Health technology assessment: Choice between a cytotoxic safety cabinet and an isolator for oncology drug reconstitution in Tunisia

2020 ◽  
pp. 107815522094713
Author(s):  
Manel Boufaied ◽  
Mehdi Bouhlel ◽  
Mohamed Ali Soussi ◽  
Olfa Lazreg ◽  
Myriam Razgallah Khrouf
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Negative Pressure ◽  
Health Technology ◽  
Operating Costs ◽  
Air Treatment ◽  
Oncology Drug ◽  
Purchase Cost ◽  
Implementation Costs ◽  
The One

Introduction In order to implement a centralized cytotoxic reconstitution unit (CCRU), a study was conducted to compare the implementation costs of a CCRU equipped with a cytotoxic safety cabinet (CSC) and one equipped with an isolator with negative pressure. Materials and methods This study compares items such as infrastructure, air treatment and CCRU qualification costs, equipment’s purchase and qualifications costs, as well as staff dressing costs. Two plans were elaborated according to the international recommendations in a way that they respond to the necessary requirements in both cases. Requests for quotes for the compared items were sent to different suppliers. Results The implementations’ cost of a CCRU equipped with a CSC is cheaper than the one equipped with an isolator. The price of an isolator is much higher than a CSC; its qualification is also more expensive. However, the requirements and the costs for the air treatment and the dressing of the staff are less in the case of an isolator. The overall cost of the CCRU’s implementation is approximately 1.3 times higher in the case of an isolator. However, by excluding the equipment purchase cost, the overall cost of a CSC’s implementation becomes higher. Conclusion For Tunisia, it seems that the CSC is the most adapted. However, this work should be completed by the comparison of the CCRU’s operating costs in order to optimize the resources and figure out the cheapest system.

What does meaningful look like? A qualitative study of patient engagement at the Pan-Canadian Oncology Drug Review: perspectives of reviewers and payers

2018 ◽  
Vol 23 (2) ◽  
pp. 72-79 ◽  
Author(s):  
Linda Rozmovits ◽  
Helen Mai ◽  
Alexandra Chambers ◽  
Kelvin Chan
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Patient Engagement ◽  
Patient Advocacy ◽  
Health Technology ◽  
Assessment Process ◽  
Advocacy Groups ◽  
Oncology Drug ◽  
Patient Advocacy Groups ◽  
Drug Review

Objectives While there is wide support for patient engagement in health technology assessment, determining what constitutes meaningful (as opposed to tokenistic) engagement is complex. This paper explores reviewer and payer perceptions of what constitutes meaningful patient engagement in the Pan-Canadian Oncology Drug Review process. Methods Qualitative interview study comprising 24 semi-structured telephone interviews. A qualitative descriptive approach, employing the technique of constant comparison, was used to produce a thematic analysis. Results Submissions from patient advocacy groups were seen as meaningful when they provided information unavailable from other sources. This included information not collected in clinical trials, information relevant to clinical trade-offs and information about aspects of lived experience such as geographic differences and patient and carer priorities. In contrast, patient submissions that relied on emotional appeals or lacked transparency about their own methods were seen as detracting from the meaningfulness of patient engagement by conflating health technology assessment with other functions of patient advocacy groups such as fundraising or public awareness campaigns, and by failing to provide credible information relevant to deliberations. Conclusions This study suggests that misalignment of stakeholder expectations remains an issue even for a well-regarded health technology assessment process that has promoted patient engagement since its inception. Support for the technical capacity of patient groups to participate in health technology assessment is necessary but not sufficient to address this issue fully. There is a fundamental tension between the evidence-based nature of health technology assessment and the experientially oriented culture of patient advocacy. Divergent notions of what constitutes evidence and how it should be used must also be addressed.

scholarly journals Rival perspectives in health technology assessment and other economic evaluations for investing in global and national health. Who decides? Who pays?

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 72 ◽  
Author(s):  
Anthony Culyer ◽  
Kalipso Chalkidou ◽  
Yot Teerawattananon ◽  
Benjarin Santatiwongchai
Keyword(s):  
Health Technology Assessment ◽  
Societal Perspective ◽  
Technology Assessment ◽  
Health Technology ◽  
Economic Evaluations ◽  
First Principle ◽  
Explicit Statement ◽  
The One ◽  
Selection Of ◽  
The Ideal

There seems to be a general agreement amongst practitioners of economic evaluations, including Health Technology Assessment, that the explicit statement of a perspective is a necessary element in designing and reporting research. Moreover, there seems also to be a general presumption that the ideal perspective is “societal”. In this paper we endorse the first principle but dissent from the second. A review of recommended perspectives is presented. The societal perspective is frequently not the one recommended. The societal perspective is shown to be less comprehensive than is commonly supposed, is inappropriate in many contexts and, in any case, is in general not a perspective to be determined independently of the context of a decision problem. Moreover, the selection of a perspective, societal or otherwise, is not the prerogative of analysts.

scholarly journals THE ADDED VALUE OF INTEGRATE-HTA GUIDANCE IN THE WORK PROCESSES OF HEALTH TECHNOLOGY ASSESSMENT AGENCIES

2017 ◽  
Vol 33 (5) ◽  
pp. 597-598 ◽  
Author(s):  
Gert Jan van der Wilt ◽  
Wietske Kievit ◽  
Wija Oortwijn
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Added Value ◽  
Work Processes ◽  
Central Idea ◽  
Policy Relevance ◽  
Perverse Incentives ◽  
Potential Impact ◽  
The One

A central idea underlying the INTEGRATE-HTA project is that many of the interventions that are being used in health care are quite complex. By this, we mean that the relation between the delivery of the intervention on the one hand, and the onset of (desired and undesired) changes may be less straightforward than hoped for. There may be all sorts of reasons for this, varying from a lack of resources, lack of skills, perverse incentives, organizational problems, etc. Not identifying such factors and their potential impact may seriously compromise the policy relevance of a health technology assessment (HTA) (1). However, current approaches and methods in HTA do not seem to be adequately geared to deal with this complexity.

PP015 Methodological Quality Of Health Technology Assessment Reports

2017 ◽  
Vol 33 (S1) ◽  
pp. 74-75
Author(s):  
Elke Hausner ◽  
Marco Knelangen ◽  
Laura Sanders ◽  
Siw Waffenschmidt
Keyword(s):  
Health Care ◽  
Health Technology Assessment ◽  
Systematic Reviews ◽  
Technology Assessment ◽  
Methodological Quality ◽  
Health Technology ◽  
Cochrane Reviews ◽  
Literature Source ◽  
The One

INTRODUCTION:Health Technology Assessment (HTA) reports may have a major impact on the health care provided in a country. Hence, one would assume that these reports have a high methodological quality and thus represent a potentially important source of information, for instance, for identifying primary studies for inclusion in the evidence syntheses (for example, systematic reviews, Cochrane reviews, HTA reports). The aim of the present analysis is to evaluate the methodological quality of HTA reports used as a literature source for HTA reports produced by the German Institute for Quality and Efficiency in Health Care (IQWiG).METHODS:Eligible IQWiG reports were assessments of drug or non-drug interventions considering HTA reports as the literature source for primary studies and published up to October 2016. An HTA report included in the IQWIG report was considered in the analysis if it was a complete report published in English or German and indexed in the Health Technology Assessment Database (Wiley) or MEDLINE. Only the most current HTA report in an IQWiG report was considered; if more than one current HTA report was available, the one for inclusion in the analysis was randomly selected. The methodological quality of the HTA reports identified was evaluated with the AMSTAR (“Assessment of Multiple Systematic Reviews”) tool (1), which comprises 11 items on methodological quality (meaning a maximum achievable score of 11).RESULTS:A total of fifty eligible IQWiG reports using fourty-one eligible HTA reports as literature sources were identified. The mean AMSTAR score of these HTA reports was 5.3 (95 percent Confidence Interval, CI: 4.3, 6.2). None of the HTA reports achieved a score of 11, nineteen (46 percent) had a score between 6 and 10, and twenty-two had a score below 6.CONCLUSIONS:HTA reports included in IQWiG reports only have an average methodological quality.

PP86 Impact Of Health Technology Assessment On Drug Price Negotiations: Canada

2018 ◽  
Vol 34 (S1) ◽  
pp. 98-99
Author(s):  
Angela Rocchi ◽  
Ferg Mills
Keyword(s):  
Health Economics ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Cost Effectiveness Ratio ◽  
Oncology Drug ◽  
Time Period ◽  
Price Negotiations ◽  
Public Drug

Introduction:Subsequent to review by Canada's two central health technology assessment (HTA) agencies, confidential drug prices are negotiated by the pan-Canadian Pharmaceutical Alliance (pCPA) on behalf of public drug plans. This analysis is the first to examine characteristics of drugs considered for negotiation, and the duration of negotiations, from inception in 2011 to August 2017. The objectives were to identify how HTA recommendations impacted price negotiations, and in particular the role of health economics in the process.Methods:The dataset contained 208 drug indications from the pCPA archives: those with a decision to negotiate (n=155) or a decision not to negotiate (n=53). Data were abstracted from the publicly-maintained websites of the respective agencies; descriptive statistics were conducted.Results:There was close but imperfect alignment between the HTA agency listing recommendation and the pCPA's decision to negotiate. The incremental cost-effectiveness ratio (ICER) of negotiated drugs (as estimated by HTA agencies) approached CAD 200,000/QALY (i.e. USD 157,000) for oncology drugs, but was closer to CAD 100,000/QALY (i.e. USD 78,000) for non-oncology drugs, revealing that negotiations would require a substantial discount to achieve conventionally ‘acceptable’ value-for-money. ICERs were influential to non-oncology drug recommendations (and were increasingly used to set pCPA negotiation targets) but did not appear to influence oncology drug HTA recommendations. The time period required to initiate negotiations was dramatically shorter for oncology versus non-oncology drugs (53 versus 263 days), and also differed markedly between therapeutic areas. The time period for pCPA activities was surprisingly similar for drugs recommended without a price condition and for those conditional on a price reduction.Conclusions:These findings revealed an implicit prioritization pattern at the pCPA, as well as the evolving role of health economics in Canada's two-stage reimbursement process.

scholarly journals Health technology assessment in Switzerland

2009 ◽  
Vol 25 (S1) ◽  
pp. 174-177 ◽  
Author(s):  
Pedro Koch ◽  
Julian Schilling ◽  
Marlène Läubli ◽  
Florian Mitscherlich ◽  
Dieter Melchart ◽  
...  
Keyword(s):  
Public Health ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technologies ◽  
Health Technology ◽  
Federal Law ◽  
Public And Private ◽  
Health Technologies ◽  
For Profit ◽  
The One

Objectives and Methods: To review Switzerland's mixed public and private healthcare system with regard to health technology assessment (HTA).Results: In the past, remarkable work in HTA was done. Accomplishments include the following: (i) Switzerland became an early member of the International Network of Agencies for Health Technology Assessment. (ii) HTA has its legal bases in terms of effectiveness, appropriateness, and efficiency. (iii) The federal law allows the introduction of new technologies for a limited time for evaluation. (iv) A Swiss Network for Health Technology Assessment was established. In 2004, federal HTA activities moved from the Swiss Federal Office “of Social Security” to the one for “Public Health.” The Office mainly mandates, manages, and coordinates evaluations attached to its prevention and intervention sections in the fields of AIDS, illegal drugs, and legal drugs.Conclusions: Because of the absence of a governmental institution assessing and reporting on new health technologies, private and for profit organizations became more important for the decision-making processes. In a regulated market, the implications may be crucial for the public health.

REPORT FROM THE CATALAN AGENCY FOR HEALTH TECHNOLOGY ASSESSMENT (CAHTA)

1999 ◽  
Vol 15 (1) ◽  
pp. 266-267
Author(s):  
Seymour Perry
Keyword(s):  
Primary Care ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Scientific Evidence ◽  
Care Program ◽  
Health Technology ◽  
Level Of Care ◽  
Gynecology And Obstetrics ◽  
Obstetric Ultrasonography ◽  
The One

In Catalonia, ultrasonographic control of pregnancies is carried out in hospitals and in certain primary care centers within the women's care program. There is no scientific evidence on its efficacy in the improvement of the fetal viability at this level of care; therefore, the question of whether obstetric ultrasonography is efficacious and safe in primary care cannot be answered properly to recommend its application. However, it may be assessed whether routine ultrasonography, the one expected to be carried away in primary care centers, is more effective than selective ultrasonography, i.e., the one carried away in the referential gynecology and obstetrics service due to risk conditions during the pregnancy.

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