scholarly journals Assessing potential cures: are there distinctive elements of value beyond health gain?

2021 ◽  
Vol 10 (4) ◽  
pp. 255-265
Author(s):  
Saskia Hendriks ◽  
Steven D Pearson
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Gain ◽  
Health Technology ◽  
Opportunity Costs ◽  
Double Counting ◽  
Deliberative Process ◽  
Potential Opportunity

Assessing the ‘value’ of potential cures can be challenging, as some have suggested that cures may offer distinctive benefits from noncurative treatments. We explore what these – previously unspecified – additional benefits may be. We suggest that three new elements of value seem distinctive to cures: liberation from the identity of being diseased, liberation from the stigma associated with the disease and liberation from the burden of ongoing therapy. However, including additional elements of value in health technology assessment may result in double counting and requires consideration of potential opportunity costs. We suggest health technology assessment should explore the relevance of these three elements of value and may have good reasons to – judiciously – integrate them through the deliberative process.

PP120 Health Technology Assessment Framework To Capture The Full Value Of Value Added Medicines

2017 ◽  
Vol 33 (S1) ◽  
pp. 128-129
Author(s):  
Mondher Toumi ◽  
Cecile Remuzat ◽  
Adam Plich
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Drug Repositioning ◽  
Value Added ◽  
Health Technology ◽  
Access To Medicines ◽  
Deliberative Process ◽  
Study Objective ◽  
Healthcare Needs ◽  
Patient Reported

INTRODUCTION:Value added medicines (VAM) are medicines based on known molecules that address healthcare needs and deliver relevant improvements for patients, healthcare professionals and/or payers through drug repositioning, drug reformulation or drug combination (1-3). Recently, the European Commission, through the Safe and Timely Access to Medicines for Patients (STAMP) program, considered the issue of VAM development and regulatory process. Current Health Technology Assessment (HTA) tools may not fully capture the benefits of VAM, which could lead to obstacles for patient access to VAM in several European countries (1). The study objective was to identify how HTA frameworks should evolve to reflect VAM value.METHODS:HTA expert interviews were performed as a preparatory step to an advisory board meeting. The following topics were addressed: (i) Eligibility for HTA and early HTA dialogues; (ii) Attributes that should be considered in HTA; (iii) HTA methodology; and (iv) Involvement of stakeholders in HTA.RESULTS:VAMs bring additional benefit to patients and society. Therefore, the possibility for VAM assessment on a voluntary basis and within the appropriate assessment patterns/tools should be, in principle, included into HTA frameworks, as well as into early HTA dialogues. HTA should be patient-centric, and attributes such as patient preference, adherence, and patient reported outcomes should be considered where relevant. Unmet patient needs and disease burden should be used in a transparent and reproducible deliberative process. All these attributes should be used as explicitly and meaningfully weighted appraisal modifiers. HTA methodology should be comprehensive and should integrate societal perspectives. Patient representatives should take part in the decision-making process.CONCLUSIONS:Current HTA frameworks should evolve to enhance VAM value recognition and encourage industry investment in medicines with high potential value for society.

Patients' perspectives in health technology assessment: A route to robust evidence and fair deliberation

2010 ◽  
Vol 26 (3) ◽  
pp. 334-340 ◽  
Author(s):  
Karen Facey ◽  
Antoine Boivin ◽  
Javier Gracia ◽  
Helle Ploug Hansen ◽  
Alessandra Lo Scalzo ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Social Science Research ◽  
Science Research ◽  
Health Technology ◽  
Deliberative Process ◽  
Quantitative Evidence ◽  
Research Engagement ◽  
Robust Evidence

There is increasing emphasis on providing patient-focused health care and ensuring patient involvement in the design of health services. As health technology assessment (HTA) is meant to be a multidisciplinary, wide-ranging policy analysis that informs decision making, it would be expected that patients’ views should be incorporated into the assessment. However, HTA is still driven by collection of quantitative evidence to determine the clinical and cost effectiveness of a health technology. Patients’ perspectives about their illness and the technology are rarely included, perhaps because they are seen as anecdotal, biased views. There are two distinct but complementary ways in which HTAs can be strengthened by: (i) gathering robust evidence about the patients’ perspectives, and (ii) ensuring effective engagement of patients in the HTA process from scoping, through evidence gathering, assessment of value, development of recommendations and dissemination of findings. Robust evidence eliciting patients’ perspectives can be obtained through social science research that is well conducted, critically appraised and carefully reported, either through meta-synthesis of existing studies or new primary research. Engagement with patients can occur at several levels and we propose that HTA should seek to support effective patient participation to create a fair deliberative process. This should allow two-way flow of information, so that the views of patients are obtained in a supportive way and fed into decision-making processes in a transparent manner.

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.

scholarly journals Why do health technology assessment drug reimbursement recommendations differ between countries? A parallel convergent mixed methods study

2019 ◽  
Vol 15 (3) ◽  
pp. 386-402 ◽  
Author(s):  
Elena Nicod ◽  
Laia Maynou ◽  
Erica Visintin ◽  
John Cairns
Keyword(s):  
Mixed Methods ◽  
Health Technology Assessment ◽  
Conceptual Framework ◽  
Technology Assessment ◽  
Health Technology ◽  
Deliberative Process ◽  
Drug Reimbursement ◽  
Quantitative And Qualitative Research ◽  
Research Designs ◽  
Stakeholder Input

AbstractUsing quantitative and qualitative research designs, respectively, two studies investigated why countries make different health technology assessment (HTA) drug reimbursement recommendations. Building on these, the objective of this study was to (a) develop a conceptual framework integrating the factors explaining these decisions, (b) explore their relationship and (c) assess if they are congruent, complementary or discrepant. A parallel convergent mixed methods design was used. Countries included in both previous studies were selected (England, Sweden, Scotland and France). A conceptual framework that integrated and organised the factors explaining the decisions from the two studies was developed. Relationships between factors were explored and illustrated through case studies. The framework distinguishes macro-level factors from micro-level ones. Only two of the factors common to both studies were congruent, while two others reached discrepant conclusions (stakeholder input and external review of the evidence processes). The remaining factors identified within one or both studies were complementary. Bringing together these findings contributed to generating a more complete picture of why countries make different HTA recommendations. Results were mostly complementary, explaining and enhancing each other. We conclude that differences often result from a combination of factors, with an important component relating to what occurs during the deliberative process.

OP177 Identification Of Technologies Of No Or Low Added Value

2018 ◽  
Vol 34 (S1) ◽  
pp. 65-65
Author(s):  
Maria Eugenia Esandi ◽  
Iñaki Gutiérrez-Ibarluzea ◽  
Nora Ibargoyen-Roteta ◽  
Brian Godman
Keyword(s):  
Health Technology Assessment ◽  
Systematic Reviews ◽  
Technology Assessment ◽  
Ad Hoc ◽  
Descriptive Analysis ◽  
Health Gain ◽  
Health Technology ◽  
Added Value ◽  
Limited Health ◽  
Basic Approaches

Introduction:Health technology has no or low added value when it is harmful and/or is deemed to deliver limited health gain relative to its cost, representing inefficient health resource allocation. A joint effort by the Health Technology Assessment International (HTAi) interest group (IG) on disinvestment and early awareness, the IG on ethics, the EuroScan network and the International Network of Agencies for Health Technology Assessment (INAHTA) is aiming to design a toolkit that could aid organizations and individuals considering disinvestment activities. We synthesized state of the art methods for identifying candidate technologies for disinvestment, and propose a framework for executing this task.Methods:We searched systematic reviews on disinvestment and compared the methods used for identifying potential candidates. A descriptive analysis was performed including sources of evidence used and methods for selection / filtration.Results:Ten systematic reviews were retrieved, and the methods of 29 disinvestment initiatives were compared. A new framework for identifying potential candidates was proposed which comprises seven basic approaches based on the wide definition of evidence provided by Lomas et al.; 11 triggers for disinvestment were adapted from Elshaug's proposal, and 13 methods for applying these triggers that were grouped in embedded and ad-hoc methods.Conclusions:Identification methods have been described in the literature, and have been tested in different contexts. Context is crucial in determining the ‘not to do’ practices as they are described in different sources.

Priority setting for health technology assessment at CADTH

2010 ◽  
Vol 26 (3) ◽  
pp. 341-347 ◽  
Author(s):  
Don Husereau ◽  
Michel Boucher ◽  
Hussein Noorani
Keyword(s):  
Health Technology Assessment ◽  
Priority Setting ◽  
Technology Assessment ◽  
Contextual Information ◽  
Committee Member ◽  
Research Priorities ◽  
Health Technology ◽  
Deliberative Process ◽  
Comparison Approach ◽  
Available Information

Objectives: The aim of this study was to describe a current practical approach of priority setting of health technology assessment (HTA) research that involves multi-criteria decision analysis and a deliberative process.Methods: Criteria related to HTA prioritization were identified and grouped through a systematic review and consultation with a selection committee. Criteria were scored through a pair-wise comparison approach. Criteria were pruned based on the average weights obtained from consistent (consistency index < 0.2) responders and consensus. HTA proposals are ranked based on available information and a weighted criteria score. The rank, along with additional contextual information and discussion among committee members, is used to achieve consensus on HTA research priorities.Results: Six of eleven criteria represented > 75 percent of the weight behind committee member decisions to conduct an HTA. These criteria were disease burden, clinical impact, alternatives, budget impact, economic impact, and available evidence. Since May 2006, committees have considered 102 proposals at sixteen biannual in-person advisory committee meetings. These have selected twenty-nine research priorities for the HTA program.Conclusions: The approach works well and was easy to implement. Feedback from committee members has been positive. This approach may assist HTA and other research agencies in better priority setting by informing the selection of the most important and policy-relevant topics in the presence of a wide variety of research proposals. This may in turn lead to efficiently allocating resources available for HTA research.

PP159 Making Health Technology Assessment A Common Language In Controversies: A Hidden Role For The National Evidence-Based Healthcare Collaborating Agency

2018 ◽  
Vol 34 (S1) ◽  
pp. 128-129
Author(s):  
Jeong-eun Park ◽  
Min Ji Lee ◽  
Eunkyo Park ◽  
Miseong Kim ◽  
Jooyeon Park
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Rapid Review ◽  
Evidence Based ◽  
Common Language ◽  
Deliberative Process ◽  
Evidence Based Healthcare

Introduction:In order to improve research planning it is critical to understand how decision makers have used previous health technology assessment (HTA) results, and what expectations policy makers and health professionals have in HTA programs. In this study, we aimed to examine how HTA results have been used by decision makers, and explore complex relationships between the National Evidence-based Healthcare Collaborating Agency (NECA) and various decision-making bodies in Korea.Methods:Three areas of healthcare decision in which NECA has been extensively involved were selected: prevention programs, single technology reimbursement, and clinical guidelines. We conducted in-depth interviews with two or three key informants from decision making bodies in each selected area. The interview participants included clinicians and government officials. We also conducted interviews with the researchers who participated in the related research to better capture the context. The interviews were analyzed using qualitative content analysis.Results:Eight interviews with decision makers and five interviews with researchers were conducted and analyzed. Three main themes were revealed in the data. Firstly, it was revealed that NECA was primarily expected to be an intermediary between clinicians and government. Both government and clinicians had referred to NECA's HTA results, which are expected to be scientific and impartial, when they need to reach one another on controversial topics. Secondly, there was a high need for deliberative process to resolve the conflicting interests regarding HTA results. Lastly, they wanted the HTA process to be more responsive to fast changing healthcare environments by introducing a form of rapid review.Conclusions:Lack of effective communication channels between government and healthcare providers in Korea has made a room for HTA to be a common language for both sides. It is time to give up the ‘one-size-fits-all’ approach to conducting HTA research and tailor the research process to various needs of decision makers.

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 Deliberative Appraisal Processes in Health Technology Assessment

2021 ◽  
Vol 1 (5) ◽  
Author(s):  
Marina Richardson ◽  
Nicole Mittmann ◽  
David Kaunelis
Keyword(s):  
Health Technology Assessment ◽  
Health System ◽  
Technology Assessment ◽  
Medical Condition ◽  
Health Technology ◽  
Multiple Perspectives ◽  
Deliberative Process ◽  
Course Of Action ◽  
Deliberative Processes ◽  
Appraisal Processes

Deliberation — the bringing together of individuals with multiple perspectives, experiences, and values to critically examine evidence, share reasons and rationales, and reach a decision on a course of action — occurs at all stages of the health technology assessment (HTA) process. The focus of this report is on deliberation at the committee appraisal stage of HTA. The objectives are to review and conceptualize the evidence and key considerations for deliberative processes at the committee appraisal stage of HTA and the available guidance for assessing the quality of the deliberative process at this stage. National and international practices for deliberative processes at the committee appraisal stage of HTA vary depending on contextual considerations (e.g., type of health technology and the medical condition being treated), the mandate of the HTA organization, health system and funding structures, and societal values. Each aspect of the deliberative appraisal process should be rooted in the values of the health system and be principled, clear, transparent, purposeful, and reasoned.

scholarly journals Implementing evidence-informed deliberative processes in health technology assessment: a low income country perspective

2020 ◽  
Vol 36 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Lydia Kapiriri ◽  
Rob Baltussen ◽  
Wija Oortwijn
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Low Income ◽  
Technology Assessment ◽  
Health Technology ◽  
Income Country ◽  
Deliberative Process ◽  
Health Technologies ◽  
Low Income Country ◽  
Deliberative Processes

AbstractThe purpose of this paper is to discuss the potential feasibility and utility of evidence-informed deliberative processes (EPDs) in low income country (LIC) contexts. EDPs are implemented in high and middle income countries and thought to improve the quality, consistency, and transparency of decisions informed by health technology assessment (HTA). Together these would ultimately improve the legitimacy of any decision making process. We argue—based on our previous work and in light of the priority setting literature—that EDPs are relevant and feasible within LICs. The extreme lack of resources necessitates making tough decisions which may mean depriving populations of potentially valuable health technologies. It is critical that the decisions and the decision making bodies are perceived as fair and legitimate by the people that are most affected by the decisions. EDPs are well aligned with the political infrastructure in some LICs, which encourages public participation in decision making. Furthermore, many countries are committed to evidence-informed decision making. However, the application of EDPs may be hampered by the limited availability of evidence of good quality, lack of interest in transparency and accountability (in some LICs), limited capacity to conduct HTA, as well as limited time and financial resources to invest in a deliberative process. While EDPs would potentially benefit many LICs, mitigating the identified potential barriers would strengthen their applicability. We believe that implementation studies in LICs, documenting the contextualized enablers and barriers will facilitate the development of context specific improvement strategies for EDPs.

Sign in / Sign up

Export Citation Format

Share Document