Commentary on the article “Key principles for the improved conduct of health technology assessments for resource allocation decisions”

2008 ◽  
Vol 24 (03) ◽  
pp. 366-367 ◽  
Author(s):  
Duncan Neuhauser
Keyword(s):  
Resource Allocation ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
To Come ◽  
Definition Of ◽  
Allocation Decisions ◽  
Resource Allocation Decisions

“Key principles for the improved conduct of health technology assessment for resource allocation decisions.” The title says it all. I am amazed that such a summary is even possible and that it defines this field so well. Perhaps this report will be cited for years to come as the best and central definition of HTA. A field like this can be defined in other ways.

Implementing health technology assessment in Ghana to support universal health coverage: building relationships that focus on people, policy, and process

2019 ◽  
Vol 36 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Samantha Hollingworth ◽  
Martha Gyansa-Lutterodt ◽  
Lydia Dsane-Selby ◽  
Justice Nonvignon ◽  
Ruth Lopert ◽  
...  
Keyword(s):  
Resource Allocation ◽  
Health Technology Assessment ◽  
Universal Health Coverage ◽  
Technology Assessment ◽  
Health Technology ◽  
Health Coverage ◽  
African Countries ◽  
Allocation Decisions ◽  
Universal Health ◽  
Resource Allocation Decisions

AbstractGhana is one of the few African countries to enact legislation and earmark significant funding to establish universal health coverage (UHC) through the National Health Insurance Scheme, although donor funds have declined recently. Given a disproportionate level of spending on medicines, health technology assessment (HTA) can support resource allocation decisions in the face of highly constrained budgets, as commonly found in low-resource settings. The Ghanaian Ministry of Health, supported by the International Decision Support Initiative (iDSI), initiated a HTA study in 2016 to examine the cost-effectiveness of antihypertensive medicines. We aimed to summarize key insights from this work that highlights success factors beyond producing purely technical outputs. These include the need for capacity building, academic collaboration, and ongoing partnerships with a broad range of experts and stakeholders. By building on this HTA study, and with ongoing interactions with iDSI, HTAi, WHO, and others, Ghana will be well positioned to institutionalize HTA in resource allocation decisions and support progress toward UHC.

Commentary on the article “Key principles for the improved conduct of health technology assessments for resource allocation decisions”

2008 ◽  
Vol 24 (03) ◽  
pp. 362-365 ◽  
Author(s):  
H. David Banta
Keyword(s):  
Resource Allocation ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
The World ◽  
Allocation Decisions ◽  
Resource Allocation Decisions

The article “Key principles for the improved conduct of health technology assessments for resource allocation decisions” presents fifteen principles for health technology assessment. Many of these cannot be disputed, and application of the principles as stated would undoubtedly improve HTA as it is developing in the world at large. My question is, are these the most important principles? The document does not really try to answer this question.

scholarly journals HTA Agencies Need Evidence-Informed Deliberative Processes Comment on "Use of Evidence-Informed Deliberative Processes by Health Technology Assessment Agencies Around the Globe"

2020 ◽  
Author(s):  
Michael Schlander
Keyword(s):  
Resource Allocation ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Healthcare Resource ◽  
Allocative Efficiency ◽  
Health Technology ◽  
Analytical Framework ◽  
Pluralistic Societies ◽  
Deliberative Processes ◽  
Allocation Decisions

There are at least two reasons why health technology assessment (HTA) agencies need to seek process-based solutions to support the legitimacy of healthcare resource allocation, ie, (i) in pluralistic societies, the existence of often conflicting and incommensurable claims (ie, the "fragmentation of value") and the lack of a broadly accepted, ethically defensible analytical framework, and (ii) the well-documented loopholes of the conventional logic of cost-effectiveness (CE) with its reductionist concept of allocative efficiency, which fails to reflect the distributive dimension of resource allocation decisions in collectively financed health schemes.

scholarly journals Announcing the New Definition of Health Technology Assessment

2020 ◽  
Vol 23 (6) ◽  
pp. 824-825
Author(s):  
Brian O’Rourke ◽  
Wija Oortwijn ◽  
Tara Schuller
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Definition Of Health ◽  
Definition Of

Redefining health technology assessment in Canada: Diversification of products and contextualization of findings

2004 ◽  
Vol 20 (3) ◽  
pp. 325-336 ◽  
Author(s):  
Pascale Lehoux ◽  
Stéphanie Tailliez ◽  
Jean-Louis Denis ◽  
Myriam Hivon
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Chief Executive Officers ◽  
Social Issues ◽  
Chief Executive ◽  
Health Technology ◽  
Scientific Journals ◽  
Informational Basis ◽  
Definition Of ◽  
Executive Officers

Objectives:While strategies for enhancing the dissemination and impact of Health Technology Assessment (HTA) are now being increasingly examined, the characteristics of HTA production have received less attention.Methods:This study presents the results of a content analysis of the HTA documents (n=187) produced by six Canadian agencies from 1995 to 2001, supplemented by interviews with chief executive officers and researchers (n=40). The goal of this analysis was to characterize the agencies' portfolios and to analyze the challenges these agencies face in responding to the increased demand for HTA.Results:On average, thirty HTA products were issued annually by the agencies. While the bulk of documents produced were full HTA reports (76 percent), two agencies showed significant diversification in their products. Three agencies in particular actively supported the publication of results in scientific journals. Three agencies showed evidence of adapting to different institutional environments by specializing in certain areas (drugs, health services). Overall, a significant portion of the agencies' HTAs contained data on costs (37 percent) and effectiveness (48 percent), whereas ethical and social issues were rarely addressed (17 percent). Most agencies addressed issues and outcomes that did not strictly fall under the typical definition of HTA but that increased the “contextualization” of their findings.Conclusions:Our discussion highlights four paradoxes and reflects further on challenges raised by the coordination of HTA within large countries and among European states. This study concludes that HTA is being redefined in Canada as HTA agencies offer a more contextualized informational basis, an approach that may prove more compatible with the increased demand for HTA.

Evidence-Based Practice Center network and health technology assessment in the United States: Bridging the cultural gap

2006 ◽  
Vol 22 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Antonio Sarría-Santamera ◽  
David B. Matchar ◽  
Emma V. Westermann-Clark ◽  
Meenal B. Patwardhan
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Evidence Based Practice ◽  
Health Technology ◽  
The United States ◽  
Healthcare Research ◽  
Evidence Based ◽  
Is Integration ◽  
Definition Of

Objectives:The purpose of this study was to identify the Evidence-Based Practice Center (EPC) network participants' perceptions of the characteristics of the EPC process and the relationship of the process to the success of EPC reports.Methods:Semistructured interviews were conducted with the three groups involved in the EPC: EPC staff, Agency for Healthcare Research and Quality (AHRQ) staff, and representatives of partner organizations.Results:The analysis of the coded transcripts revealed three related major themes, which form the conceptual basis for the interpretation presented here: the definition of a successful report, the determinants of a successful report, and the role of AHRQ in the process.Conclusions:A successful report is a report that is used. The ultimate success of the core health technology assessment objective, moving from research to policy, depends on balancing two values: excellence and relevance. Our findings are consistent with the “two communities thesis,” which postulates the existence of two camps that confer different values to excellence and relevance, with resulting tension. A promising model for approaching this tension is integration or collaboration, which requires linking researchers and policy makers, promoting productive dialogues about the formulation and timing of analysis, and early consideration of how the resulting analysis will be used. This effort suggests that actively blurring the frontiers between these two groups will enhance their interaction. Furthermore, enhancing the role of the AHRQ as scientific broker will maximize the potential of the EPC network.

Ethical perspectives on health technology assessment

2004 ◽  
Vol 20 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Henk ten Have
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Medical Technology ◽  
Health Technology ◽  
Minor Role ◽  
Engineering Model ◽  
Ethical Aspects ◽  
A Value ◽  
Definition Of ◽  
A Minor

This study analyses why ethical aspects play a minor role in health technology assessment (HTA) studies, even when comprehensive approaches of technology assessment are advocated. Technology is often regarded as a value-neutral tool. At the same time, bioethics is dominated by an engineering model. Ethical contributions to evaluation of medical technology should go beyond issues of application in clinical practice and focus also on the definition of problems, the demarcation of technical and nontechnical issues, and the morally problematic implications of technologies.

Defining capacity building in the context of HTA: a proposal by the HTAi Scientific Development and Capacity Building Committee

2019 ◽  
Vol 35 (5) ◽  
pp. 362-366 ◽  
Author(s):  
Franz Pichler ◽  
Wija Oortwijn ◽  
Alric Ruether ◽  
Rebecca Trowman
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Interest Groups ◽  
Capacity Building ◽  
Technology Assessment ◽  
Health Technology ◽  
Scientific Development ◽  
Multiple Stakeholders ◽  
Building Activities ◽  
Definition Of

AbstractObjectivesTo develop a definition of “capacity building” relevant to Health Technology Assessment international (HTAi).MethodsA review of capacity building activities undertaken by HTAi members, members of the International Network of Agencies for Health Technology Assessment (INAHTA), and regional HTA networks was compared against general literature on capacity building definitions and frameworks. The findings were reviewed by the HTAi Scientific Development and Capacity Building Committee. Furthermore, the Executive Committee and Interest Groups of HTAi provided input on the draft final paper.ResultsThe literature demonstrated the need for a definition of capacity building specific to HTA. In the context of HTAi, it was necessary for the definition to cover (i) the broadest range of HTA-related activities, (ii) multiple stakeholders involved in the HTA process, and (iii) the spectrum of activities that compose capacity building. We propose the following definition of HTA capacity building: The process by which individuals and organizations develop or strengthen abilities related to understanding, providing input to, conducting, or utilizing HTA for health policy and decision making, as well as, developing awareness and support in the environment within which HTA is being used.ConclusionA definition of HTA-related capacity building that was intended to provide clarity about what this term means to HTAi was developed. As HTA is context-dependent, a need for further work to develop an operationalization “menu” relevant to the specific needs in which HTA is being used was identified.

HEALTH TECHNOLOGY ASSESSMENT AND EVIDENCE-BASED POLICY MAKING: QUEENSLAND DEPARTMENT OF HEALTH EXPERIENCE

2014 ◽  
Vol 30 (6) ◽  
pp. 595-600 ◽  
Author(s):  
Hong Ju ◽  
Kaye Hewson
Keyword(s):  
Resource Allocation ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Making ◽  
Health Technology ◽  
Evidence Based ◽  
Health Technologies ◽  
Queensland Department ◽  
Department Of Health ◽  
Evidence Based Policy

Background: Evidence-based policy making is increasingly used for better resource allocation. Queensland Department of Health has developed a new model to introduce innovative health technologies through a health technology assessment (HTA) program.Structure: A state-wide committee and several sub-committees at health service district level were established to oversee the HTA program and to monitor the uptake of technologies. The committees are supported by a multidisciplinary secretariat comprising staff with key HTA skills.Process: The process starts with HTA applications, which are then shortlisted according to prespecified criteria. A due diligence process adopting a rapid evidence assessment approach is used to evaluate the applications. Based on the assessment, recommendations are made using a deliberative decision-making process guided by well-recognized tools. With positive recommendation, a technology is piloted in constrained local setting before its system-wide diffusion.Outcome: The HTA program has assisted health administrators in prioritizing their health technology agendas. It has gained trust and wide support from policy makers and is increasingly used to support funding allocations, indicating the increasing awareness of and confidence in the program.Conclusions: The HTA program is a valuable process to assist evidence-based policy development and to guide better resource allocation.

scholarly journals The importance of health technology assessment to ensure an efficient and equitable access to high-cost therapies

2020 ◽  
Author(s):  
◽  
Ion Agirrezabal
Keyword(s):  
Primary Care ◽  
Resource Allocation ◽  
Insulin Glargine ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Real World ◽  
Health Technology ◽  
Decision Makers ◽  
The Real ◽  
Innovative Drugs

According to the World Health Organization, the key goal of health systems is to improve the average level of the population health and to reduce health inequalities in the population. In order to realise this goal, health system decision-makers need to decide which health technologies to invest in and which not to. Health technology assessment (HTA) provides a framework for decision-makers to make resource allocation and priority setting decisions based on the existing evidence. Considering the increasingly tight healthcare budgets and the rich pipeline of high-cost, innovative drugs very likely coming to market in the next few years, it is crucial that a robust and transparent HTA process be undertaken to assess these drugs, evaluating all aspects of the disease and treatment and involving all stakeholders affected. We conducted three standalone projects analysing different aspects of recently launched innovative drugs. In our first study, we combined high-quality sources of evidence, both from the real-world and randomised controlled trials, to evaluate the cost-effectiveness of carfilzomib for treating multiple myeloma patients. By harnessing the power of these data sources, we demonstrated that the reimbursement of carfilzomib is likely to represent an efficient allocation of existing resources. Despite the availability of good sources of evidence, the real-world distribution and use of innovative drugs may not be efficient nor fair, and this is what we demonstrated with our two other studies. Firstly, we showed that significant inequalities exist in the distribution of anti-osteoporosis drugs in primary care in England. The most striking case was that of denosumab, a high-cost innovative treatment, with prescriptions disproportionately concentrated among the least deprived. Substantial inequalities also exist in the use of insulin glargine biosimilars in primary care in England, even though guidelines and initiatives to promote the use of biosimilars have been put in place. In this study we observed that the real-world savings realised from the use of insulin glargine biosimilars represents a small proportion compared with what could have been achieved should their uptake had been higher. The results of these two studies, therefore, show that resource allocation may not be efficient nor fair in the real world, and similar situations are likely to exist in other disease areas. In summary, even though in many cases ample evidence exists to assist healthcare authorities making resource allocation decisions, we have demonstrated that resource allocation in the real world may not be optimal.

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