scholarly journals The Potential for Early Health Economic Modelling in Health Technology Assessment and Reimbursement DecisionMaking Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling"

2020 ◽  
Author(s):  
Hansoo Kim ◽  
Stephen Goodall ◽  
Danny Liew
Keyword(s):  
Health Economic ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Economic Modelling ◽  
Broad Perspective ◽  
Health Technologies ◽  
Early Health ◽  
Health Economic Modelling

Grutters et al recently investigated the role of early health economic modelling of health technologies by undertaking a secondary analysis of health economic modelling assessments performed by their group. Our commentary offers a broad perspective on the potential utility of early health economic modelling to inform health technology assessment (HTA) and decision-making around reimbursement of new health technologies. Further we provide several examples to compliment Grutters and colleagues’ observations.

scholarly journals It’s Not the Model, It’s the Way You Use It: Exploratory Early Health Economics Amid Complexity Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modelling"

2020 ◽  
Author(s):  
Andrew Partington ◽  
Jonathan Karnon
Keyword(s):  
Health Economic ◽  
Complex Interventions ◽  
Healthcare Services ◽  
Economic Modelling ◽  
Learning And Development ◽  
Health Technologies ◽  
Significant Disagreement ◽  
Early Health ◽  
Health Economic Modelling

In a review recently published in this journal, Grutters et al outline the scope and impact of their early health economic modelling of healthcare innovations. Their reflections shed light on ways that health economists can shift-away from traditional reimbursement decision-support, towards a broader role of facilitating the exploration of existing care pathways, and the design of options to implement or discontinue healthcare services. This is a crucial role in organisations that face constant pressure to react and adapt with changes to their existing service configurations, but where there may exist significant disagreement and uncertainty on the extent to which change is warranted. Such dynamics are known to create complex implementation environments, where changes risk being poorly implemented or fail to be sustained. In this commentary, we extend the discussion by Grutters et al on early health economic modelling, to the evaluation of complex interventions and systems. We highlight how early health economic modelling can contribute to a participatory approach for ongoing learning and development within healthcare organisations.

Health technology assessment in Australia: a role for clinical registries?

2017 ◽  
Vol 41 (1) ◽  
pp. 19 ◽  
Author(s):  
Anna Mae Scott
Keyword(s):  
Cost Effectiveness ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Medical Procedures ◽  
Policy Decisions ◽  
Health Technologies ◽  
Clinical Registries ◽  
Public Subsidy

Objective Health technology assessment (HTA) is a process of assessing evidence to inform policy decisions about public subsidy of new drugs and medical procedures. Where evidence is uncertain but the technology itself is promising, funders may recommend funding on an interim basis. It is unknown whether evidence from clinical registries is used to resolve uncertainties identified in interim-funded decisions made by Australian HTA bodies. Therefore, the present study evaluated the role of evidence from clinical registries in resolving evidence uncertainties identified by the Medical Services Advisory Committee (MSAC). Methods All HTAs considered by MSAC between 1998 and 2015 were reviewed and assessments that recommended interim funding were identified. The MSAC website was searched to identify reassessments of these recommendations and sources of evidence used to resolve the uncertainties were identified. Results Of 173 HTA reports considered by MSAC, 17 (10%) contained an interim funding recommendation. Eight recommendations cited uncertainty around safety, 15 cited uncertainty around clinical effectiveness and 13 cited uncertainty around economics (cost-effectiveness and/or budget impact). Of the 17 interim funding recommendations, 11 (65%) have been reassessed. Only two reassessments relied on clinical registry evidence to resolve evidence gaps identified at the time of the interim funding recommendation. Conclusions Clinical registries are underused as a source of evidence for resolving uncertainties around promising new health technologies in Australia. An open dialogue between stakeholders on the role of registries in this context is needed. What is known about the topic? HTA is a process of assessing the evidence to inform policy decisions about public subsidy of new health technologies (e.g. pharmaceuticals, diagnostic tests, medical procedures). Where evidence is uncertain but the technology under evaluation is promising, funders may recommend the funding of the technology on a temporary basis while additional evidence is collected. Clinical registries have been suggested as a means of collecting additional evidence in these situations. What is does this paper add? It is currently unknown whether evidence from clinical registries is used to resolve uncertainties identified at the time that temporary (interim) funding decisions are made by Australia’s HTA bodies, in particular MSAC. The present study found that MSAC rarely relies on the interim funding mechanism (17/173 assessments). Of the 11 subsequent reassessments of interim recommendations, two relied on registry evidence to provide Australian-specific data for addressing uncertainties around long-term safety, effectiveness and cost-effectiveness. These findings suggest that clinical registries, although a feasible source of evidence for HTAs, are rarely used for this purpose. What are the implications for practitioners? Given the registries’ ability to resolve both a wider range of questions than those typically addressed by randomised control trials and applicability to a wider group of patients (and, hence, providing estimates of outcomes that are more generalisable), the potential of clinical registries to resolve HTA issues needs more attention from both researchers and decision makers. Stakeholder collaboration to define the evidence requirements for new technologies early in their development phase would be valuable to determine the potential role for clinical registries.

scholarly journals Historical development of health technology assessment in Thailand

2009 ◽  
Vol 25 (S1) ◽  
pp. 241-252 ◽  
Author(s):  
Yot Teerawattananon ◽  
Sripen Tantivess ◽  
Jomkwan Yothasamut ◽  
Pritaporn Kingkaew ◽  
Kakanang Chaisiri
Keyword(s):  
Public Health ◽  
Health Economic ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
National Policy ◽  
Health Benefit ◽  
Health Technology ◽  
Civil Society Organizations ◽  
Policy Makers ◽  
Health Technologies

Objectives: This study aims to review the development of health technology assessment (HTA), including the socioeconomic context, outputs, and policy utilization in the Thai setting.Methods: This study was conducted through extensive document reviews including these published in both domestic and international literature.Results: Evidence suggests that contextual elements of the health system, especially the country's economic status and health financing reforms, as well as their effects on government budgeting for medical and public health services, played an important role in the increasing needs and demands for HTA information among policy makers. In the midst of substantial economic growth during the years 1982 to 1996, several studies reported the rapid diffusion and poor distribution of health technologies, and inequitable access to high-cost technology in public and private hospitals. At the same time, economic analysis and its underpinning concept of efficiency were suggested by groups of scholars and health officials to guide national policy on the investment in health technology equipment. Related research and training programs were subsequently launched. However, none of these HTA units could be institutionalized into national bodies. From 1997 to 2005, an economic recession, followed by the introduction of a universal health coverage plan, triggered the demands for effective measures for cost containment and prioritization of health interventions. This made policy makers and researchers at the Ministry of Public Health (MOPH) pay increasing attention to economic appraisals, and several HTA programs were established in the Ministry. Despite the rising number of Thai health economic publications, a major problem at that period involved the poor quality of studies. Since 2006, economic recovery and demands from different interests to include expensive technologies in the public health benefit package have been crucial factors promoting the role of HTA in national policy decisions. Meanwhile, HTA capacity has been strengthened through the establishment of many health economic and HTA initiatives. An illustration of the work and contributions of the Health Intervention and Technology Assessment Program (HITAP) is provided. In this phase, HTA policy integration has been enhanced through different mechanisms and organizations.Conclusion: Over the past two decades a notable progression has been made in relation to the capacity building of HTA research and its policy utility in Thailand. Such development has been shaped by multiple factors. It is anticipated that experience gained among academics, health officials, and civil society organizations will be helpful not only in sustaining the momentum but also in improving formal HTA systems in the future.

scholarly journals Etica e Health Technology Assessment (HTA): sulle difficoltà della loro integrazione

2015 ◽  
Vol 64 (2) ◽  
Author(s):  
Pietro Refolo
Keyword(s):  
Health Economic ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Research Field ◽  
Health Technologies ◽  
Legal Consequences

L’etica è stata da sempre considerata parte integrante dei processi di Health Technology Assessment (HTA), nel senso che la valutazione delle conseguenze di tipo etico relative all’impiego di tecnologie sanitarie rappresenta uno degli obiettivi fondamentali di questo settore di ricerca, alla stregua delle valutazioni sulla sicurezza, l’efficacia, l’impatto economico, quello organizzativo, socio-culturale e legale. A queste dichiarazioni di intenti non ha però corrisposto una effettiva attuazione nella pratica: l’etica non ha infatti avuto grande spazio nell’HTA e solo raramente le analisi etiche hanno trovato posto nei report. Sulle ragioni della difficoltà di integrare l’etica nell’HTA è stata avanzata una serie di ipotesi. Il presente articolo intende argomentare sull’ipotesi, secondo cui, alla base dell’insuccesso dell’integrazione dell’etica nell’HTA, vi sia anche e soprattutto un problema di natura epistemologica. ---------- Ethics has been identified as a key element in Health Technology Assessment (HTA) since its conception, meaning that examining ethical consequences – as well the health, economic, social-cultural and legal consequences – raised by the use of health technologies is a fundamental aim of this research field. Nevertheless, HTA rarely addresses ethics and ethical analyses have been rarely integrated explicitly in HTA reports. Many hypotheses have been provided to explain this lack. The article intends to discuss the hypothesis for which ethics is rarely integrated in HTA also and above all because of epistemological reasons.

scholarly journals Early Health Economic Modelling – Optimizing Development for Medical Device Developers? Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling"

2019 ◽  
Author(s):  
Conor Teljeur ◽  
Máirín Ryan
Keyword(s):  
Health Economic ◽  
Early Stage ◽  
Data Gathering ◽  
Economic Modeling ◽  
Economic Modelling ◽  
Negative Consequences ◽  
Health Technologies ◽  
Stage Of Development ◽  
Early Health

Abstract This commentary considers the positive and negative consequences of early economic modelling and explores potential future directions. Early economic modelling offers device manufacturers an opportunity to assess the potential value of an innovation at an early stage of development. Early modelling can direct resources into potentially viable technologies and reduce investment in technologies with limited prospect of value. However, it is unclear whether early modelling is sufficiently specific to identify innovations with low value. It may be that early modelling is more useful for directing data gathering to reduce decision uncertainty. Early modelling is of primary benefit to the manufacturer and may have both positive and negative consequences for reimbursement processes that should be considered

scholarly journals Imaginary Worlds: The European Network for Health Technology Assessment (EUnetHTA) Recommendations for Health Economic Evaluations

2016 ◽  
Vol 7 (3) ◽  
Author(s):  
Paul C Langley
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Relative Effectiveness ◽  
Health Technology ◽  
Economic Evaluations ◽  
Normal Science ◽  
European Network ◽  
Health Technologies

The European Network for Health Technology Assessment (EUnetHTA) guidelines for health economic evaluations represent a consolidated view of non-binding recommendations for assessments of the relative effectiveness of pharmaceuticals or other health technologies. EUnetHTA views itself as the scientific and technological backbone of the development of health technology assessment in the European Union and among its member states and other partners. Unfortunately, the standards for health technology assessment proposed by EUnetHTA do not meet the standards of normal science. They do not support credible claims for the clinical and comparative cost-effectiveness of pharmaceuticals. In rejecting the standards of normal science the guidelines put to one side the opportunity not only to re-assess and replicate clinical and cost-effectiveness claims but to provide meaningful feedback on claims assessment to health care decision makers. The purpose of this review is to make the case that, in failing to support standards for experimentation, EUnetHTA is advocating its partners support the creation of modeled or simulated imaginary or false worlds. While EUnetHTA is not alone in recommending the construction of imaginary worlds to support formulary decisions, there is still the opportunity to revisit these recommendations and decide whether or not to encourage a scientifically rigorous approach to health technology assessments - to abandon a commitment to intelligent design in favor of natural selection.  Conflict of Interest None   Type: Commentary  

scholarly journals Expanding the Role of Early Health Economic Modelling in Evaluation of Health Technologies Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling"

2020 ◽  
Author(s):  
Carlo Federic ◽  
Aleksandra Torbica
Keyword(s):  
Health Economic ◽  
Early Stage ◽  
Economic Modeling ◽  
Evaluation Framework ◽  
Economic Modelling ◽  
Health Technologies ◽  
Innovative Methods ◽  
Healthcare Decision Making ◽  
Early Health

In this commentary, we discuss early stage assessments of innovative medical technologies both in terms of methods applied as well as their use in healthcare decision-making. We argue that cost-effectiveness alone may be too reductive if taken as the only decision rule, and it would benefit from being used within a broader evaluation framework. We discuss innovative methods which may contribute to better estimate the potential costs and consequences of a technology in the absence of solid clinical data, as frequently the case in early assessments. Finally, we comment on the potential synergies which may take place should early economic models be used not only by technology developers alone but as a negotiating base during early dialogues with health technology assessment (HTA) bodies.

scholarly journals Analiza możliwości wdrożenia szpitalnej oceny technologii medycznych (HB-HTA) na podstawie modelu z koordynującą rolą niezależnej organizacji zewnętrznej

2021 ◽  
Vol 18 (4) ◽  
pp. 259-270
Author(s):  
Tomasz Bochenek ◽  
Alicja Sobczak ◽  
Dariusz Szplit ◽  
Agata Smoleń ◽  
Anna Tybińkowska ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Positive Impact ◽  
Functional Model ◽  
Health Technology ◽  
Health Technologies ◽  
Local Decision ◽  
External Organization ◽  
Local Decision Making

Implementation of Hospital-Based Health Technology Assessment (HB-HTA) with the coordinating role of independent external organization Hospital-Based Health Technology Assessment (HB-HTA) aims to support local decision-making on investing in new health technologies limited to the hospital level. The goal of this study was to prepare and present the strategic functional model of HB-HTA in Poland with coordinating role of an organization labelled as the independent external organization (NOZ). The stakeholders of the HB-HTA process were identified, together with their interests and relations among them, as well as the goals and consequences of health policy in area of implementation of HB-HTA in Poland. The conduct of HB-HTA process was presented, the tasks foreseen for NOZ, its possible organizational forms, barriers, and possibilities of development; as well as the overall capacity of this organization in area of HB-HTA. It is foreseen that the development of HB-HTA in Poland based on NOZ should take place within a positively inclined environment, having a generally positive impact on the health care system, positive prognoses, and opportunities for implementation of HB-HTAh.

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