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Tefera BB, Demsie DG, Yehualaw A, Tafere C, Feyisa K, Yismaw MB, Kefale B, Yilma Z. Characteristics and Quality Appraisal of the Economic Evaluations Done in Ethiopia: A Systematic Review. PHARMACOECONOMICS - OPEN 2023; 7:877-886. [PMID: 37624553 PMCID: PMC10721755 DOI: 10.1007/s41669-023-00433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/23/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Health economic evaluation identifies, measures, values, and compares alternative strategies to efficiently allocate scarce resources. The validity, methodological quality, and generalizability of economic evaluations must be assessed, as poorly designed studies can lead to incorrect conclusions. Therefore, this study aimed to evaluate the quality and characteristics of published economic evaluations done in Ethiopia, using the Quality of Health Economics Studies (QHES) and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) instruments. METHODOLOGY Various electronic databases were searched using different keywords. We included only original studies conducted in Ethiopia that evaluated the cost and consequences of at least two health interventions. Abstracts, treatment guidelines, reviews, expert opinions, and studies that included other countries were excluded. Two reviewers independently evaluated each study using the QHES and CHEERS instruments and any disagreements were then resolved by a third reviewer. RESULT The study included 21 studies published between 2002 and 2021. HIV was the most frequently evaluated medical condition, examined in four (19.06%) of the 21 studies. Seventeen of the studies (80.95%) compared healthcare services or programs, while the other four examined pharmaceutical products. Cost-utility analysis was the economic evaluation technique used in 14 studies (66.67%). Of the studies that disclosed their funding sources, foreign institutions were involved in funding 71.43% of them. Disability-adjusted life-year (DALY) was an outcome metric used in nine (42.86%) studies. The average QHES score of the studies was 82%. Fourteen studies had QHES scores of ≥75% and two had scores of <50%. The studies evaluated using the CHEERS instrument ranged in quality from 42.9% to 92.9%, with an average of 78.23%. CONCLUSION Our study revealed that Ethiopia lacks health economic evaluations, particularly on non-communicable diseases. This indicates that the economic evaluation of healthcare interventions in Ethiopia is still in its early stages. Additionally, Ethiopian institutions have played a very limited role in funding research, highlighting the importance of active participation from local institutions.
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Affiliation(s)
| | | | - Adane Yehualaw
- Bahir Dar University College of Medicine and Health Sciences, Bahir Dar, Ethiopia
| | - Chernet Tafere
- Bahir Dar University College of Medicine and Health Sciences, Bahir Dar, Ethiopia
| | - Kebede Feyisa
- Bahir Dar University College of Medicine and Health Sciences, Bahir Dar, Ethiopia
| | | | - Belayneh Kefale
- Bahir Dar University College of Medicine and Health Sciences, Bahir Dar, Ethiopia
| | - Zewdu Yilma
- Bahir Dar University College of Medicine and Health Sciences, Bahir Dar, Ethiopia
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Falkowski A, Ciminata G, Manca F, Bouttell J, Jaiswal N, Farhana Binti Kamaruzaman H, Hollingworth S, Al-Adwan M, Heggie R, Putri S, Rana D, Mukelabai Simangolwa W, Grieve E. How Least Developed to Lower-Middle Income Countries Use Health Technology Assessment: A Scoping Review. Pathog Glob Health 2023; 117:104-119. [PMID: 35950264 PMCID: PMC9970250 DOI: 10.1080/20477724.2022.2106108] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Health Technology Assessment (HTA) is a multidisciplinary tool to inform healthcare decision-making. HTA has been implemented in high-income countries (HIC) for several decades but has only recently seen a growing investment in low- and middle-income countries. A scoping review was undertaken to define and compare the role of HTA in least developed and lower middle-income countries (LLMIC). MEDLINE and EMBASE databases were searched from January 2015 to August 2021. A matrix comprising categories on HTA objectives, methods, geographies, and partnerships was used for data extraction and synthesis to present our findings. The review identified 50 relevant articles. The matrix was populated and sub-divided into further categories as appropriate. We highlight topical aspects of HTA, including initiatives to overcome well-documented challenges around data and capacity development, and identify gaps in the research for consideration. Those areas we found to be under-studied or under-utilized included disinvestment, early HTA/implementation, system-level interventions, and cross-sectoral partnerships. We consider broad practical implications for decision-makers and researchers aiming to achieve greater interconnectedness between HTA and health systems and generate recommendations that LLMIC can use for HTA implementation. Whilst HIC may have led the way, LLMIC are increasingly beginning to develop HTA processes to assist in their healthcare decision-making. This review provides a forward-looking model that LLMIC can point to as a reference for their own implementation. We hope this can be seen as timely and useful contributions to optimize the impact of HTA in an era of investment and expansion and to encourage debate and implementation.
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Affiliation(s)
- Anna Falkowski
- Division of Communicable Disease, Michigan Department of Health and Human Services, State of Michigan, USA
| | - Giorgio Ciminata
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Francesco Manca
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Janet Bouttell
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Nishant Jaiswal
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Hanin Farhana Binti Kamaruzaman
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow.,Malaysian Health Technology Assessment Section (MaHTAS), Ministry of Health Malaysia, Putrajaya
| | | | - Mariana Al-Adwan
- F. Hoffman-La Roche Ltd, Amman, Jordan and Jordan ISPOR Chapter, Amman, Jordan
| | - Robert Heggie
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Septiara Putri
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow.,Health Policy and Administration Department, Faculty of Public Health, University of Indonesia, Depok, West Java, Indonesia
| | - Dikshyanta Rana
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Warren Mukelabai Simangolwa
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu Natal, Durban, South Africa and Patient and Citizen Involvement in Health, Lusaka, Zambia
| | - Eleanor Grieve
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
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Erku D, Mersha AG, Ali EE, Gebretekle GB, Wubshet BL, Kassie GM, Mulugeta A, Mekonnen AB, Eshetie TC, Scuffham P. A Systematic Review of Scope and Quality of Health Economic Evaluations Conducted in Ethiopia. Health Policy Plan 2022; 37:514-522. [PMID: 35266523 PMCID: PMC9128743 DOI: 10.1093/heapol/czac005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 12/16/2021] [Accepted: 02/20/2022] [Indexed: 11/13/2022] Open
Abstract
There has been an increased interest in health technology assessment and economic evaluations for health policy in Ethiopia over the last few years. In this systematic review, we examined the scope and quality of healthcare economic evaluation studies in Ethiopia. We searched seven electronic databases (PubMed/MEDLINE, EMBASE, PsycINFO, CINHAL, Econlit, York CRD databases and CEA Tufts) from inception to May 2021 to identify published full health economic evaluations of a health-related intervention or programme in Ethiopia. This was supplemented with forward and backward citation searches of included articles, manual search of key government websites, the Disease Control Priorities-Ethiopia project and WHO-CHOICE programme. The quality of reporting of economic evaluations was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. The extracted data were grouped into subcategories based on the subject of the economic evaluation, organized into tables and reported narratively. This review identified 34 full economic evaluations conducted between 2009 and 2021. Around 14 (41%) of studies focussed on health service delivery, 8 (24%) on pharmaceuticals, vaccines and devices, and 4 (12%) on public-health programmes. The interventions were mostly preventive in nature and focussed on communicable diseases (n = 19; 56%) and maternal and child health (n = 6; 18%). Cost-effectiveness ratios varied widely from cost-saving to more than US $37 313 per life saved depending on the setting, perspectives, types of interventions and disease conditions. While the overall quality of included studies was judged as moderate (meeting 69% of CHEERS checklist), only four out of 27 cost-effectiveness studies characterized heterogeneity. There is a need for building local technical capacity to enhance the design, conduct and reporting of health economic evaluations in Ethiopia.
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Affiliation(s)
- Daniel Erku
- Centre for Applied Health Economics, Griffith University, Nathan, QLD
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD
- Addis Consortium for Health Economics and Outcomes Research (AnCHOR)
| | - Amanual G Mersha
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Eskindir Eshetu Ali
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University
| | - Gebremedhin B Gebretekle
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
| | - Befikadu L Wubshet
- Health Services Research Centre Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Gizat Molla Kassie
- University of South Australia: Clinical & Health Sciences, Quality Use of Medicines and Pharmacy Research Centre
| | - Anwar Mulugeta
- Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, Australia, SA 5000, Australia
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa 1000, Ethiopia
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Alemayehu B Mekonnen
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, VIC, Australia
| | - Tesfahun C Eshetie
- Plein Center for Geriatric Pharmacy Research, Education and Outreach, School of Pharmacy, University of Washington, Seattle, WA, USA
| | - Paul Scuffham
- Centre for Applied Health Economics, Griffith University, Nathan, QLD
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD
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Hollingworth SA, Ruiz F, Gad M, Chalkidou K. Health technology assessment capacity at national level in sub-Saharan Africa: an initial survey of stakeholders. F1000Res 2021; 9:364. [PMID: 32595957 PMCID: PMC7309411 DOI: 10.12688/f1000research.23263.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Health technology assessment (HTA) is an effective tool for supporting priority setting (PS) in health. Stakeholder groups need to understand HTA appropriate to their role and to interpret and critique the evidence produced. We aimed to rapidly assess current health system priorities and policy areas of demand for HTA in Sub-Saharan Africa, and identify key gaps in data and skills to inform targeted capacity building. Methods: We revised an existing survey, delivered it to 357 participants, then analysed responses and explored key themes. Results: There were 51 respondents (14%, 30 full completions) across 14 countries. HTA was considered an important and valuable PS tool with a key role in the design of health benefits packages, clinical guideline development, and service improvement. Medicines were identified as a technology type that would especially benefit from the application of HTA. Using HTA to address safety issues (e.g. low-quality medicines) and value for money concerns was particularly highlighted. The perceived availability and accessibility of suitable local data to support HTA varied widely but was mostly considered inadequate and limited. Respondents also noted a need for training support in research methodology and data gathering. Conclusions: While important in raising awareness of HTA as a tool for PS, this study had a low response rate, and that respondents were self-selected. A more refined survey will be developed to support engagement strategies and capacity building.
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Affiliation(s)
| | - Francis Ruiz
- School of Public Health, Imperial College London, London, UK
- London School of Hygeine and Tropical Medicine, London, UK
| | - Mohamed Gad
- School of Public Health, Imperial College London, London, UK
- London School of Hygeine and Tropical Medicine, London, UK
| | - Kalipso Chalkidou
- School of Public Health, Imperial College London, London, UK
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
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Hollingworth S, Fenny AP, Yu SY, Ruiz F, Chalkidou K. Health technology assessment in sub-Saharan Africa: a descriptive analysis and narrative synthesis. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2021; 19:39. [PMID: 34233710 PMCID: PMC8261797 DOI: 10.1186/s12962-021-00293-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background Countries in Sub-Saharan Africa (SSA) are moving towards universal health coverage. The process of Health Technology Assessment (HTA) can support decisions relating to benefit package design and service coverage. HTA involves institutional cooperation with agreed methods and procedural standards. We systematically reviewed the literature on policies and capacity building to support HTA institutionalisation in SSA. Methods We systematically reviewed the literature by searching major databases (PubMed, Embase, etc.) until June 2019 using terms considering three aspects: HTA; health policy, decision making; and SSA. We quantitatively extracted and descriptively analysed content and conducted a narrative synthesis eliciting themes from the selected literature, which varied in study type and apporach. Results Half of the 49 papers identified were primary research studies and mostly qualitative. Five countries were represented in six of ten studies; South Africa, Ghana, Uganda, Cameroon, and Ethiopia. Half of first authors were from SSA. Most informants were policy makers. Five themes emerged: (1) use of HTA; (2) decision-making in HTA; (3) values and criteria for setting priority areas in HTA; (4) involving stakeholders in HTA; and (5) specific examples of progress in HTA in SSA. The first one was the main theme where there was little use of evidence and research in making policy. The awareness of HTA and economic evaluation was low, with inadequate expertise and a lack of local data and tools. Conclusions Despite growing interest in HTA in SSA countries, awareness remains low and HTA-related activities are uncoordinated and often disconnected from policy. Further training and skills development are needed, firmly linked to a strategy focusing on strengthening within-country partnerships, particularly among researchers and policy makers. The international community has an important role here by supporting policy- relevant technical assistance, highlighting that sustainable financing demands evidence-based processes for effective resource allocation, and catalysing knowledge-sharing opportunities among countries facing similar challenges. Supplementary Information The online version contains supplementary material available at 10.1186/s12962-021-00293-5.
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Affiliation(s)
- Samantha Hollingworth
- School of Pharmacy, University of Queensland, 20 Cornwall St, Woolloongabba, Brisbane, QLD, 4102, Australia. .,Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ama Pokuaa Fenny
- Institute of Statistical, Social and Economics Research, University of Ghana, Accra, Ghana
| | - Su-Yeon Yu
- National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Francis Ruiz
- iDSI, London School of Hygiene and Tropical Medicine, London, UK
| | - Kalipso Chalkidou
- The Global Fund To Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
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6
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Uzochukwu BSC, Okeke C, O’Brien N, Ruiz F, Sombie I, Hollingworth S. Health technology assessment and priority setting for universal health coverage: a qualitative study of stakeholders' capacity, needs, policy areas of demand and perspectives in Nigeria. Global Health 2020; 16:58. [PMID: 32641066 PMCID: PMC7346669 DOI: 10.1186/s12992-020-00583-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/17/2020] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Health technology assessment (HTA) is an effective tool to support priority setting and generate evidence for decision making especially en route to achieving universal health coverage (UHC). We assessed the capacity needs, policy areas of demand, and perspectives of key stakeholders for evidence-informed decision making in Nigeria where HTA is still new. METHODS We surveyed 31 participants including decision makers, policy makers, academic researchers, civil society organizations, community-based organizations, development partners, health professional organizations. We revised an existing survey to qualitatively examine the need, policy areas of demand, and perspectives of stakeholders on HTA. We then analyzed responses and explored key themes. RESULTS Most respondents were associated with organizations that generated or facilitated health services research. Research institutes highlighted their ability to provide expertise and skills for HTA research but some respondents noted a lack of human capacity for HTA. HTA was considered an important and valuable priority-setting tool with a key role in the design of health benefits packages, clinical guideline development, and service improvement. Public health programs, medicines and vaccines were the three main technology types that would especially benefit from the application of HTA. The perceived availability and accessibility of suitable local data to support HTA varied widely but was mostly considered inadequate and limited. Respondents needed evidence on health system financing, health service provision, burden of disease and noted a need for training support in research methodology, HTA and data management. CONCLUSION The use of HTA by policymakers and communities in Nigeria is very limited mainly due to inadequate and insufficient capacity to produce and use HTA. Developing sustainable and institutionalized HTA systems requires in-country expertise and active participation from a range of stakeholders. Stakeholder participation in identifying HTA topics and conducting relevant research will enhance the use of HTA evidence produced for decision making. Therefore, the identified training needs for HTA and possible research topics should be considered a priority in establishing HTA for evidence-informed policy making for achieving UHC particularly among the most vulnerable people in Nigeria.
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Affiliation(s)
- Benjamin S. C. Uzochukwu
- Department of Community medicine, College of Medicine, University of Nigeria Enugu Campus Nigeria, Enugu, Nigeria
| | - Chinyere Okeke
- International Decision Support Initiative (iDSI), Global Health and Development Group, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG UK
| | - Niki O’Brien
- International Decision Support Initiative (iDSI), Global Health and Development Group, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG UK
| | - Francis Ruiz
- International Decision Support Initiative (iDSI), Global Health and Development Group, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG UK
| | - Issiaka Sombie
- West Africa Health Organisation, Organisation Ouest Africaine de la Santé, 175 avenue Ouezzin Coulibaly, Bobo-Dioulasso 01, 01 BP 153 Burkina Faso
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Hollingworth SA, Ruiz F, Gad M, Chalkidou K. Health technology assessment capacity at national level in sub-Saharan Africa: an initial survey of stakeholders. F1000Res 2020; 9:364. [PMID: 32595957 DOI: 10.12688/f1000research.23263.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Health technology assessment (HTA) is an effective tool to support priority setting (PS) in health. Stakeholder groups need to understand HTA appropriate to their role and to interpret and critique the evidence produced. We aimed to rapidly assess current health system priorities and policy areas of demand for HTA in Sub-Saharan Africa, and identify key gaps in data and skills to inform targeted capacity building. Methods: We revised an existing survey, delivered it to 357 participants, then analysed responses and explored key themes. Results: There were 51 respondents (14%) across 14 countries. HTA was considered an important and valuable PS tool with a key role in the design of health benefits packages, clinical guideline development, and service improvement. Medicines were identified as a technology type that would especially benefit from the application of HTA. Using HTA to address safety issues (e.g. low-quality medicines) and value for money concerns was particularly highlighted. The perceived availability and accessibility of suitable local data to support HTA varied widely but was mostly considered inadequate and limited. Respondents also noted a need for training support in research methodology and data gathering. Conclusions: While important in raising awareness of HTA as a tool for PS, this study had a low response rate, and that respondents were self-selected. A more refined survey will be developed to support engagement strategies and capacity building.
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Affiliation(s)
| | - Francis Ruiz
- School of Public Health, Imperial College London, London, UK
| | - Mohamed Gad
- School of Public Health, Imperial College London, London, UK
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Addo R, Hall J, Haas M, Goodall S. The knowledge and attitude of Ghanaian decision-makers and researchers towards health technology assessment. Soc Sci Med 2020; 250:112889. [PMID: 32146238 DOI: 10.1016/j.socscimed.2020.112889] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 11/26/2022]
Abstract
Although health technology assessment (HTA) is intended to provide policymakers with objective information, the likelihood that a health decision-maker (HDM) will use this information is associated with their knowledge, role and perception of the HTA process. In Ghana, policymakers are working towards formalising the use of HTA, but HDM knowledge of and attitude towards HTA are not known. Between March and May 2016, we conducted in-depth interviews and used inductive thematic analysis to explore Ghanaian HDMs (n = 23) and researchers' (n = 4) perceptions of and barriers to HTA and identify ways to promote HTA. We compare our findings with those reported in previous studies conducted in low-and-middle-income countries. Common themes were that resources, political and cultural factors act as barriers to HTA use. Recommendations made in previous studies which were also identified in this study included the need for the development of both human and data capacity, allocating funds to HTA and stakeholder involvement in HTA processes. Specific recommendations made by Ghanaian HDMs and researchers in this study focused on the establishment of an HTA body: its location, the constitution of the appraisal team, the type of evidence to appraise and who makes the final decision. The findings provide important information in the context of current planning to institutionalise HTA in Ghana. Addressing the identified barriers will enable policymakers to maximise the chances of realising the expected benefits of HTA, as participants who are potential producers and end-users are likely to use what they have contributed to.
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Affiliation(s)
- Rebecca Addo
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Broadway, Sydney, Australia.
| | - Jane Hall
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Broadway, Sydney, Australia
| | - Marion Haas
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Broadway, Sydney, Australia
| | - Stephen Goodall
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Broadway, Sydney, Australia
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Zegeye EA, Reshad A, Bekele EA, Aurgessa B, Gella Z. The State of Health Technology Assessment in the Ethiopian Health Sector: Learning from Recent Policy Initiatives. Value Health Reg Issues 2018; 16:61-65. [PMID: 30195092 DOI: 10.1016/j.vhri.2018.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 07/02/2018] [Accepted: 07/11/2018] [Indexed: 11/25/2022]
Abstract
Health technology assessment (HTA) has previously been implemented only in a fragmented manner in the Ethiopian health sector decision-making cycle, and the sector has been hampered by limited institutional capacity and skilled human resources to inform evidence-based decision making. The country is in the midst of widescale implementation of a community-based health insurance scheme and is preparing for the launch of a social health insurance scheme. The country continues to face a limited financial resource envelope, undergoing an epidemiological transition, and is facing a much greater burden of noncommunicable diseases, for which the essential health benefit package, defined 12 years ago, may no longer be suitable. This has called for an in-depth review of the application of HTA in the context of the current health needs and institutional settings. To meet the increasing need for HTA, the Health Economics and Financing Analysis (HEFA) team was established within the Finance Resource Mobilization Department under the Ministry of Health. The HEFA team is tasked with spearheading the application of evidence-based health care decision making in Ethiopia by organizing available evidence, costing interventions, and defining effectiveness measures of the different health programs and then supporting policymakers at the national and regional levels. Improving and harmonizing the institutional approach to HTA, including staffing the HEFA team with the appropriate mix of expertise, and networking with relevant sector organizations will improve Ethiopia's ability to tackle the current health sector challenges as well as protect fledgling insurance schemes' progress toward universal health coverage.
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Affiliation(s)
- Elias Asfaw Zegeye
- Health Economics and Financing Analysis Team, Finance Resource Mobilization Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia.
| | | | - Eyersualem Animut Bekele
- Partnership and Coordination Team, Finance Resource Mobilization Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Belay Aurgessa
- Partnership and Coordination Team, Finance Resource Mobilization Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Zenebech Gella
- Health Economics and Financing Analysis Team, Finance Resource Mobilization Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
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Adeagbo CU, Rattanavipapong W, Guinness L, Teerawattananon Y. The Development of the Guide to Economic Analysis and Research (GEAR) Online Resource for Low- and Middle-Income Countries' Health Economics Practitioners: A Commentary. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:569-572. [PMID: 29753354 PMCID: PMC5947918 DOI: 10.1016/j.jval.2017.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/05/2017] [Accepted: 10/10/2017] [Indexed: 05/15/2023]
Abstract
Public health authorities around the world are increasingly using economic evaluation to set priorities and inform decision making in health policy, especially in the development of health benefit packages. Nevertheless, researchers in low- and middle-income countries (LMICs) encounter many barriers when conducting economic evaluations. In 2015, the Health Intervention and Technology Assessment Program identified key technical and context-specific challenges faced in conducting and using health economic evaluations in LMICs. On the basis of these research findings, the Guide to Economic Analysis and Research (GEAR) online resource (www.gear4health.com) was developed as a reliable aid to researchers in LMICs that would help overcome those challenges. Funded by the Thailand Research Fund and the Bill and Melinda Gates Foundation, GEAR is a free online resource that provides a visual aid tool for planning economic evaluation studies (GEAR mind maps), a repository of national and international economic evaluation guidelines (GEAR guideline comparison), and an active link to a network of volunteer international experts (GEAR: Ask an expert). GEAR will evolve over time to provide relevant, reliable, and up-to-date information through inputs from its users (e.g., periodic survey on methodological challenges) and experts (e.g., in responding to users' questions). The objective of this commentary was to give a brief description of the development and key features of this unique collective information hub aimed at facilitating high-quality research and empowering health care decision makers and stakeholders to use economic evaluation evidence.
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Affiliation(s)
- Chiaki Urai Adeagbo
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Nonthaburi, Thailand.
| | - Waranya Rattanavipapong
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Lorna Guinness
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Nonthaburi, Thailand
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