The Evolution of HTA in Emerging Markets Health-Care ... - TREE

OHE Consulting Report for PhRMA
5 January 2011
2 Introduction and Context
2.1 Purpose of this report
This project was commissioned by PhRMA to inform the development of policy positions with
respect to the role (if any) for Health Technology Assessment (HTA) in emerging markets. PhRMA’s
policy stance is not to promote the use of HTA where it doesn't exist but to be prepared with an
appropriate response to engage and shape HTA when it is put forward by a payer.
The purpose of the study is to help inform such an approach. This project was commissioned to
inform the development of policy positions with respect to the role (if any) for Health Technology
Assessment (HTA) in emerging markets, with a particular focus on Brazil, China and Taiwan.
The term ‘emerging markets’ is generally applied to the set of countries that are experiencing rapid
economic growth and/or a shift toward industrialisation. The definition of emerging markets is
somewhat loose: it is used somewhat broadly to refer countries which are considered to be in a
transitional phase between developing and developed status. The lack of a precise definition is
reflected in the variation between the various classification systems that exist. For example, MSCI
Barra list 21 economies as being emerging markets; and Dow Jones 35. FTSE distinguish between
‘Advanced’ and ‘Secondary’ emerging markets, on the basis of both their national income and the
state of development of the economic infrastructure.
Emerging markets, however defined, are of particular interest to the pharmaceutical industry. Most
obviously, the increases in incomes in these countries mean they are becoming an important source
of potential demand for pharmaceutical products. Economic growth in these countries is
accompanied by changes in the way the economy is organised, and this typically extends to changes
in arrangements about the way health care is financed, provided and regulated. Understanding the
way in which these changes are likely to unfold, and the implications for market access and pricing of
pharmaceuticals, is of key interest to industry.
2.2 Structure of this Report
This report is structured as follows:
Section 2 recaps the Terms of Reference for the project
Section 3 sets out the approach we are taking
Section 4 seeks to categorise the development of health care systems
Section 5 looks at the evolution of HTA
Section 6 links together HTA and health care systems
Section 7 describes the main results from our review of the health care systems and use of
HTA in Brazil, China and Taiwan
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