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Alnaqbi KA, Elshamy AM, Gebran N, Fahmy S, Aldallal S, Korra N, Fasseeh AN, Kaló Z. Consensus-Based Recommendations for the Implementation of Health Technology Assessment in the United Arab Emirates. Value Health Reg Issues 2024; 43:101012. [PMID: 38861786 DOI: 10.1016/j.vhri.2024.101012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/27/2024] [Accepted: 04/17/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVES Healthcare research and development have accelerated at an unprecedented rate creating a challenge even for high-income countries to finance all new technologies. Health technology assessment (HTA) aims to maximize health gains out of available resources. Our study aimed to provide tailor-made recommendations for HTA implementation in the United Arab Emirates (UAE). METHODS We conducted a policy survey to explore the gap between the current and preferred future environment of HTA implementation in the UAE. The survey was distributed in 2 workshops discussing the importance of HTA implementation, and results were further aggregated to yield a list of draft recommendations. Recommendations were then assessed for their feasibility in a round table discussion with experts in the field to generate actions for HTA implementation. RESULTS Survey results and round table discussion indicated the need to leverage HTA for value-based decision making. Experts confirmed the unmet need for broader coverage of graduate and postgraduate HTA training with the aim of specific PhD programs in the UAE. Public funding for HTA appraisals and expanding the scope of HTA to nonpharmaceuticals was recommended. Furthermore, experts recommended that several HTA bodies should be coordinated centrally and highlighted the importance of having an explicit soft cost-effectiveness threshold for common technologies and a higher threshold for orphan drugs. CONCLUSIONS Although HTA in the UAE is still in its early stages, strong initiatives are being taken for its implementation. Our survey results served as a step in developing a detailed action plan for HTA implementation that will enhance the sustainability of the healthcare system.
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Affiliation(s)
- Khalid A Alnaqbi
- Rheumatology Division, Tawam Hospital, Al Ain, United Arab Emirates; Internal Medicine Department, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | | | - Nicole Gebran
- Internal Medicine Department, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates; Abu Dhabi Healthcare Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Sahar Fahmy
- College of Pharmacy, Helwan University, Cairo, Egypt
| | - Sara Aldallal
- Dubai Health Authority, Dubai, United Arab Emirates; Emirates Health Economics Society, United Arab Emirates
| | | | - Ahmad Nader Fasseeh
- Syreon Middle East, Alexandria, Egypt; Faculty of Pharmacy Alexandria University, Alexandria, Egypt
| | - Zoltán Kaló
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary; Syreon Research Institute, Budapest, Hungary
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Al Rashdi I, Al Balushi S, Al Shuaili A, Al Rashdi S, Ibrahim Al Bulushi N, Ibrahim Al Kindi A, Al Salmi Q, Al Sabti H, Korra N, Abaza S, Fasseeh AN, Kaló Z. A roadmap towards implementing health technology assessment in Oman. J Health Organ Manag 2024; 38:241-257. [PMID: 39308088 PMCID: PMC11346210 DOI: 10.1108/jhom-01-2024-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/03/2024] [Accepted: 04/30/2024] [Indexed: 09/26/2024]
Abstract
PURPOSE Health technologies are advancing rapidly and becoming more expensive, posing a challenge for financing healthcare systems. Health technology assessment (HTA) improves the efficiency of resource allocation by facilitating evidence-informed decisions on the value of health technologies. Our study aims to create a customized HTA roadmap for Oman based on a gap analysis between the current and future status of HTA implementation. DESIGN/METHODOLOGY/APPROACH We surveyed participants of an advanced HTA training program to assess the current state of HTA implementation in Oman and explore long-term goals. A list of draft recommendations was developed in areas with room for improvement. The list was then validated for its feasibility in a round table discussion with senior health policy experts to conclude on specific actions for HTA implementation. FINDINGS Survey results aligned well with expert discussions. The round table discussion concluded with a phasic action plan for HTA implementation. In the short term (1-2 years), efforts will focus on building capacity through training programs. For medium-term actions (3-5 years), plans include expanding the HTA unit and introducing multiple cost-effectiveness thresholds while from 6-10 years, publishing of HTA recommendations, critical appraisal reports, and timelines is recommended. ORIGINALITY/VALUE Although the HTA system in Oman is still in its early stages, strong initiatives are being taken for its advancement. This structured approach ensures a comprehensive integration of HTA into the healthcare system, enhancing decision-making and promoting a sustainable, evidence-based system addressing the population's needs.
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Affiliation(s)
- Ibrahim Al Rashdi
- Directorate General of Medical Supplies,
Ministry of Health Oman E-Library, Muscat,
Oman
| | - Sara Al Balushi
- Directorate General of Medical Supplies,
Ministry of Health Oman E-Library, Muscat,
Oman
| | - Alia Al Shuaili
- Directorate General of Medical Supplies,
Ministry of Health Oman E-Library, Muscat,
Oman
| | - Said Al Rashdi
- Directorate General of Medical Supplies,
Ministry of Health Oman E-Library, Muscat,
Oman
| | | | - Asiya Ibrahim Al Kindi
- Directorate General of Medical Supplies,
Ministry of Health Oman E-Library, Muscat,
Oman
| | - Qasem Al Salmi
- Director General of Planning and Studies,
Ministry of Health Oman E-Library, Muscat,
Oman
| | - Hilal Al Sabti
- Senior Consultant Cardiothoracic Surgeon,
Sultan Qaboos University Hospital, Muscat,
Oman
- Minister of Health Office,
Ministry of Health Oman E-Library, Muscat,
Oman
| | | | | | - Ahmad Nader Fasseeh
- Syreon Middle East, Alexandria, Egypt
- Faculty of Pharmacy,
Alexandria University, Alexandria, Egypt
| | - Zoltán Kaló
- Syreon Research Institute, Budapest,
Hungary
- Center for Health Technology Assessment,
Semmelweis University, Budapest, Hungary
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Hedibel M, Ghanassi FZ, El-Fass KA, Fasseeh AN, Abaza S, Kaló Z. Designing a Roadmap for Health Technology Assessment Implementation in Algeria. Cureus 2024; 16:e65558. [PMID: 39192895 PMCID: PMC11349251 DOI: 10.7759/cureus.65558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 08/29/2024] Open
Abstract
Background The scarcity of resources restricts healthcare financing decisions, affecting the population's health. Health technology assessment (HTA) balances restricted budgets with the best possible health outcomes. We aim to characterize the current status of HTA in Algeria and describe the future directions for HTA implementation according to the priorities set by local stakeholders. Methods Stakeholders from the public and private sectors responded to a policy survey about the current and preferred future status of HTA implementation in Algeria. The survey was administered during an online workshop and used a widely accepted international scorecard covering eight domains: capacity building, HTA financing, process and organizational structure, scope of HTA implementation, decision criteria, standardization of methodology, use of local data, and international collaboration. After that, one-on-one interviews with another local expert were conducted to validate and modify the draft recommendations. The interviewees were representatives from government agencies, hospitals, and pharmaceutical companies. Results Thirty-one experts filled out the HTA scorecard survey; most of them were from the public sector (74%). They highlighted that project-based HTA workshops or short courses were the most common form of HTA education in Algeria and recommended the establishment of postgraduate HTA training programs in the future to build sustainable capacities. They reported a lack of funding for HTA research and critical appraisal and recommended an increased public budget for HTA and the introduction of submission fees by manufacturers. There was consensus about the need for local HTA evidence generation in the future. Most of the experts advocated an explicit soft decision threshold. The interviewees further recommended using multi-criteria decision analysis in the short term. The application of quality indicators was believed to improve the reliability of the HTA process. Conclusion The results of our policy research delineate the gap between the current and preferred future status of HTA in Algeria based on insights from multiple stakeholders. The need to improve the educational HTA programs in Algeria, use local data in policy decisions, and increase funding for HTA were the most advocated recommendations.
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Affiliation(s)
- Meriem Hedibel
- Pharmaceutics and Industrial Pharmacy Research Laboratory, Faculty of Pharmacy, University of Algiers, Algiers, DZA
| | - Fatma-Zohra Ghanassi
- Pharmaceutics and Industrial Pharmacy Research Laboratory, Faculty of Pharmacy, University of Algiers, Algiers, DZA
| | | | - Ahmad N Fasseeh
- Modelling, Syreon Middle East, Alexandria, EGY
- Faculty of Pharmacy, Alexandria University, Alexandria, EGY
| | - Sherif Abaza
- Health Economics, Syreon Middle East, Cairo, EGY
| | - Zoltán Kaló
- Health Economics, Syreon Research Institute, Budapest, HUN
- Center for Health Technology Assessment, Semmelweis University, Budapest, HUN
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Bala C, Rusu A, Ciobanu D, Roman G. Length of Hospital Stay, Hospitalization Costs, and Their Drivers in Adults with Diabetes in the Romanian Public Hospital System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10035. [PMID: 36011670 PMCID: PMC9408410 DOI: 10.3390/ijerph191610035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
The aim of this analysis was to assess the costs associated with the hospitalizations of persons with diabetes in a Romanian public hospital. We performed a retrospective “top-down” cost analysis of all adult patients discharged from a tertiary care hospital with an ICD-10 primary or secondary code of diabetes mellitus (type 1, type 2, or specific forms) between 1 January 2015 and 31 December 2018. All costs were adjusted with the annual inflation rates and converted to EUR. We included 16,868 patients with diabetes and 28,055 episodes of hospitalization. The total adjusted hospitalization cost in the analyzed period was EUR 26,418,126.8 and the adjusted median cost/episode of hospitalization was EUR 596.5. The mean length of a hospital stay/episode was 7.3 days. In the multivariate regression analysis, higher adjusted average costs/episodes of hospitalization and longer lengths of hospital stays were associated with increasing age, the presence of cardiovascular diseases, chronic kidney disease, and foot ulcerations. Moreover, a significant association between the average cost/episode of hospitalization and the length of hospital stay was observed (β = 0.704, p < 0.001). This study shows the burden on Romanian public hospitals of inpatient diabetes care and the main drivers of the costs.
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Affiliation(s)
- Cornelia Bala
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Diabetes Centre, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
| | - Adriana Rusu
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Diabetes Centre, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
| | - Dana Ciobanu
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Diabetes Centre, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
| | - Gabriela Roman
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Diabetes Centre, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
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Setiawan AW, Wicaksono AA. Implementation of Health Technology Assessment and Management Course in Undergraduate Program in Biomedical Engineering ITB. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:3281-3284. [PMID: 36086143 DOI: 10.1109/embc48229.2022.9871949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Undergraduate Program in Biomedical Engineering ITB, Indonesia, introduce the Health Technology Assessment and Management as an elective course in 2021. This course is implemented to support the World Health Assembly that urges the member states to establish national strategies in health technology assessment and management, particularly medical devices. Furthermore, it is designed to give biomedical engineering students a broader insight into their career opportunities. Therefore, this course is delivered by the practitioner and guided by the main lecturer. The course syllabus is developed from the WHO Medical Devices Technical Series and European Network for Health Technology Assessment. It tries to implement HTA Core Model for Rapid Relative Effectiveness Assessments. A questionnaire is used to measure the students' perception of the course implementation. Moreover, it is used to obtain the students' comments and feedback. The course that is delivered by the practitioner not only gives the course content but also the context. After attending the course, students have a broader insight into the career opportunities as biomedical engineers in Indonesia.
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Janez A, Battelino T, Klupa T, Kocsis G, Kuricová M, Lalić N, Stoian AP, Prázný M, Rahelić D, Šoupal J, Tankova T, Zelinska N. Hybrid Closed-Loop Systems for the Treatment of Type 1 Diabetes: A Collaborative, Expert Group Position Statement for Clinical Use in Central and Eastern Europe. Diabetes Ther 2021; 12:3107-3135. [PMID: 34694585 PMCID: PMC8586062 DOI: 10.1007/s13300-021-01160-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/18/2021] [Indexed: 01/23/2023] Open
Abstract
In both pediatric and adult populations with type 1 diabetes (T1D), technologies such as continuous subcutaneous insulin infusion (CSII), continuous glucose monitoring (CGM), or sensor-augmented pumps (SAP) can consistently improve glycemic control [measured as glycated hemoglobin (HbA1c) and time in range (TIR)] while reducing the risk of hypoglycemia. Use of technologies can thereby improve quality of life and reduce the burden of diabetes management compared with self-injection of multiple daily insulin doses (MDI). Novel hybrid closed-loop (HCL) systems represent the latest treatment modality for T1D, combining modern glucose sensors and insulin pumps with a linked control algorithm to offer automated insulin delivery in response to blood glucose levels and trends. HCL systems have been associated with increased TIR, improved HbA1c, and fewer hypoglycemic events compared with CSII, SAP, and MDI, thereby potentially improving quality of life for people with diabetes (PwD) while reducing the costs of treating short- and long-term diabetes-related complications. However, many barriers to their use and regional inequalities remain in Central and Eastern Europe (CEE). Published data suggest that access to diabetes technologies is hindered by lack of funding, underdeveloped health technology assessment (HTA) bodies and guidelines, unfamiliarity with novel therapies, and inadequacies in healthcare system capacities. To optimize the use of diabetes technologies in CEE, an international meeting comprising experts in the field of diabetes was held to map the current regional access, to present the current national reimbursement guidelines, and to recommend solutions to overcome uptake barriers. Recommendations included regional and national development of HTA bodies, efficient allocation of resources, and structured education programs for healthcare professionals and PwD. The responsibility of the healthcare community to ensure that all individuals with T1D gain access to modern technologies in a timely and economically responsible manner, thereby improving health outcomes, was emphasized, particularly for interventions that are cost-effective.
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Affiliation(s)
- Andrej Janez
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia.
| | - Tadej Battelino
- University Medical Center Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tomasz Klupa
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
- University Hospital, Kraków, Poland
| | - Győző Kocsis
- Department of Medicine and Oncology, Semmelweis University Budapest, Budapest, Hungary
| | - Miriam Kuricová
- Pediatric Department, National Institute of Endocrinology and Diabetology, Ľubochňa, Slovakia
- Department of Children and Adolescents, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovakia
| | - Nebojša Lalić
- Faculty of Medicine of the University of Belgrade, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia
| | - Anca Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Martin Prázný
- Third Department of Internal Medicine, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Czechia
| | - Dario Rahelić
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
- School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Jan Šoupal
- Third Department of Internal Medicine, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Czechia
| | - Tsvetalina Tankova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Nataliya Zelinska
- Ukrainian Scientific and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine, Kyiv, Ukraine
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Almomani E, Alabbadi I, Fasseeh A, Al-Qutob R, Al-Sharu E, Hayek N, Tarawneh MR, Kaló Z. Implementation Road Map of Health Technology Assessment in Middle-Income Countries: The Case of Jordan. Value Health Reg Issues 2021; 25:126-134. [PMID: 34015521 DOI: 10.1016/j.vhri.2021.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 11/13/2020] [Accepted: 01/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Health technology assessment (HTA) can increase the appropriateness and transparency of pricing and reimbursement decisions. Jordan is still in the early phase of its HTA implementation, although the country has very limited public resources for the coverage of healthcare technologies. The study objective was to explore and validate priorities in the HTA road map for Jordan and propose to facilitate the preferred HTA status. METHODS Health policy experts from the public and private sectors were asked to participate in a survey to explore the current and future status of HTA implementation in Jordan. Semistructured interviews with senior policy makers supported by literature review were conducted to validate survey results and make recommendations for specific actions. RESULTS Survey and interview results indicated a need for increased HTA training, including both short courses and academic programs and gradually increasing public funding for technology assessment and appraisal. Multiple HTA bodies with central coordination can be the most feasible format of HTA institutionalization. The weight of cost-effectiveness criterion based on local data with published reports and explicit decision thresholds should be increased in policy decisions of pharmaceutical and nonpharmaceutical technologies. CONCLUSION Currently, HTA has limited impact on health policy decisions in Jordan, and when it is used to support pharmaceutical reimbursement decisions, it is mainly based on results from other countries without considering transferability of international evidence. Policy makers should facilitate HTA institutionalization and use in policy decisions by increasing the weight of local evidence in HTA recommendations.
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Affiliation(s)
- Emad Almomani
- Jordanian Royal Medical Services, Department for Health Technology Assessment, Amman, Jordan; High Health Council, Department for Health Economics and Financing, Amman, Jordan.
| | - Ibrahim Alabbadi
- The University of Jordan, Faculty of Pharmacy, Amman, Jordan; Faculty of Pharmaceutical Science, UCSI University, Malaysia
| | - Ahmad Fasseeh
- Doctoral School of Sociology, Faculty of Social Sciences, Eötvös Loránd University Budapest, Budapest, Hungary; Syreon Middle East, Alexandria, Egypt
| | - Raeda Al-Qutob
- The University of Jordan, School of Medicine, Dept of Family and Community Medicine, Amman, Jordan
| | - Emad Al-Sharu
- Jordanian Royal Medical Services, Department for Health Technology Assessment, Amman, Jordan
| | - Noha Hayek
- Theodore Bilharz Reseach Institute, Giza, Egypt
| | | | - Zoltán Kaló
- Semmelweis University, Center for Health Technology Assessment, Budapest, Hungary; Syreon Research Institute, Budapest, Hungary
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Lorenzovici L, Székely A, Csanádi M, Gaál P. Cost Assessment of Inpatient Care Episodes of Stroke in Romania. Front Public Health 2020; 8:605919. [PMID: 33344405 PMCID: PMC7746609 DOI: 10.3389/fpubh.2020.605919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/11/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction: Stroke is the second leading cause of death worldwide and Romania is no exception. There is a high economic burden associated with the treatment of stroke patients, which puts pressure on the healthcare budget. This study aims to measure the inpatient treatment costs of stroke patients in Romania. Methods: Our retrospective analysis follows stroke patients in six Romanian hospitals at different progressivity level from different regions. Patients are identified from the official hospital databases, reported for reimbursement purposes. Mean inpatient costs incurred with the treatment of these stroke patient episodes are calculated using the gross costing method. The cost data are derived from the management control system of the study hospitals. Results: 3,155 patient episodes of stroke were identified in the study hospitals. The average cost per stroke inpatient care episode sums up to EUR 995.57 (95% CI: EUR 963.74-EUR 1 027.39) in 2017, while the overall yearly healthcare burden adds up to EUR 140 million, representing 2.18% of the total national health insurance budget and a cost of EUR 7.15 per capita. Conclusion: The hospital cost of stroke inpatient care episode in Romania is high and it represents a sizable part of the healthcare budget, but it is among the lowest in Europe, which can mainly be explained by the level of economic development of the country. As both the number of patients and the cost of acute care are expected to increase in the future, the economic burden of stroke is also expected to increase.
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Affiliation(s)
- László Lorenzovici
- Syreon Research Romania, Tirgu Mures, Romania
- G. E. Palade University of Medicine, Pharmacy, Science and Technology, Tirgu Mures, Romania
| | | | | | - Péter Gaál
- Health Services Management Training Centre, Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
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Németh B, Goettsch W, Kristensen FB, Piniazhko O, Huić M, Tesař T, Atanasijevic D, Lipska I, Kaló Z. The transferability of health technology assessment: the European perspective with focus on central and Eastern European countries. Expert Rev Pharmacoecon Outcomes Res 2020; 20:321-330. [PMID: 32500749 DOI: 10.1080/14737167.2020.1779061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Lower-income European countries have a worse health status and less funds for health care compared to Western Europe. Despite their limited human and financial capacities for conducting Health Technology Assessment (HTA), the need for evidence-based decision-making is growing. Two main approaches emerged as potential solutions: joint clinical assessments on the European level, and simplified procedures relying on the judgments of well-established HTA agencies of Western countries. AREAS COVERED Based on considerations of transferability, the European Network for Health Technology Assessment (EUnetHTA) was built up to harmonize HTA methodologies across the European Union, and to develop an HTA Core Model by focusing on joint production of relative effectiveness assessment, which can be used as a basis for national value assessments. The second approach has been suggested in various forms without considering transferability issues. EXPERT OPINION Joint clinical assessments reduce duplication of efforts based on appropriate scientific rationale. On the other hand, recent examples show that relying on judgments of HTA agencies from wealthier countries with potentially different health-care priorities can lead to suboptimal allocation decisions. In the short term, some stakeholders may benefit from ignoring transferability, but it will ultimately lead to limited access in other disease areas.
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Affiliation(s)
| | - Wim Goettsch
- WHO CollaboratingUtrecht Centre for Pharmaceutical Policy, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University , Utrecht, The Netherlands.,National Health Care Institute , Diemen, The Netherlands
| | - Finn Børlum Kristensen
- Faculty of Health Sciences, Department of Public Health, Research Unit of User Perspectives, University of Southern Denmark , Odense, Denmark.,Department of Strategy and Innovation, Copenhagen Business School , Copenhagen, Denmark
| | - Oresta Piniazhko
- Health Technology Assessment Department, State Expert Centre of Ministry of Health of Ukraine , Kyiv, Ukraine
| | | | - Tomáš Tesař
- Department of Organisation and Management in Pharmacy, Faculty of Pharmacy, Comenius University , Bratislava, Slovakia
| | | | - Iga Lipska
- Departament of Health Care Services, National Health Fund HQ , Warsaw, Poland
| | - Zoltán Kaló
- Syreon Research Institute , Budapest, Hungary.,Centre for Health Technology Assessment, Semmelweis University , Budapest, Hungary
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