(s):  
Decision Support ◽  
Health Technology Assessment ◽  
Medical Devices ◽  
Technology Assessment ◽  
Health Technology ◽  
Similarity Coefficients ◽  
University Hospitals ◽  
Common Basis ◽  
Decision Support Models ◽  
Individual Use

Background: The number of new medical devices for individual use that are launched annually exceeds the assessment capacity of the French national health technology assessment (HTA) agency. This has resulted in hospitals, and particularly university hospitals (UHs), developing hospital-based HTA initiatives to support their decisions for purchasing innovative devices. However, the methodologies used in such hospitals have no common basis. The aim of this study was to assess a mini-HTA model as a potential solution to harmonize HTA methodology in French UHs.Methods: A systematic review was conducted on Medline, Embase, Health Technology Assessment database, and Google Scholar to identify published articles reporting the use of mini-HTA tools and decision support-like models. A survey was also carried out in eighteen French UHs to identify in-house decision support tools. Finally, topics evaluated in the Danish mini-HTA model and in French UHs were compared using Jaccard similarity coefficients.Results: Our findings showed differences between topics evaluated in French UHs and those assessed in decision support models from the literature. Only five topics among the thirteen most evaluated in French UHs were similar to those assessed in the Danish mini-HTA model. The organizational and ethical/social impacts were rarely explored among the surveyed models used in French UHs when introducing new medical devices.Conclusions: Before its widespread and harmonized use in French UHs, the mini-HTA model would first require adaptations to the French context.

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.

HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT FOR THE ADOPTION OF INNOVATIVE MEDICAL DEVICES WITHIN FRENCH HOSPITALS: OPPORTUNITIES AND CHALLENGES FOR INDUSTRY

2017 ◽  
Vol 33 (2) ◽  
pp. 297-302 ◽  
Author(s):  
Camille Dutot ◽  
Grégoire Mercier ◽  
Isabelle Borget ◽  
Côme de Sauvebeuf ◽  
Nicolas Martelli
Keyword(s):  
Health Technology Assessment ◽  
Medical Devices ◽  
Technology Assessment ◽  
Market Access ◽  
National Level ◽  
Health Technology ◽  
Primary Role ◽  
University Hospitals ◽  
Pilot Survey ◽  
Managerial Decisions

Objectives:Within French university hospitals, some internal committees are in charge of conducting hospital-based health technology assessment (Hb-HTA) to support managerial decisions regarding the adoption of innovations. For manufacturers, hospitals are usually the entry point for new and innovative medical devices, which cannot be accessed without the Hb-HTA committees' approval. Thus, the main objective of this pilot survey was to explore manufacturers’ insights into Hb-HTA processes.Methods:A two-step pilot survey was conducted in 2014. First, semi-structured phone interviews were carried out to capture manufacturers' feedback on the Hb-HTA procedure. Second, a prospective and iterative questionnaire designed to explore manufacturers’ market access strategies was administered.Results:Eight manufacturers from the medical device industry completed the retrospective phone interviews, and five of them participated in the prospective survey. According to the overall feedback, the Hb-HTA process timeline and transparency are major issues, and the expectations of internal committees, especially in terms of clinical evidence, remain difficult to understand. However, despite this and due to the complexity of reimbursement processes at the national level, manufacturers are increasingly considering hospital adoption through Hb-HTA submission as a viable market access and coverage opportunity.Conclusions:Our study reaffirms the primary role of hospitals in the diffusion of innovative medical devices. However, to ensure efficient and broad access to innovation, cooperation between local and national HTA bodies is critical and should be promoted.

scholarly journals Health technology assessment in sub-Saharan Africa: a descriptive analysis and narrative synthesis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Samantha Hollingworth ◽  
Ama Pokuaa Fenny ◽  
Su-Yeon Yu ◽  
Francis Ruiz ◽  
Kalipso Chalkidou
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Technical Assistance ◽  
Health Technology ◽  
Sub Saharan Africa ◽  
Main Theme ◽  
Narrative Synthesis ◽  
Policy Makers ◽  
Sub Saharan

Abstract Background Countries in Sub-Saharan Africa (SSA) are moving towards universal health coverage. The process of Health Technology Assessment (HTA) can support decisions relating to benefit package design and service coverage. HTA involves institutional cooperation with agreed methods and procedural standards. We systematically reviewed the literature on policies and capacity building to support HTA institutionalisation in SSA. Methods We systematically reviewed the literature by searching major databases (PubMed, Embase, etc.) until June 2019 using terms considering three aspects: HTA; health policy, decision making; and SSA. We quantitatively extracted and descriptively analysed content and conducted a narrative synthesis eliciting themes from the selected literature, which varied in study type and apporach. Results Half of the 49 papers identified were primary research studies and mostly qualitative. Five countries were represented in six of ten studies; South Africa, Ghana, Uganda, Cameroon, and Ethiopia. Half of first authors were from SSA. Most informants were policy makers. Five themes emerged: (1) use of HTA; (2) decision-making in HTA; (3) values and criteria for setting priority areas in HTA; (4) involving stakeholders in HTA; and (5) specific examples of progress in HTA in SSA. The first one was the main theme where there was little use of evidence and research in making policy. The awareness of HTA and economic evaluation was low, with inadequate expertise and a lack of local data and tools. Conclusions Despite growing interest in HTA in SSA countries, awareness remains low and HTA-related activities are uncoordinated and often disconnected from policy. Further training and skills development are needed, firmly linked to a strategy focusing on strengthening within-country partnerships, particularly among researchers and policy makers. The international community has an important role here by supporting policy- relevant technical assistance, highlighting that sustainable financing demands evidence-based processes for effective resource allocation, and catalysing knowledge-sharing opportunities among countries facing similar challenges.

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