scholarly journals True North: Building Imaginary Worlds with the Revised Canadian (CADTH) Guidelines for Health Technology Assessment

2017 ◽  
Vol 8 (2) ◽  
Author(s):  
Paul C Langley

In March 2017 the Canadian Agency for Drugs and Technologies in Health (CADTH) released the 4th edition of their Guidelines for the Economic Evaluation of Health Technologies: Canada. These guidelines, which were first published and revised for a 3rd edition in 2006 are intended to help decision makers, health systems leaders and policy makers make well-informed decisions. They are designed, apparently, to support best practice in conducting health technology assessments in Canada. The purpose of this commentary is to consider whether or not the evidence standards proposed and the consequent modeled claims for economic effectiveness meet the standards of normal science: are the CADTH standards capable of generating claims for competing products that are credible, evaluable and replicable? The review argues that the standards proposed by CADTH do not meet the standards expected in normal science. Technical sophistication in building reference case imaginary worlds is not a substitute for claims that are experimentally evaluable or capable of assessment through systematic observation. There is no way of judging whether imaginary claims are right or even if they are wrong. CADTH is not alone in setting standards that fail to meet the standards of normal science. Recent commentaries on formulary submission guidelines in a number of other countries, to include Ireland, the Netherlands, France, Australia, the UK and New Zealand conclude that they are subject to the same criticism. If the CADTH guidelines were never intended to support feedback to health system decision makers, then this should be made clear. If not, then consideration should be given to withdrawing the guidelines to ensure they conform to these standards. Hopefully, future versions of the CADTH guidelines will address this issue and focus on a rigorous research program of claims assessment and feedback and not the building of imaginary worlds.   Type:  Commentary

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Paul C Langley

In September 2016 the Australian Department of Health published Version 5.0 of the Guidelines for Preparing Submissions to the Pharmaceutical Benefits Advisory Committee (PBAC). These guidelines, which were first published for comment in 1990, set out how to prepare a submission to list a new medicine or medicinal product on the Pharmaceutical Benefits Schedule (PBS). The guidelines give instructions on the information required by the PBAC and the Economic Sub-Committee (ESC), the most appropriate form for presenting clinical evidence and the standards for an economic evaluation. The purpose of this commentary is to consider whether or not the evidence standards proposed and the consequent modeled claims for economic effectiveness meet the standards of normal science: are the claims presented to support PBS listing credible, evaluable and replicable. The review concludes that the PBAC guidelines do not meet the standards expected in normal science. The absence of empirically evaluable claims means there is no way of judging whether they are right or even if they are wrong. If the Guidelines were never intended to support experimentation and systematic observation to generate feedback to health system decision makers, then this should be made clear by the PBAC. If not, then consideration should be given to redrafting the guidelines to ensure they conform to these standards. Hopefully, future versions of the guidelines will address this issue and focus on a rigorous research program of claims assessment and feedback.   Type: Commentary


2008 ◽  
Vol 24 (03) ◽  
pp. 244-258 ◽  
Author(s):  
Michael F. Drummond ◽  
J. Sanford Schwartz ◽  
Bengt Jönsson ◽  
Bryan R. Luce ◽  
Peter J. Neumann ◽  
...  

Health technology assessment (HTA) is a dynamic, rapidly evolving process, embracing different types of assessments that inform real-world decisions about the value (i.e., benefits, risks, and costs) of new and existing technologies. Historically, most HTA agencies have focused on producing high quality assessment reports that can be used by a range of decision makers. However, increasingly organizations are undertaking or commissioning HTAs to inform a particular resource allocation decision, such as listing a drug on a national or local formulary, defining the range of coverage under insurance plans, or issuing mandatory guidance on the use of health technologies in a particular healthcare system. A set of fifteen principles that can be used in assessing existing or establishing new HTA activities is proposed, providing examples from existing HTA programs. The principal focus is on those HTA activities that are linked to, or include, a particular resource allocation decision. In these HTAs, the consideration of both costs and benefits, in an economic evaluation, is critical. It is also important to consider the link between the HTA and the decision that will follow. The principles are organized into four sections: (i) “Structure” of HTA programs; (ii) “Methods” of HTA; (iii) “Processes for Conduct” of HTA; and (iv) “Use of HTAs in Decision Making.”


2018 ◽  
Vol 23 (4) ◽  
pp. 301-311 ◽  
Author(s):  
Mohammadkarim Bahadori ◽  
Ramin Ravangard ◽  
Mahya Tohidi Nezhad ◽  
Naeimeh Pourtaheri ◽  
Sayyed Morteza Hosseini-Shokouh

PurposeAccording to the great importance of community health as well as the ever-increasing development of health technologies, the importance of designing an interactive model of factors affecting health technology assessment (HTA) can be highlighted. The purpose of designing and implementing the framework of health information system assessment is to ensure that the required accurate data which are necessary to measure the main health indicators are available. The purpose of this paper is to design an interactive model of factors affecting HTA.Design/methodology/approachThis is a cross-sectional, descriptive-analytic study conducted in the Iran Ministry of Health and Medical Education in the second half of 2017. A sample of 60 experts and professionals working in the field of health technologies are selected using purposive and snowball sampling methods. Two researcher-made questionnaires are used to collect the required data. The collected data are analyzed using decision-making trial and evaluation laboratory (DEMATEL) and MATLAB R2013a.FindingsThe results showed that “Legal dimension,” “safety,” “Effectiveness” and “Social dimension” were the affecting factors and net causes, and “Current application,” “Knowledge of technology,” “Ethical dimension,” “Costs” and “Organizational dimension” were the affected factors and net effects in the interactive model. Furthermore, “Legal dimension” with the coordinates C: [1.88, 1.27] and “Ethical dimension” with the coordinates C: [1.75, −75] were known as the most affecting and most affected factors in the interactive model, respectively.Originality/valueThe DEMATEL model is an appropriate tool for managers and policy makers to structure and prioritize factors influencing the HTA. Policy makers and decision makers can use this model for identifying relationships among factors and prioritize them. Because health policy makers and managers have a major role in formulating the regulations and guidelines related to the HTA, they should pay more attention to the legal considerations in their decisions and use the management tools to move the available resources toward implementing and enforcing rules and guidelines related to the HTA.


2017 ◽  
Vol 33 (S1) ◽  
pp. 122-123
Author(s):  
Roza Yagudina ◽  
Andrey Kulikov ◽  
Dzhumber Ugrekhelidze

INTRODUCTION:Health Technology Assessment (HTA) processes are extensively used during making decisions on the inclusion of medicinal products in Essential medicines lists. There is a high interest in HTA among specialists in the healthcare sphere and decision makers in Russia. According to a survey of chief physicians 62 percent of them would like to attend HTA educational programs. One of the steps necessary to disseminate HTA in Russia is the exploration of experience and best practices.METHODS:Information retrieval using websites of medical institutions in Russia were observed.RESULTS:As a result, it was found that educational program “Modern requirements for conducting health technology assessment” for decision makers in the area of health care is held in Department of organization of medicinal provision and pharmacoeconomics of the I.M. Sechenov First Moscow State Medical University. During this course basic methods of pharmacoeconomic analysis and their practical application, modern schemes of treatment and peculiarities of the conduct of pharmacoeconomic studies in different diseases, issues of HTA at different levels of the health system are covered. More than 1,900 specialists from 12 subjects of Russia (Samara, Nizhny Novgorod, Rostov, Orenburg, Bryansk, Astrakhan regions, Khanty-Mansi Autonomous Okrug, Altai, Krasnoyarsk, Stavropol and Perm territories, the Republic of Tatarstan) attended seminars including heads of regional health authorities, chief specialists of the ministries, chief physicians of hospitals, and heads of pharmacies.CONCLUSIONS:During the educational process the results of pharmacoeconomic analysis and their interpretation at the regional level, legislative changes in the sphere of health technologies circulation, the data requirements for inclusion of a medicinal product in the state lists, the rules of state procurement, and the interchangeability of medicines are highlighted. During educational process the results of pharmacoeconomic analysis and their interpretation at the regional level, legislative changes in the sphere of health technologies circulation, the data requirements for inclusion of a medicinal product in the state Lists, the rules of state procurement, and the interchangeability of medicines are highlighted.


2009 ◽  
Vol 25 (S1) ◽  
pp. 102-107 ◽  
Author(s):  
Marjukka Mäkelä ◽  
Risto P. Roine

Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency, with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries.


2021 ◽  
Author(s):  
Paul Michael Garrett ◽  
Joshua Paul White ◽  
Simon Dennis ◽  
Stephan Lewandowsky ◽  
Cheng-Ta ◽  
...  

In response to the COVID-19 pandemic, countries are introducing digital passports that allow citizens to return to normal activities if they were previously infected with (immunity passport) or vaccinated against (vaccination passport) SARS-CoV-2. To be effective, policy decision makers must know whether immunity and vaccination passports will be widely accepted by the public, and under what conditions? We collected representative samples across six countries – Australia, Japan, Taiwan, Germany, Spain, and the United Kingdom – during the 2020 COVID-19 pandemic to assess attitudes towards the introduction of immunity passports. Immunity passport support was moderate-to-low, ranging from 51% in the UK and Germany, down to 22% in Japan. Bayesian generalized linear mixed effects modelling controlling for each country showed neoliberal world views, personal concern and perceived virus severity, the fairness of immunity passports, and willingness to become infected to gain an immunity passport, were all predictive factors of immunity passport support. By contrast, gender (woman), immunity passport concern, and risk of harm to society predicted a decrease in support for immunity passports. Minor differences in predictive factors were found between countries. These findings will help policy makers introduce effective immunity passport policies in these six countries and around the world.


2021 ◽  
pp. 445-477
Author(s):  
Carmelo Danisi ◽  
Moira Dustin ◽  
Nuno Ferreira ◽  
Nina Held

AbstractThe previous chapters have offered an in-depth, empirically and theoretically informed analysis of a broad range of issues affecting SOGI asylum claimants and refugees in Europe, with a focus on Germany, Italy and the UK. This analysis has applied new insights to findings unearthed by previous research and shone light on issues that have so far been relatively neglected. But the question often posed to us as academics is ‘so what?’ To address this question, this chapter offers a range of recommendations addressed to decision-makers, policy-makers, governments, NGOs and service providers, aimed at improving the socio-legal framework that applies to SOGI asylum. These apply mainly at a domestic level, but also refer to the European level, where relevant, to offer proposals that recognise the intersections of national, European and international frameworks. As in the previous analysis, we are strongly guided by our participants’ voices, complemented by broader scholarly debates and our analysis and views of these. Our data and analysis thereof also shed light on broader issues in the asylum system, and many of the recommendations set out here would benefit non-SOGI asylum claimants and refugees as well. We hope they will be of wider value in this way.


Author(s):  
Steven Simoens

This chapter introduces health technology assessment and health economics as tools for decision makers to allocate scarce resources in the healthcare sector. It argues that information about the safety, efficacy and effectiveness, organizational implications, social and ethical consequences, legal considerations, and health economic aspects of the application of a health technology needs to be taken into account with a view to informing decisions about the registration and reimbursement of a health technology. Also, the author hopes that understanding the methodology and use of health technology assessment and health economics will persuade the reader of the added value of such studies and promote the application of health technologies that support further health improvements, whilst containing health expenditure.


2009 ◽  
Vol 23 (3) ◽  
pp. 243-252 ◽  
Author(s):  
Cindy Millman ◽  
Wang-Chan Wong ◽  
Zhengwei Li ◽  
Harry Matlay

A growing body of research evaluates various aspects of entrepreneurship education (such as curriculum, delivery and assessment) and links it to outcomes in terms of both the number and quality of entrepreneurs entering an economy. There is, however, a marked paucity of empirically rigorous research appraising the impact of entrepreneurship education on graduates' intentions and perceived ability to set up Internet-based e-enterprises that can operate across temporal and geographical boundaries. This paper provides a comparative overview of entrepreneurship education in the UK, the USA and China with a focus on IT and non-IT students' e-entrepreneurship intentions, perceptions and outcomes. The research on which the paper is based was carried out in two distinct phases: first, focus groups were used to design, pilot and develop a comprehensive research questionnaire for use in a wider, multi-country survey; second, questionnaires were then distributed to students in IT and non-IT related disciplines in the UK, the USA and China. The preliminary results show that most respondents were slow to conceptualize and contextualize e-entrepreneurship in the prevailing socio-economic and political conditions of their countries of origin. There were no significant differences between students of IT and non-IT disciplines in their perceptions of the viability and practicality of engaging in e-entrepreneurship. Generic support initiatives appear to neglect the vast portfolio of skills needs for graduates engaging in Internet trading. The authors recommend that entrepreneurship education providers should engage with emergent models of e-entrepreneurship and that policy makers should provide innovative initiatives to cater for the specific needs of e-entrepreneurs.


2019 ◽  
Vol 35 (S1) ◽  
pp. 59-60
Author(s):  
Claire Davis ◽  
Sophie Hughes ◽  
Susan Myles

IntroductionA new Health Technology Assessment (HTA) agency, Health Technology Wales (HTW), has been established to consider the identification, appraisal, and adoption of non-medicine health technologies. This includes, for example, medical devices, surgical procedures and diagnostics. HTW recognizes the importance of effective patient and public involvement (PPI) and is building smart capabilities.MethodsHTW consulted with external organizations to identify the first steps toward effective PPI. Public partners were recruited as a priority before working together on a PPI strategy. Building smart capabilities is key to establishing effective PPI and future-proofing. HTW established a PPI Standing Group to inform HTW throughout its work, including the development of processes and procedures.ResultsKnowledge and resources have been shared and future collaborations identified, including events to encourage new topics from patients and the public. The HTW PPI lead has become a member of key PPI groups, locally and internationally. HTW has recruited public partners who are actively contributing as full members of the Assessment Group and the Appraisal Panel; two members on each Committee. The PPI Standing Group has been established. They have provided advice and co-produced PPI tools for piloting.ConclusionsThe PPI Standing Group concluded that PPI methods and approaches should be tailored for each project based on best practice, and should be piloted to allow them to evolve based on impact evaluation. A PPI strategy or framework would be more useful at a later stage. HTW is committed to identifying and following best practice. Future-proofing and building smart capability will be key to ensuring that HTW develops effective PPI that can be dynamic and responsive to the evolving PPI and HTA landscapes.


Sign in / Sign up

Export Citation Format

Share Document